|
||||||
|
|
|
|
|||||||||||
|
|||||||||||||
| ||||||||||||||||||||||||||||||||||||
A new, free online tool from the federal Agency for Healthcare Research and Quality (AHRQ) promises to help caregivers deliver patient-specific preventive services at the point of care, but some are questioning whether doctors will actually use it.
The Electronic Preventive Services Selector (ePSS) lets clinicians search among 110 recommendations in 59 categories of preventive services, based on patient age, sex, and risk for various conditions. For example, "Men age 20–35 will be recommended screenings for lipids if they have other risk factors for cardiovascular disease," says Mary Barton, MD, scientific director of the U.S. Preventive Services Task Force.
The task force, a governmentsupported, independent panel of preventive health and primary care professionals, is providing the evidence-based clinical measures for the ePSS system.
The searchable ePSS database can be downloaded onto Windows- or Palm-based personal digital assistants or accessed online from any personal computer with an Internet connection. "The Web-based tool is identical to the PDA program," Barton says. PC users, however, have the added ability to print personalized health reports.
|
At the October introduction of ePSS, Health and Human Services Secretary Michael O. Leavitt said that the utility would "help us create a culture of wellness."
But as long as volume-based reimbursement predominates in health care, at least one tech-savvy primary care physician is skeptical.
"The tool is apparently wonderful, accurate, and comprehensive," says Allen R. Wenner, MD, a family practitioner in Lexington, S.C. "The problem is, it answers the wrong need."
Wenner, who also is vice president for clinical applications design at Primetime Medical Software, the Columbia, S.C.,–based creator of an automated patient-information collector, says ePSS ignores the reality of office workflow. "You have to make a tool that will function in a noninvasive way for the provider," he contends.
According to Wenner, a physician would have to see the patient and review vitals, complaints, and diagnoses before consulting the database. At that point, calling a nurse in to deliver previously unscheduled preventive services is impractical. "The nurse is already working on the next patient," Wenner says.
"Unless you give the data to the provider before they use it, it's worthless," he adds.
The other problem is that fee-for-service health plans will not reimburse for a preventive examination on top of a sick visit. "Nobody pays for prevention," Wenner says. "That's why prevention is so poor."
He suggests that this system might work in a capitated health care environment, where providers are reimbursed on a per member basis.
Barton says that AHRQ thoroughly tested the system before its October launch. "We had primary care clinicians in various types of settings participate in Web-enabled user protocols," Barton says. This allowed AHRQ personnel to watch the testing remotely and respond to participants' concerns.
According to Barton, there were "hundreds of downloads" during the first 3 weeks ePSS was available, but AHRQ has no way of tracking how and if physicians actually use the system in practice.
"Early adopters might be residency programs," Barton says.
Footnotes
The Agency for Healthcare Research and Quality tool is available online at http://epss.ahrq.gov.
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
| ||||||||||||||||||||||||||||||||||||
|
||||||
|
| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
