Domain

Learning Health System

Type

Case Study or Comparative Case Study

Theme

population; quality

Start Date

7-6-2014 10:25 AM

End Date

7-6-2014 11:45 AM

Structured Abstract

1) Introduction

Health care organizations are experiencing economic and social pressures to produce improvements in care delivery, positively impact patient outcomes and reduce costs. Electronic health data is a tool to support the creation of positive patient outcomes and cost reductions. A learning health system harnessed the combined power of electronic health data and quality improvement education to change the care delivery system. The results show collaborative, inter-professional teams leading improvements by managing populations of patients using electronic health data. The case study from this health system describes the processes used to integrate quality, clinical care, operations, information services and finance functions to transform the care delivery system.

2) Background

Prior to the full installation of the electronic medical record it became clear that the entire organization required a robust data strategy. The data strategy expanded into a Board of Trustees quality strategy led by the Quality & Safety department in partnership with the department of Information Technology. to create clinical, data and governance systems. The lessons learned from this health system will benefit others who are seeking ways to improve care by creating clinical, data and governance systems and by utilizing electronic health data.

3) Findings

Teams with knowledge of quality improvement principles, easy access to meaningful data and a supportive governance structure demonstrated improvements and reduction of costs. For example, the Asthma Care Process team achieved a 15% decrease in the percentage of chest X-rays ordered within one and a half months. The Appendectomy Care Process Team showed improvements in the standardization of the best antibiotic (based on the evidence) by 65% in less than six months. Additional Care Process Teams such as Diabetes, Pneumonia, Pregnancy and Spine Surgery have formed and more will be added. The efficiencies improved within the Information Technology department by decreasing the amount of time it took to create a data warehouse and to generate data. The one year cost savings for this department are over $550,000 and will continue to grow exponentially as more data is requested.

4) Lessons Learned

The incorporation of the data strategy into the Board of Trustee’s quality strategy expanded the purpose of electronic health data. The purpose was to improve care delivery. The results of the initiative show the importance of using data to identify opportunities for improvement and then rapidly applying quality improvement methods to achieve positive patient outcomes. As a learning health system, many iterative cycles were used to achieve the results.

5) Conclusion

The federally funded economic incentives that exist for the installation of an electronic medical record and for reporting of performance measurements are changing care delivery systems within an organization. The case study shows an example of a foundation that has been laid for integrated systems of care delivery. In the future, the organization will add additional layers to the foundation including operations, research and health plans. The national health policies do not provide a “How To” guide, the learning comes from organizations sharing results of policy implementation, this case study is one example.

Acknowledgements

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Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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Jun 7th, 10:25 AM Jun 7th, 11:45 AM

Harnessing the Power of a Learning Health System to Change Systems of Care Delivery

1) Introduction

Health care organizations are experiencing economic and social pressures to produce improvements in care delivery, positively impact patient outcomes and reduce costs. Electronic health data is a tool to support the creation of positive patient outcomes and cost reductions. A learning health system harnessed the combined power of electronic health data and quality improvement education to change the care delivery system. The results show collaborative, inter-professional teams leading improvements by managing populations of patients using electronic health data. The case study from this health system describes the processes used to integrate quality, clinical care, operations, information services and finance functions to transform the care delivery system.

2) Background

Prior to the full installation of the electronic medical record it became clear that the entire organization required a robust data strategy. The data strategy expanded into a Board of Trustees quality strategy led by the Quality & Safety department in partnership with the department of Information Technology. to create clinical, data and governance systems. The lessons learned from this health system will benefit others who are seeking ways to improve care by creating clinical, data and governance systems and by utilizing electronic health data.

3) Findings

Teams with knowledge of quality improvement principles, easy access to meaningful data and a supportive governance structure demonstrated improvements and reduction of costs. For example, the Asthma Care Process team achieved a 15% decrease in the percentage of chest X-rays ordered within one and a half months. The Appendectomy Care Process Team showed improvements in the standardization of the best antibiotic (based on the evidence) by 65% in less than six months. Additional Care Process Teams such as Diabetes, Pneumonia, Pregnancy and Spine Surgery have formed and more will be added. The efficiencies improved within the Information Technology department by decreasing the amount of time it took to create a data warehouse and to generate data. The one year cost savings for this department are over $550,000 and will continue to grow exponentially as more data is requested.

4) Lessons Learned

The incorporation of the data strategy into the Board of Trustee’s quality strategy expanded the purpose of electronic health data. The purpose was to improve care delivery. The results of the initiative show the importance of using data to identify opportunities for improvement and then rapidly applying quality improvement methods to achieve positive patient outcomes. As a learning health system, many iterative cycles were used to achieve the results.

5) Conclusion

The federally funded economic incentives that exist for the installation of an electronic medical record and for reporting of performance measurements are changing care delivery systems within an organization. The case study shows an example of a foundation that has been laid for integrated systems of care delivery. In the future, the organization will add additional layers to the foundation including operations, research and health plans. The national health policies do not provide a “How To” guide, the learning comes from organizations sharing results of policy implementation, this case study is one example.