Editor’s Note: We at Healthcare Informatics were once again ecstatic with the exceptional quality of the submissions we received from innovating patient care organizations across the U.S. In addition to the four winning teams this year (whose stories will be posted throughout this week), our editorial team also selected several runners-up. Below, please find descriptions of the initiatives of the 14 teams whom we have awarded semifinalist status in this year’s program.
Centre for Addiction and Mental Health (Ontario, Canada)
Improving patient care through achievement of HIMSS EMRAM Stage 7
In May 2014, CAMH implemented a clinical information system using a big-bang approach with an integrated team of clinicians, information technology, and other staff. But after implementation, CAMH noted a lack of clinical practice standardization. A new initiative emerged that included work to refine the inputting of clinical documentation to the EHR, the development of electronic whiteboards to display and manage assessment and risk factors, leveraging data to inform improvement initiatives, and many other requirements as defined by the HIMSS EMRAM (EMR Adoption Model) Stage 7 criteria.
CAMH is the first academic teaching hospital to achieve HIMSS Stage 7 in Canada; this achievement is a milestone in both the Canadian and international health landscape. Now, more than 99 percent of CAMH clinically-relevant documentation is completed directly within the EHR and CPOE (computerized provider order entry) rates have been over 90 percent since December 2016. What’s more, the creation of a suicide risk dashboard has led to 90 percent of patients having a suicide risk assessment completed within 24 hours of admission.
Cleveland Clinic (Cleveland, Ohio)
An enterprise imaging service
The goal of the enterprise imaging service is to provide a comprehensive longitudinal medical record through incorporation of all medical images into a single archive. Through a universal viewer, the archive is integrated with the EHR and provides a foundation for image distribution to all caregivers throughout the enterprise. The archive also serves as a foundation for image sharing. Implementation required a comprehensive assessment of all image generating equipment throughout all hospitals and outpatient centers.
The Clinic’s officials say that the establishment of an enterprise imaging program has led to the consolidation of imaging archives throughout the health system. Images which were not previously easily accessible are now readily viewable through the EHR (electronic health record) with access points both within the firewall and from home. To date, 11 different service lines and more than 440 pieces of image generating equipment outside of radiology have been integrated.
Compass Medical (Massachusetts)
Annual wellness, chronic care management and quality outcomes
By leveraging new information technology, Compass Medical has been able to follow proven population health management and care management principles, allowing patient care leaders to identify and target specific population groups, stratify and prioritize care gaps and engage and individualize care plan activities. In 2016, for example, Compass Medical was able to identify and target more than 14,000 Medicare patients that were struggling to manage their chronic health conditions and needed a more personalized and comprehensive care plan. One year later, Compass Medical developed and launched a new Chronic Care Management Program to help engage with and closely manage Medicare patients that suffer from two or more chronic health conditions. With the help of its EHR and big data platform, Compass Medical positioned itself to automate many of the workflows for care management nurses.
The Annual Wellness Visit (AWV) is another example of a preventive care service that has been positively affected by leveraging IT. In 2017, national trends suggested utilization of AWV were still hovering around the low 20-percent range with the highest performing state reaching 35 percent. Utilizing EHR-based patient engagement campaigns for increasing focused outreach, incorporating a team based care model with scribes, and creating standard work processes for reducing provider burden have helped Compass Medical reach 57 percent AWV utilization for its Medicare eligible population by the end of year 2017.
Duke University School of Medicine (Durham, N.C.)
A NICU discrete event simulation model
Duke’s neonatal clinicians care for more than 800 babies each year in the Duke Neonatal Intensive Care Unit (NICU). Although the majority do well, about 40 babies do not survive. How could they improve outcomes and save lives? Duke’s neonatal research team partnered with analytics company SAS to create an analytics-based model of Duke Children’s Hospital’s Level IV neonatal intensive care unit. The result was the creation of a discrete event simulation model that closely resembled the clinical outcomes of Duke’s training unit, which was validated using data held back from the original model, which also closely tracked actual unit outcomes.
The model uses a vast resource of clinical data to simulate the experience of patients, their conditions and staff responses in a computerized environment. It creates virtual babies experiencing care within a simulated NICU environment, including virtual beds staffed by virtual nurses. The research team attests that they cannot find any evidence of discrete event simulation modeling being used in a NICU setting, making this a first in neonatal care.
Houston Methodist (Houston, Texas)
A coordinated care/Medicare Shared Savings Program (MSSP) initiative
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