AHRQ ePSS Helps Clinicians Track Preventive Services in EHR Systems

NextGen Healthcare, a vendor of electronic health record (EHR) systems, participated in AHRQ's electronic Preventive Services Selector (ePSS) project to share how providers can track preventive services in EHR systems. NextGen Healthcare includes the U.S. Preventive Services Task Force (USPSTF) recommendations as part of its EHR products.

In 2006, NextGen Healthcare developed an integrated knowledge database for its EHR products. As part of this database, the company included the USPSTF recommendations as health maintenance and disease management alerts. According to Jan Lee, MD, Vice President of Knowledgebase and Content at NextGen Healthcare, "From a provider's perspective, both of these alerts are essential protocols."

NextGen Healthcare's EHR products allow practices to set up standing orders using a protocol that displays the USPSTF's A and B recommendations for routine health maintenance according to age and sex. Lee says, "Having the USPSTF recommendations as part of the health maintenance alert allows staff to improve efficiency and provides the physician more time to focus on the patient."

By looking ahead and including the USPSTF recommendations, NextGen Healthcare addressed providers' quality improvement needs in an increasingly competitive environment. Lee thinks other vendors developing products should "think ahead to where the puck is going to be, not just where it is today. If you build today's solution to today's requirements, you are behind by the time you finish the development cycle."

Because it is often resource-intensive for providers to update health maintenance recommendations on their own, NextGen Healthcare's most recent product release has the ability to push updates to the USPSTF recommendations into a provider's local EHR system. However, according to Lee, "It is still a challenge to keep the code and patient data up to date with minimal intervention on the part of the end user."

NextGen Manager of Interoperability and Standards, Robert Barker, believes that industry-wide standards on health maintenance guideline nomenclature would be helpful. Lee and her team believe such standards will make it easier to code, capture, and report quality measures such as the USPSTF recommendations.

The ePSS is designed to provide real-time decision support for clinicians regarding appropriate screening, counseling, and preventive services for their patients. It is based on the recommendations of the USPSTF and can be searched by specific patient characteristics, such as age, sex, and selected behavioral risk factors.

To implement ePSS, AHRQ has worked with more than a dozen primary care provider groups across the United States in the following ways:

• Assisting providers in implementing the ePSS widget into their EHRs.
• Assisting providers in implementing ePSS recommendations into their EHRs' clinical decision-support systems.
• Working with EHR vendors to ensure appropriate support during the technical implementation process.
• Providing support in using the USPSTF recommendations.

The ePSS, which is updated as new recommendations are released, can be downloaded to a PDA, accessed on the Web, or installed on any Web site as a widget. More information on both the PDA and Web versions is available at http://epss.ahrq.gov/PDA/index.jsp.