Methodist LeBonheur Healthcare (MLH) is a six-hospital health system serving the Mid-South region. We do $1.92 billion in revenue, and see 405,000 ED visits, nearly 64,000 hospital admissions, and 1.4 million ambulatory visits per year.
Our promise is to improve every life we touch through excellence in clinical quality, patient safety, and compassionate care.
Like many other health care delivery organizations, MLH invested early in health IT and enhanced those capabilities in part through funding from HITECH. Those EHRs now contain quantitative data (eg, laboratory values), qualitative data (eg, text-based documents and demographics), and transactional data (eg, a record of medication delivery). The big benefit with the EMR is the aggregation of patient data over the long term.
With the foundation in place, this phase of care innovations enabled by technology now allows for a transformation of care by delivering information directly to patients and empowering them to play a more active role in their care. We’re now exchanging data — not just for Meaningful Use, but to improve patient health. We’re connecting with Methodist partners and physicians in the community (including providers who serve both underinsured and self-pay patients) through mobile applications and text messaging programs that provide disease-specific education and reminders.
We also have cutting-edge initiatives underway, including joint projects with Cerner, big data work with the University of Tennessee, and precision medicine and population health programs — all of which are aimed at serving a unique patient population.
And in fact, it was that culture that led to development of a life-saving alert system based on Cerner tools. With 90 percent of doctors using iPhones, iPads or Apple Watches, the IT shop created an algorithm that sits on top of its EHR platform to continuously monitor changes and alert clinicians accordingly.
This algorithm has already saved thousands of lives by shrinking the time it takes to notify a physician when a patient is diagnosed with severe sepsis from six hours to fewer than five minutes. It also alerts physicians when a patient is at risk of fall or readmission; users can hover over the alert for clinical decision intelligence that explains the steps that can be taken to avoid readmission.
Cerner, in turn, has added that algorithm to its EHR for other hospitals to use. It’s been amazing to see innovation like this take hold. Advancing health outcomes and ensuring healthcare fits seamlessly with an individual’s lifestyle is our key focus.
Here are some key takeaways to enable patient-centered innovations:
- Maintain organizational leadership and develop blue chip-focused support structures. At present, many organizations are trying to manage enormous numbers of requests for IT changes. If these are not actively addressed, value is not likely to be achieved, with the consequence that “sharp-end” providers may become discouraged. The systems that vendors offer tend to be “bare-bones,” and the implicit assumption being made is that organizations will use the system tools offered to make care improvements. But achieving this requires organizations to continuously develop local human resource and governance structures, and focus on key blue chips and priorities for patients and families.
- Improve the basic care and business process first. Before taking on new initiatives, focus on improving today’s business or clinical problems. Success breeds success. Agreement in relation to goals is important to ensure that optimization efforts of stakeholders are aligned.
- Promote transparency as a cultural norm. If we don’t promote transparency of results, outside regulators or payors will do so, and not very gently. We have the data in our EMRs. Those leaders who promote this will find that the benefits outweigh the risk. The more the data are used, the better it will get.
- Create a top-down vision and stimulate bottom-up innovation. Actively managing the process of change is essential because all organizations have difficulty in navigating major organizational change. Effective organizational transformations require long periods of time and constant effort.
- Set a specific benefits-driven approach. Start with a benefits-driven method. Our approach begins with the identification of a specific aim (eg, 5 percent reduction in hospital readmissions within 12 months), followed by an assessment of current and future states. After these important preliminary steps, relevant data items are identified and specified, which allows monitoring of progress toward this goal.
We’re seeing innovation take hold. Advancing health outcomes and ensuring that health care fits seamlessly with an individual’s lifestyle is our key focus.
This piece was written by Cynthia Davis, Chief Health Information Officer at Methodist Le Bonheur Healthcare, a six-hospital system based in Memphis, Tennessee.
sbalentine says
With ever diminishing reimbursements and greater demands, this is a very timely topic for discussion.
Cynthia Davis says
Thank you Scott – out of greater challenges come greater ideas and opportunities. We must keep our focus on making sure the sacred trust of excellent patient care is not impacted yet improved.