Nebraska Medicine is the latest recipient of the Stage 7 Award from HIMSS Analytics that recognizes provider organizations that have reached the highest level of adoption of electronic health records technology. About 233 hospitals now have the designation.
“Nebraska Medicine has effectively developed its governance, clinical and business analytics, and disaster recovery/business continuity strategies in a way that helps to ensure process improvements are sustainable,” said John H. Daniels, global vice president, healthcare advisory services group at HIMSS Analytics. “They are driven not by the information technologies they use; they are driven by how they can best use those technologies to drive improvements in safety, care quality, and cost efficiencies.”
Nebraska Medicine Chief Transformation Officer Michael Ash, MD says, “Achieving HIMSS 7 designation validates that we are using technology to provide safer, more efficient, cost effective and ultimately higher quality care for our patients.”
When adopting the HIMSS Analytics Electronic Medical Record Adoption Model toward a quest to reach Stage 7, an organization from the start has to take an enterprisewide view of the project, Ash says. Nebraska Medicine includes 621-bed Nebraska Medical Center, Nebraska Medicine-Bellevue, a 55-bed community hospital, and more than 40 outpatient clinics.
Ash advises that this is not a project that can be done in isolation by the IT department or finance departments, and pharmacy can’t just barcode some medications; there has to be commitments across the organization.
When Nebraska Medicine finally started work on Stage 7, it soon learned about its biggest challenge in finishing the task—a requirement that all documents be scanned within 24 hours. “This was the part we really had to invest in,” Ash says. That’s because HIMSS Analytics will walk in the health information management department, pull documents—lots of them—off the shelves and took to make sure they are stamped as scanned, and then have personnel go into the HIM system and show them that these documents are scanned. This, Ash says, is an area where organization leaders really need to understand how the HIM department operates and what happens to paper flows.
Another final step also was more difficult than envisioned; the creation of case studies on how the EHR technology is used to improve the quality, safety and efficiency of care. However, being able to show how the project impacted care is the most valuable part of Stage 7, Ash says.
HIMSS Analytics measures hospitals’ EHR development via a 0-8 scale, with 0 meaning a facility has not yet installed three important ancillary systems: laboratory, pharmacy and radiology, and 7 meaning it no longer uses paper charts to deliver and manage care. Other achievements under Stage 7 include having a mix of discrete data, document images and medical images within the EHR environment; using a data warehouse/analytics technology to analyze clinical data to improve care quality, safety and efficiency, standards-based sharing of clinical information and demonstrating summary data continuity for all hospital services, according to HIMSS Analytics.
Validation of a hospital as having reached Stage 7 includes a site visit by a HIMSS Analytics executive as well as former or current chief information officers to evaluate the HIT environments.
So, select leaders of the hospital—responsible for getting buy-in from those working in their departments—who will start the conversations early on why the organization is taking this step, how it will distract from and affect current ways of practicing, and how the organization and patients will benefit from the initiative, and then make sure the message stays consistent, Ash advises. For instance, physicians generally know the EHR is better than paper, but many still like the paper more, so they have to be shown real value that the EHR brings over paper.
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