Centura uses central database to manage chronic conditions
Centura Health has been building on its electronic health records system for more than a decade, making gains through a series of opportunistic innovations that grew from a single effort, its top executives say.
Developing one records database, to contain all information from across the system, was a key to its success. That’s no small undertaking for the integrated delivery system, which operates 17 hospitals in Colorado and Kansas.
For its efforts, the system received a 2015 HIMSS Enterprise Davies Award for a series of patient initiatives that improved care delivery while reducing costs.
“It really started with our decision to implement our current EHR system back in 2004 and 2005,” says CIO Dana Moore. The system-spanning database helped Centura share best practices across its hospitals.
Centura used Meditech for its EHR system. The implementation, completed in 2007, streamlined and improved care across Centura's 17 hospitals, which range from Porter Adventist Hospital in Denver, which operates 368 beds, to remote 30-bed facilities.
The Meditech system maintains all patient information in a proprietary database. Clinicians and administrators access patient data through Meditech's software, managing health information such as treatment, allergies, medications and more. The database also contains patient accounting information, as well as other patient information.
All information resides in Centura's data center on Cisco UCS and IBM Storage hardware, completly cbacked up to a failover data center.
Centura uses software from Explorys for data analytics to support population health initiatives, and to aggregate data within its Meditech EHR system with data from outside physicians using other record systems, says Amy Feaster, Centura's vice president of IT.
By using a single database and emphasizing data analytics, Centura was able to achieve a variety of clinical improvements over time. For example, it was able to significantly reduce hospitalizations through chronic disease management by stratifying patients into risk groups, finding those who are most at risk, so the organization could give them more attention and outreach to manage their conditions.
Centura achieved the following improvements in care delivery:
- Readmissions for heart failure fell nearly 15 percent, and the overall per-member cost per year fell 7.4 percent.
- Post-operation deep vein thrombosis and pulmonary embolisms were reduced by 58 percent.
- Catheter days have been cut by 38 percent since 2012, with catheter-associated urinary tract infections down 32 percent.
- In the remote Durango, Colo., community, Mercy Family Medicine cut by 27 percent the admission rate for conditions, such as angina, asthma, chronic obstructive pulmonary disease, diabetes, epileptic convulsions, heart failure and pulmonary edema, and hypertension.
- Savings of $325.3 million from 2005 to 2015. With total IT costs of $113.3 million, the organization reported net savings through use of IT of almost $212 million.
Change management has been a key challenge for Centura. Stakeholders on the Meditech implementation and subsequent projects have included the IT team, chief medical informatics officers, chief nursing informatics officers, BI analysts, clinicians, and representatives from business and administrative departments, the pharmacy, and others.
“It's very much a multidisciplinary effort,” Feaster says. “Every team tries to make sure all the right people are there and all the stakeholders are involved.”
Looking into the future, Moore says Centura is in the process of moving from Meditech to Epic's EHR solution. The move, expected to be completed in April 2017, is driven in part by the growth of Epic's market share in Colorado, and by the added functionality the change will bring, in ambulatory care and anesthesia, among others. With Epic in place, Centura will continue to share clinical data with major local and national healthcare systems.