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Developing an Informatics Tool To Advance Supportive Care: The Veterans Health Care Administration Palliative Care National Clinical Template

ScholarsArchive at Oregon State University

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Title Developing an Informatics Tool To Advance Supportive Care: The Veterans Health Care Administration Palliative Care National Clinical Template
Names Goebel, Joy R. (creator)
Ahluwalia, Sangeeta C. (creator)
Chong, Kelly (creator)
Shreve, Scott T. (creator)
Goldzweig, Caroline L. (creator)
Austin, Colletta (creator)
Asch, Steven M. (creator)
Lorenz, Karl A. (creator)
Date Issued 2014-03-11 (iso8601)
Note This is the publisher’s final pdf. The published article is copyrighted by Mary Ann Liebert, Inc. and can be found at: http://www.liebertpub.com/jpm.
Abstract BACKGROUND: Increasing emphasis in performance-based payment, public reporting, and quality improvement
(QI) has led to widespread interest in measuring and improving the quality of care. By 2014, hospice programs
will be required to report quality data to the federal government or incur financial penalties. With this increased
interest in quality reporting comes an opportunity to develop informatics tools to capture data that reflect the
complex practices involved in palliative care (PC). Therefore, there is a need to disseminate information on
developing tools that facilitate capturing data and fostering improved performance. The Veterans Health Care
Administration, a national leader in health information technology (HIT) and PC, established the Quality Improvement
Resource Center (QuIRC) to develop innovative HIT tools to standardize and improve PC practices
throughout the 153 Department of Veterans Affairs (VA) medical centers nationwide.
OBJECTIVE: The aim of the paper is to describe the development of the Palliative Care-National Clinical Template
(PC-NCT) for documenting initial PC consults.
RESULTS: Domains of quality of life provided the foundation for this template. Principles of user-centered informatics
design guided development activities. A national consensus panel of PC experts prioritized quality
indicators as targets for QI. An interdisciplinary team of PC providers identified desired aspects of template
functionality. QuIRC balanced PC providers' desired aspects of functionality against the feasibility within the
VA HIT system. Formal pilot and usability testing contributed to numerous iterations of the PC-NCT currently
piloted in five geographically distributed sites.
CONCLUSION: This paper presents a robust approach to developing an informatics tool for PC practice. Data
collected via the PC-NCT will bring variations in current practice into view and assist in directing resources at
"important targets" for QI. Although the development of HIT tools to quantify PC practice is complex, there is
enormous potential to improve the quality of care for patients and families facing serious illnesses.
Genre Article
Identifier Goebel, J. R., Ahluwalia, S. C., Chong, K., Shreve, S. T., Goldzweig, C. L., Austin, C., ... & Lorenz, K. A. (2014). Developing an Informatics Tool To Advance Supportive Care: The Veterans Health Care Administration Palliative Care National Clinical Template. Journal of Palliative Medicine, 17(3), 266-273. doi:10.1089/jpm.2013.0288

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