Optimize. It’s not a super sexy word. It sounds more like a command Tony Stark would bark at his computerized helper Jarvis to get the Mark 45 Iron Man suit ready for battle. With apologies to the genius/billionaire/playboy/philanthropist, optimization is actually the mantra for today’s real-life health information virtuoso.
After more than a decade of building the foundational elements of a digitized health care environment, and billions of dollars in federal and private sector spending, hospitals and health systems are tapping into the power of the bits and bytes they’ve been collecting. This coincides not only with the requirement to meet federal standards for meaningful use of health information technology, but also the push toward value-based payments, population health management and cost-efficiency.
As evidenced by data collected over the 17-year history of Health Care’s Most Wired Survey, hospitals and health systems have continually ratcheted up their use of cornerstone IT applications. For instance, 95 percent of the 2015 Most Wired hospitals have standing, evidence-based electronic order sets built into their CPOE systems. That’s up from 79 percent in 2010. Since 2008, the percentage of Most Wired organizations that have a compliance-driven alert system for Centers for Medicare & Medicaid Services key indicators leapt from 50 percent to 79 percent in 2015.
While work still needs to be done to bring implementation of these types of applications to 100 percent — and sustain their use over time — leaders at Most Wired hospitals are not merely resting on their laurels waiting to install the next gadget; they are using data to drive clinical improvement and shape strategy.
“Through implementation of our Epic system, we’ve been able to elevate the use of real-time information at the bedside,” says Paula Smith, senior vice president and chief information officer, Oakwood Healthcare, Dearborn, Mich. “We consolidated multiple, disparate systems into a single database that has provided more streamlined documentation of care delivery at every transition-of-care event.”
Records from emergency department visits, for instance, are instantly available to caregivers at the receiving inpatient unit. This, Smith says, accelerates quality care because the clinicians are prepared in advance of the patient’s arrival.
Organizations on the 2015 Most Wired list are extending the use of IT systems outside the hospital’s four walls, including connecting directly with patients. In fact, improvement in patient engagement — in its many forms — stands out in this year’s survey. More than two-thirds of the Most Wired extend the care environment to the patient and family via the Internet, providing education about his or her condition and allowing for e-visits with the care team, among other things. This dovetails nicely with efforts to improve population health.
At MetroHealth System, an automated screening and alert system led to a 15-fold increase in screening and 23 percent increase in diagnosis for depression between 2011 and 2014. There was a 25 percent increase in adolescent immunizations during the same period, largely a result of automated messaging to parents. And, importantly, between 2011 and 2012, a 15 percent increase in patients scheduling and completing referrals 30 days after discharge, reports David Kaelber, M.D., chief medical informatics officer for the Cleveland-based health system. All of these efforts are ongoing.