LVHN Achieves Health Information Technology (HIT) Awards Grand Slam
In the world of entertainment, winning an EGOT (Emmy, Grammy, Oscar and Tony) is considered a grand slam. In the world of health information technology (HIT), LVHN achieved a similar multifaceted achievement over the past summer by earning HIMSS (Healthcare and Information Management Systems Society) EMR Adoption Model Stage 7 designation (for inpatient and ambulatory care) in May, three Most Wired awards, including Innovator and Advanced in June, and the prestigious HIMSS Davies Award in August.
The latest award, the HIMSS Nicholas E. Davies Award of Excellence, is considered to be the pinnacle of health IT achievement. In August, representatives from HIMSS Davies Committee (HIMSS is an international health IT organization that works to positively transform health and healthcare through the best use of information technology with thought leadership, community building, professional development, public policy, and events) performed an onsite review that included three case studies where LVHN leaders shared how they innovate with the electronic health record (EHR) and other technologies. After deliberation, the HIMSS Davies Committee awarded LVHN the Davies Award of Excellence.
Michael Minear, LVHN Chief Information Officer, says, “The Davies Award is especially meaningful because it assessed the work that literally thousands of LVHN’s clinical, administrative, informatics and technology support colleagues have done to deploy and use the EHR to enhance patient care. Our work in health IT is always about the patients and the communities LVHN serves, and the three case studies presented to the HIMSS Davies Committee showcased how LVHN has improved patient care, safety and satisfaction by leveraging the EHR to support many improvement projects.”
Jonathan French, Senior Director of Health Information Systems Quality and Patient Safety at HIMSS, says, “Lehigh Valley Health Network has demonstrated their dedication to patient engagement through their ‘huddle meetings’ with staff, which have help strengthen internal communications while keeping patient needs top of mind,” stated Jonathan French, CPHIMS, senior director, quality and patient safety, and director, Davies Award of Excellence Program, HIMSS. “Their efforts to reduce sepsis mortality rates and improve ambulatory care processes have also led to their recognition as a 2017 HIMSS Enterprise Davies Award recipient. We are proud to recognize Lehigh Valley Health Network for their commitment to improving patient care through the use of health IT.”
The LVHN team shared three case studies as part of the onsite assessment: the Daily Huddle, Reduction of Sepsis Mortality, and Ambulatory Care Process Improvement.
The daily huddle is a daily highly focused meeting of hospital leaders supported by real-time data in the EHR. Each morning, clinical and administrative leaders representing all functions in each LVHN hospital meet to review the needs of patients, and optimize patient flow and support. The huddle built awareness and teamwork across groups who previously worked in silos and used paper notes. The teams now use real-time dashboards and analytics embedded in the EHR to review current data that impacts patient admissions, surgeries, emergency care, and patient flow toward their discharge. The daily huddle supported a 94-percent improvement in early discharges (prior to 11 a.m.); a 34-percent improvement in patient wait times to move from the emergency department (ED) or post-anesthesia care unit (PACU) to an inpatient bed; decreased length of stay (LOS) by 5-percent for all ED patients (equivalent to adding 34,200 additional bed hours for patient care); and resulted in no diversions from the ED due to lack of bed space. For patients, this has meant shorter wait times, getting care faster, and better clinical outcomes.
Reduction of Sepsis Mortality
Sepsis is an aggressive, all-encompassing response to infection in the body. For too many patients, sepsis is fatal. To help reduce sepsis mortality, LVHN colleagues created a sophisticated improvement process led by a multi-disciplinary team to define and implement best practice for the clinical workflow to manage patients optimally and reduce mortality from sepsis. The team used the EHR to access clinical data, create new real-time alerts, new clinical order sets, and specialized clinical documentation templates to change how these patients were being managed.
All of the process and EHR changes created a system that continually surveilles all ED and inpatients for the early signs of sepsis, and helps clinicians take rapid and more precise actions to change the course of this condition. This project resulted in an initial 40-percent reduction in sepsis mortality over a five-month period. The sepsis program has contributed to LVHN being ranked among the best nationally at achieving low levels in mortality. Additional enhancements continue to be made in the program. The approach and tools used to refocus on sepsis is being used for other clinical conditions and diseases across the continuum of care.
Ambulatory Care Process Improvement
For most patients, the part of our EMR system that is “visible” to them is the patient portal, known as MyLVHN. Before MyLVHN was implemented (during the Epic ambulatory EHR go-live in February 2015), more than one patient portal existed at LVHN; all had low enrollment and engagement rates. A goal for the health network was to leverage a single patient portal to improve engagement between health care providers and patients across the health network.
From the beginning, MyLVHN was popular, achieving more than 100,000 registered LVHN patients in the first year. Now in year two, LVHN has nearly 180,000 patients actively using the portal. By providing access and tools directly to patients and families to manage their care, both better service and better care is delivered. Example MyLVHN functions include:
- Test results posted directly to the patient’s portal
- Easy online request for prescription refill
- Medical advice requests
- Pre-visit questionnaires completed in a MyLVHN account
- eVisits and Video Visits performed utilizing LVHN’s integrated medical record and patient portal
Patient and provider use of the portal has resulted in many process improvements for ambulatory practices including:
- Self-scheduled appointments have a 2-percent no-show rate compared to 7 percent no-show rates of appointments scheduled other ways.
- Patient self-scheduling through MyLVHN more than doubled in the first six months of go-live in 2017.
- Overall patient satisfaction rose from 87.2 percent to 91 percent over a 12-month period (equivalent to a move from 37 percent to 64 percent in national rankings).
- New primary care appointments are scheduled within two weeks 53 percent of the time versus 26 percent of the time before MyLVHN.
Reflecting on the Davies Award along with the other industry accolades, Minear shares “for many years clinical software has had great potential to positively impact patient care and clinical outcomes, but often came up short. It is very exciting that we have reached the point where modern software tools, embedded clinical knowledge, and teams experienced in defining and leading change have aligned and enable LVHN to create significant improvements in clinical workflow, and have the metrics to manage and demonstrate the outcomes of this work. But we feel like we are just getting started, it will be very interesting to see how far we can leverage these tools and partnerships in the future.”
The LVHN team will formally receive the Davies Award in March at the 2018 HIMSS National Conference and Exhibition in Las Vegas.