How does the chapter illustrate the potential of EHR technology and a nationwide HIT infrastructure to address healthcare quality issues, using healthcare-associated infections as an example?

The chapter uses healthcare-associated infections to show how a nationwide HIT infrastructure could apply existing tracking methods to all surgical patients, not just Medicare patients. If EHRs captured whether each surgical patient received a prophylactic antibiotic within the recommended hour before surgery and linked that to postsurgical wound infection rates, providers could build evidence-based care plans and deliver consistent quality across every facility. Reducing the estimated 1.7 million annual cases would also save billions of dollars.

The chapter argues that quality problems persist partly because performance data are not collected systematically across all settings. Using healthcare-associated infections, it notes that wound infections are a known postsurgical risk and that giving an appropriate antibiotic within an hour before surgery reduces that risk. Currently, CMS can track this prophylactic treatment and resulting infection rates only for Medicare patients. The chapter imagines the same tracking applied to all surgical patients through EHRs and a nationwide HIT infrastructure. That would allow care teams to see patterns across patient panels, identify gaps in preventive treatment, develop evidence-based care plans, and ensure that every patient within the infrastructure receives the same standard of care. The chapter concludes that this type of systematic use of EHR data would lead to better outcomes and also yield major cost savings, citing the estimated 1.7 million healthcare-associated infections contracted in U.S. hospitals each year.