Case Study - Children's Hospital & Medical Center of Omaha
Situation Analysis
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Like many health systems, Children's Hospital & Medical Center of Omaha, NE, didn't suffer from a lack of data. Its challenge was turning that data into actionable information easily accessible to all members of the care team as part of their clinical workflows. Children's physicians - particularly its many residents and interns - were accustomed to entering diagnoses and notes as free text that sat in a database separate from Children's electronic health record (EHR), using the wide range of medical terms and abbreviations typical across a medical staff. This made clear communication and smooth handoffs of patient care between clinicians difficult, and attempts to evaluate patient data across populations to foster best practices almost impossible.
IMO Solution
Children's staff turned to Intelligent Medical Objects® and its IMO® Problem (IT) because of the solution's easy integration with the medical center's Eclipsys™ Sunrise Clinical Manager™ inpatient EHR system. (IMO® Problem (IT) is also integrated with the Epic system used in Children's ambulatory clinics.) IMO® Problem (IT) enables clinicians to enter a diagnosis for a patient Problem List without altering the language they would normally use. That way, they don't have to alter their practice patterns to agree on terminology to be used by every member of the care team, or remember the often awkward and cumbersome coding languages of ICD-9, ICD-10 and other standards. IMO® provides an interface to the standard ICD-9-CM-driven terminology in the EHR search with an improved 120,000+ term search that expresses clinical intent while generating the correct coding for that intent.
Result
Coordinated care - Using IMO® Problem (IT) with the structured noting and patient handoff tool of Sunrise Clinical Manager™ has brought Children's clinicians a simple, seamlessly integrated solution to the challenge of delivering consistent, accurate and thorough information during patient handoffs between caregivers - the points where studies show the greatest potential for avoidable medical errors can occur. Instead of inconsistent free-text entries in a stand-alone database, now clinicians can easily assemble clear and accurate Problem Lists without ever leaving the EHR, reports George Reynolds, MD, MMM, FAAP, CPHIMS, the medical center's Chief Medical Informatics Officer and acting Chief Information Officer:
Our entire care team - attending physicians, nurses, residents, medical students, and others - now can all share a common understanding of the patient's problems. Placing this critical information in one common location, with clearly understood terminology thanks to IMO®, eliminates the silos of patient information and the other 'disconnects' we struggled with in the past to deliver the most coordinated, highest-quality care possible.
George Reynolds, MD, MMM, FAAP, CPHIMS
Acting Vice President
& Chief Information Officer
Chief Medical Informatics Officer
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Standardizing best practices - "The structured vocabulary of [IMO® Problem (IT)] has enabled us, with a very high degree of confidence, to search for and identify types of patients using our system dashboards," Dr. Reynolds reports. "For example, this enabled us to standardize care around bronchiolitis, which frequently occurs with hospitalized children during the winter. We were able to identify what interventions had proven to be of value, which had not, and to create a simple order set that has standardized care and further raised the bar on care quality and patient outcomes."
Education - Integration of IMO® Problem (IT) and its thousands of additional terms and concepts with Sunrise Clinical Manager™ is also providing residents and medical students with a powerful educational tool, the CMIO notes. "Using the Sunrise Clinical Manager™ InfoButton feature coupled with IMO's standard vocabularies, our residents and medical students can easily access online content providers such as Wolters Kluwer's Clin-eguide™ to perform quick research that further expands their knowledge on issues relating to the patient's condition. IMO's vocabulary seamlessly integrated with our EHR helps make that possible."
Meeting Meaningful Use, ICD-10 standards - Children's plans to aggressively pursue federal ARRA HITECH incentive dollars by meeting the standards for "Meaningful Use" of a certified EHR to support the medical center's ongoing initiatives. "One of the standards for achieving Meaningful Use is to prove you are using an accurate patient Problem List, so IMO helps us be well-prepared," says Dr. Reynolds. "Also, IMO's management of the code mappings and updates to existing standards such as ICD-9 - and IMO's preparedness for the complexities of ICD-10 - will greatly simplify our transition to the many more thousands of ICD-10 administrative codes and other industry standards as they evolve."
About the Client - Children's Hospital & Medical Center is a non-profit, regional pediatric and specialty healthcare system caring for children since 1948. It is the only full-service pediatric specialty healthcare center in Nebraska, including a 145-bed hospital, the region's only dedicated pediatric Emergency Department, home health services, and over 30 outpatient specialty clinics.
Among its many recognitions, Children's Hospital & Medical Center has achieved the Magnet designation from the American Nurses Credentialing Center's Commission on Magnet Recognition for excellence in nursing care.
www.childrensomaha.org