Late last month, Yale New Haven Health System (YNHHS) hosted its first annual National Symposium on Value Innovation at Yale and health system leaders shared their lessons learned as part of ongoing effort toward improving quality and lowering cost across the system.
The event was a collaboration with YNHHS, the Yale School of Management, the Center for Outcomes Research & Evaluation (CORE), the Yale Center for Biomedical and Interventional Technology (CBIT) and health IT vendors Strata Decision Technology and PeraHealth.
During that event, Lisa Stump, interim CIO at YNHHS, specifically addressed how the health system is using data and health IT to drive value to patients.
“We want to deliver the right data to the right people at the right time, in the right format, to drive outcomes,” she said. “We are thoughtful about the way we deploy technology and avoid implementing new technology and dashboards simply for tech itself.”
The health system has deployed a number of health IT initiatives such as complementing its electronic health record (EHR) system with advanced decision support tools, the development of a tele-ICU program at Yale New Haven Hospital, which has led to improved clinical outcomes, and using technology tools to increase patient awareness of research trials, which has increased enrollment in clinical trials, Stump said.
YNHHS is a 2,130-bed health system that operates three hospitals in Connecticut, including Yale New Haven Hospital, a 1,541-bed tertiary medical center. In early 2012, YNHHS implemented a number of key multiyear strategic initiatives aimed at improving overall value.
Stump leads the health system’s technology strategy as interim CIO, and previously associate CIO for two years. She joined YNHHS in 2008, first serving as administrative director of clinical informatics and then leading the health system’s multi-year implementation of Epic’s clinical and revenue cycle application across YNHHS hospitals and ambulatory practices, North East Medical Group physicians’ offices and Yale School of Medicine faculty practices. Stump’s educational background is in pharmacy administration and she led pharmacy services at Yale New Haven Hospital before moving over to health IT at YNHHS.
Stump spoke with Healthcare Informatics Assistant Editor Heather Landi and drilled down into the health system’s health IT strategy as it continues its journey to value-based care.
How is Yale New Haven Health System using data and technology to drive value?
We have focused a lot of our strategy on building a core platform, so a single electronic medical record (EMR), which is the main system of record for the clinical data, and then we are supporting that with an enterprise clinical data warehouse, and for that we are using Epic’s Cogito platform. And then we’ve complimented that with a Hadoop environment [data processing platform for big data analytics] to allow us to manage the big data and prepare ourselves for the genomics wave. We have a lot of data and now it’s about turning data into meaningful information for people and delivering it in a way that’s meaningful, and that’s probably one of our biggest challenges. We’re working with a variety of platforms to create the dashboards and analytics tools and we’re really looking to be predictive in our analytics. We want to start to use the data to understand the trends that are there and predict future events before they happen, so identify patients who are at risk for declining health in the next 30 days, or to identify patients who are more at risk for orthopedic conditions, so that we can be advocating health interventions and certainly preparing for what might be a more invasive intervention for those patients.
Interoperability also is a big focus of that. And I often say, we’re not trying to compete on the data, we are willing to share the data, and we also encourage others to share data with us. We working with our vendor partners, whether it’s EMR or medical device vendors, to ensure that we are getting the right data exchange and trying to turn that into meaningful information.
When did this effort begin?
The journey began in about 2010-2011, when we recognized as a health system that we needed to be on a single EMR solution. So, all of our network hospitals, our physician groups and the Yale medical group faculty physicians, all agreed that we needed to be on a common platform that would allow us to start to accumulate the same data in the same way in a consistent manner. And about the same time, we started developing the clinical data warehouse. I will tell you, the first few years of that journey we were really focused on getting the EMR platform in. Then it took us a little bit of time to understand all the data that we had. And, so it’s probably been about 18 months that we’ve really centralized on what we call our joint data and analytics team.