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Resource-Challenged Community Hospitals Can Move From Reporting to Actionable Intelligence

August 9, 2013
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Seeing best-practice alerts while the patient is still in the hospital

Analytics is the hot topic du jour in healthcare, but most of the people we interview work in large health systems or academic medical centers with a lot of resources to apply to the problem. But what about community hospitals with small IT departments and few or no clinical informaticists on staff?

I recently spoke with Anita Karcz, M.D., chief medical officer of IHM Services, a spin-off of the Institute for Health Metrics in Burlington, Mass. For the last eight years her organization has been consulting with community hospitals as they work on reporting and analytics with the data that is in their clinical information systems. That includes providing them with reports that are clinically relevant, including for meaningful use reporting.

“Community hospitals is where a lot of care is delivered, but they are often resource-challenged to do this type of analytics,” Karcz said.

More important than making reporting easier, Karcz and her team specialize in helping hospitals that use Meditech systems to use the data in real time to improve performance.

Hospitals can now use electronic surveillance to access critical data via EHRs and know whether or not best-practice care procedures are being delivered while patients are still in the hospital.

“That is a step up from retrospective monthly reports that they typically got previously,” said Karcz, who spent several years as a practicing emergency physician.“This takes it to the next level: They can see on an immediate basis, while the patient is still in the hospital, appropriate best practices as measured by CMS.”

IHM Services gives its clients information on patients twice a day. For instance, the infection surveillance solution canidentify new abnormal clinical parameters such as fever and elevated white blood count. Its solutions can flag those patients at high risk of falls or pressure ulcers. It can track urinary catheters usage to help clinicians keep infection rates down.

“We initially have to do a lot of data mapping and testing to make sure it is accurately pulling what clients want,” Karcz says. The tools allow physicians to drill down into additional patient detail, such as medication doses and timing, and into text notes. With that information, they can identify patients who are of most concern based on the clinical data. They can create a work list of those patients for intervention and can track specific populations throughout the hospital.

Hospitals benefit the most when they can use their EHR data as part of a performance improvement program, she said. Unfortunately, some are just focused on the numbers for the numbers themselves; others have a culture that is focused on improvement,” she says. “I am heartened that we have seen a shift in outlook, and the ones just looking to comply or report to earn incentives are the exceptions rather than the rule.”

Of course, financially strapped hospitals may find paying for outside consulting help on analytics out of reach as well. But at least some services like this are available, and each community hospital doesn’t have to reinvent the wheel.