The Role of Health Information Technology
in “Crossing the Quality Chasm” – The
April 25, 2002
The Leapfrog Group’s Mission
Trigger a giant leap forward in quality, customer
service, and affordability of healthcare by:
Making the American public aware of a small
number of compelling and easily understood
advances in patient safety
Specifying a simple set of purchasing principles
designed to promote these safety advances, as well
as overall customer value
More than 100 large health care purchasers
More than 31 million Americans
More than $52 billion in health care expenditures
Why Does The Quality Chasm Exist?
Purchasers — Not Buying Right
Plans — Not Letting Provider Value Show Through
Providers — Not Seeing Business Case for Reengineering
Consumers/Patients — Not In the Quality Game
New thinking needed to “leapfrog”
gridlock in the health care marketplace
Why Is Health Information
Technology Lagging Behind Other
See previous slide.
IOM’s Six Goals – We’ve Got the
Map, Now All We Need is a Road.
Safe – Who else is prescribing meds for my patient?
Effective – Try keeping track of 2,000 patients and 7,000
protocols in your head.
Patient Centered – Online same day appointments in our
Timely – When was she supposed to come in for her
Efficient – I wonder if anyone has taken an x-ray - oh well,
I’ll just call radiology and order one…
Equitable – Who’s got access, who gets treatment – the
mother of all chart reviews.
Information Technology – The
Foundation for 21st Century
Measuring and reporting:
– Patient experience
Timely, efficient and accurate transactions
Communicating among key stakeholders
Clinical decision support
Leapfrog Purchaser Strategy
Organized effort to buy right
– Purchasing principles that strongly reward
higher provider value
– Purchaser accountability
– Push via plans or directly
Create a Business Case for Providers
Emphasize tangible safety leaps
Mobilize Consumers and Patients
Initial Safety ‘Leap’ Summary
An Rx for Rx
– Computer Physician Order Entry (CPOE)
– Up to 8 in 10 serious drug errors prevented
Sick People Need Special Care
– ICU Daytime Staffing with CCM Trained M.D.
or risk-adjusted outcomes comparison
– > 10% mortality reduction
Practice Makes Perfect
– Evidence-based Hospital Referral (EHR) or
risk-adjusted outcomes comparison
– > 20% mortality reduction for 7 complex
What are the Three Leaps Worth?
Annual Gain Projected by Dartmouth:
522,000 serious med errors
58,300 X disabilities
$9.6 billion per year
(if fully implemented in U.S. urban hospitals)
Leapfrog Purchasing Principles -
Building the Business Case for
Health Information Technology
Educate and inform enrollees
Compare at the provider level
Reward superior provider value
Initially highlight 3 tangible safety Leaps
Annually increase provider rewards
Measuring and Reporting CPOE
Six Roll-Out Regions reporting : Atlanta, California,
East Tennessee, Minnesota, St. Louis and Seattle-
497 urban hospitals invited to submit results
More than half, 256 hospitals (52%) submitted
53 percent meet at least one of Leapfrog’s standards
for the safety practices
Seattle-Tacoma-Everett – 100% participation from 25
52 percent meet at least one of Leapfrog’s standards
CPOE Results – 6 Regions
Computer Physician Order Entry (CPOE)
Up to 8 in 10 serious drug errors prevented
2.3% of the responding hospitals have fully
An additional 32% say they have specific plans to
implement such systems by 2004
We Have Met the Enemy, and It is
Purchasers have to stop focusing solely on discounts.
New emphasis on consumerism creates great
NQF work has the potential to be a real driver.
CMS and seniors – The Nuclear Purchasers
If we demand value, there will be no choice.
It’s not the money, it’s the money.
That’s one small step for all of us,
one giant leap for patient safety.