In the world of health and health care, information technology enables substantial improvement in patient outcomes and return on investment.
At the HIMSS Innovation Center, located in the Global Center for Health Innovation, more than 20 organizations are on display, recognized as collaborators in the quest for better health and health care through best use of IT.
One of those organizations, MetroHealth System in Cleveland, is experiencing a transformation through the use of a fully deployed enterprise electronic health record system and a culture focused on innovation.
Here, Dr. David Kaelber, MetroHealth’s chief medical informatics officer and a 2015 HIMSS Davies Ambulatory Award recipient, shares his insights on the value of IT in improving health care delivery.
HIMSS: How do electronic health record (EHR) technologies benefit the community and public health?
Kaelber: The MetroHealth System takes care of a very large number of patients throughout Cuyahoga County.
EHR technologies enable higher-value (higher quality, more cost-effective) care so that MetroHealth makes Northeast Ohio a healthier place to live and a better place to do business.
For example, our aggressive implementation of health information exchange has benefited the community by saving millions of dollars, avoiding duplicate tests (labs and imaging) and admissions throughout Northeast Ohio.
From a public health perspective, our implementation of automated vaccine adverse events (reporting) has led to a 30-fold increase in vaccine adverse events (reporting) to the Centers for Disease Control and Prevention.
HIMSS: How does innovation occur at MetroHealth?
Kaelber: Innovation typically happens when someone in our health care system recognizes an opportunity or problem to solve. Sometimes, we partner with people and organizations outside of the MetroHealth System when approached with innovative ideas.
HIMSS: Does the EHR system play a role?
Kaelber: The EHR (system) plays a critical role in this. Typically, if the innovation involves patient care, then the EHR will be a key component in the innovation. Sometimes, new functionality in the EHR drives innovation.
HIMSS: Please describe the major benefit of the EHR to employees at MetroHealth System.
Kaelber: The major benefits to employees in the MetroHealth System is improved ability to take care of patients and provide operational efficiencies to employees because of our enterprise EHR and the innovative culture that it helps enable.
All care details of a patient, over many years, throughout our integrated delivery network are available through a few clicks from anywhere in the world with internet access. Various types of clinical decision support allow providers to provide higher quality, more efficient care that providers want.
Our electronic health record is a selling point not only for direct patient care staff recruitment and retention, but also, for information services and other staff that do not provide direct patient care. Reporting and population health activities are much easier when all of the data exists in one system.
HIMSS: Describe the major benefit of the EHR to your patients.
Kaelber: The major benefits to patients in the MetroHealth System also relates to the improved ability to take care of patients and provide operational efficiencies to patients. Patients receive improved quality of care, and they are more engaged in their care.
For example, our personal health record shows patients their results and immunizations. Both providers and patients receive all preventive care reminders. One of my favorite reasons for a patient visit is “a reminder in my personal health record told me I needed to be seen.”
HIMSS: Briefly discuss some of the important MetroHealth initiatives supported by the EHR system.
Kaelber: Diabetes: Diabetes care is a condition we have been working to improve for a decade and represents an example of technology, people and processes working together to improve care of a chronic condition. We have made slow, but steady progress, having improved care by 20% to 30% over the decade, saving millions of dollars and improving the quality of care for diabetic patients.
Ebola Treatment Center: As an essential/public health care system, we are driven to think about the health of our community, not just our patients. When the opportunity arose to create an Ebola Treatment Center in Ohio, we had the technology, people and processes to step up and did.
HIV/HCV Screenings: HIV and HCV are significant diseases in our society in which clear screening guidelines exist but are not always followed. By implementing alerts to providers and patients, we significantly increased our guideline-based screening that resulted in hundreds more HIV/HCV infections being detected early, potentially avoiding spread of the disease to others and saving additional health care expense.
Drug-resistant infections: Drug-resistant infections are significantly increasing across the United States. Technology, people and process can work together, in this situation, both to decrease initial drug-resistant infections and also to decrease the spread of a drug-resistant infection to other patients. Our efforts have resulted in fewer infections, decreased mortality and millions of dollars in cost savings.