MU Health Care uses technology ‘on hand’ to improve care

Often, winners of the HIMSS Davies Award trace their success to a new technology acquisition, such as a new electronic record system. For University of Missouri Health Care, it was about exploiting the technology that was already available, and managing change throughout the organization.

As a result of its improvements, University of Missouri Health Care received the Enterprise Davies Award in 2015.

Bryan Bliven, MU Health Care's CIO, says that in 2010, the longtime Cerner client decided to really accelerate adoption of Cerner Millennium Platform's full capabilities, and it worked closely with the vendor in pursuit of a new level of excellence. The university and Cerner co-created the Tiger Institute for Health Innovation. Owned and operated by the University of Missouri, jointly governed with Cerner, the institute enables the two participants to focus on excellence and innovation.

“It changed our dynamic from client and vendor to that of partners having strategic discussions at the highest levels,” Bliven says.

Consisting of five hospitals and more than 50 clinics staffed by more than 550 university physicians, MU Health Care offers primary, secondary, and tertiary services to central Missouri in a 25-county service area with a population of 776,861. On the HIMSS Analytics' EMR Adoption Model, he says, the organization in 2010 was at a level 2 or 4 on the scale, which tops out at 7.

“We achieved HIMSS Level 7 in 2012 on inpatient care, and on outpatient care in 2013,” he says. “There was a lot of change management work around the technology, a focus on adoption and setting this pace for how we're going to move through that as an organization.”

The Millennium EMR platform provides MU Health Care's clinical platform and patient portal platform, with all data residing in the Cerner database, remotely hosted in a Cerner data warehouse in Kansas City, Mo. Analytics are also performed within the Cerner platform, using Cerner data tools. The partnership with the Tiger Institute, he says, helped the organization build out the platform's capabilities.

“It was about implementing what was already available, moving the organization through that process,” he says. “We had to build out modules. We were implementing standards and bringing everyone up to a baseline, then layering on specialty workflows.”

In its Davies Award application, MU Health Care submitted case studies on successful IT-driven outcomes:

• Reduced catheter-associated urinary tract infections by 25 percent by getting patients off catheters sooner. Patient data automatically triggers a nurse-driven protocol for timely removal of catheters.
• Streamlining operating room start procedures. MU saw significant efficiency gains when it began tracking whether the first OR procedure of the day started on time, and what caused delays. The data drove iterative interventions to help get the day's first OR procedure start on time.
• Improved medical device connectivity. Efficiently bringing data captured in various devices and manual processes more quickly and accurately into a patient's record not only improves the information a clinician has on hand, it enables the system to automatically flag early risk factors for infection.

These and other new processes have been driven both top-down from IT and in grassroots fashion from clinicians, Bliven says.

“A unique thing here is that every person is required to participate in at least two quality improvement projects each year,” he says. “We continue through quality improvement projects, satisfaction survey results and strategic planning to improve technology and processes that let us continue to evolve.”