Columbia-based University of Missouri Health Care, like many large health operations, reached a tipping point a few years ago with its EHR, says Bryan Bliven, CIO at the five-hospital, 50-clinic health system.
It did a number of enterprise projects to try to make the electronic record the source of truth and get all clinic staff touching the software on a daily basis. It connected its myriad specialists and facilities via the system.
But it hadn’t truly tipped the scales on automation. Its success in doing so resulted in the health system being named one of four recipients of the 2015 HIMSS Enterprise Nicolas E. Davies Award of Excellence, which recognizes outstanding achievement of organizations that have utilized health information technology to substantially improve patient outcomes while achieving return on investment.
“We had all the data flowing into the EHR, but once we accomplished that, we started looking at the validity of that data, and found that some the manual processes we still used were making data much less useful than it should have been,” Bliven says.
The real pain point was data from patient monitoring devices and other machines that still required nurses and technicians to manually check the data being generated and then type the information into the EHR.
“Nurses often had to wait until the end of their shifts to enter data from vital monitoring devices and other machines, and not only did that cause manual entry errors, it also created some lag times that made that information hard to act on,” Bliven says.
So the health system decided to go all in and deploy a universal connectivity platform that enabled it to install device drivers in bedside monitors, ventilators, anesthesia systems, laboratory equipment and a host of other devices and have that data flow directly into the EHR in real-time.
In all, MU Health Care has connected 29,000 devices, including hand-held mobile devices, to its connectivity platform.
The enormous increase in data velocity and validity has reshaped the health system’s clinical efforts, Bliven says. One significant win has been vastly improved response identifying the early onset of sepsis, a chronic problem for hospitals. MU Health Care has developed a cloud-based surveillance system that analyzes data feeds from various monitoring devices and alerts caregivers when the data indicates a patient is trending into a sepsis danger zone.
“For an organization to truly commit to information technology, it has to earn the trust of its medical staff,” Bliven says. “Medical device integration signaled to our clinicians that we were going all the way with the EHR because it took the variance out of the data they were using to make clinical decisions. Once we earned their trust, it opened all kinds of doors.”
Clinician support has enabled MU Health Care to drive efficiency improvements across the organization. An effort to decrease catheter-associated urinary tract infections via automated physician prompts and nursing tasks embedded in the EHR helped the health system reduce infections by 25 percent from 2013 to 2014. A multi-faceted effort to increase efficiencies in operating rooms helped improve its percentage of on-time OR starts at its flagship University Hospital to 77 percent in 2015, up from 21 percent in 2009.
“Once you decide to truly commit to an EHR, you have to continue down that path and get rid of shadow charting and other manual tasks,” Bliven says. “When we saw the opportunity to create a connectivity platform and vastly improve the quality and speed of data flowing into the EHR, we took it.”
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