February 07 2012
HIMSS12: Reducing never events through the use of health IT
Truman Medical Centers operates one of Kansas City's largest” quality safety net” hospitals, where we provide care for a high number of lower-income patients, as well as those without insurance. This care often goes uncompensated. In fact, we provided more than $108 million in uncompensated care over the course of the fiscal year in 2010. That's a big number, and is one reason why we're constantly looking for ways to improve the quality and efficiency of the care we provide to our patients.
If a patient develops certain conditions while in a hospital, the Centers for Medicare and Medicaid Services (CMS) will not pay for treatment. These are known as “never” events in health care, and include conditions like pressure ulcers, venous thromboembolisms (VTEs) and events like patient falls. Monitoring patients and preventing these conditions and events from occurring, therefore, is a priority — especially for budget-conscious organizations like ours.
We've been able to use the data collected from our EHR system over the course of care, along with Cerner Millennium Lighthouse, a data analysis system, to accurately track, monitor and treat these conditions in a way that's impacting our bottom line. In fact, we were able to save nearly $1.7 million over a 16-month period, using the system to:
- Decrease patient pressure ulcers by 32 percent, saving an estimated $1.39 million
- Decrease patient falls by 28 percent, saving $81,491
- Avoid 19 VTE incidents, saving an estimated $214,628
Reducing the number of VTE incidents also has a direct correlation to saving patient lives.
According to a recent study published in Circulation, one-in-three VTEs become a pulmonary embolism (PE) and one-in-five PEs result in death within a year. Based on these numbers, we avoided 5 PEs and one patient death. Over five years, this will average out to be 25 PEs prevented and five lives saved.
For organizations like TMC, Lighthouse provides tools, process maps, reference data, actionable content, reporting and other materials help provide evidence-based interdisciplinary care. I like to say the system helped move us beyond simply transitioning from paper to electronic records. This system helps us use the data we capture through the course of care in a meaningful way.
John Bluford, our CEO, has always said that, when he took the job in 1999, he wasn't out to run a hospital for poor people. He set out first to create a quality-driven organization. As such, our goal is always to provide the highest quality of care possible. Pursuing that goal has helped us save money and, more importantly, lives.
Truman Medical Center was recently featured in the Kansas City Star for their innovative work.
Mitzi Cardenas is an information technology executive with more than 18 years in the healthcare IT industry. She currently serves as the Sr. Vice President, Strategy Business Development and Performance Integration at Truman Medical Centers (TMC), a two-hospital, not-for-profit health system located in Kansas City, Missouri.
In her current role, Cardenas provides leadership to the organization in developing leading clinical and administrative information systems and technology. Since her arrival in 2008, Ms. Cardenas has worked with the organizational leadership to execute an 18-month quality-focused plan to complete the roll-out of an electronic medical record. From this effort, TMC has achieved the Stage Six designation of the HIMSS Analytics EMRAM. TMC has recently received Most Wired destination. Mitzi is also co-chair of the Technology and Operations Workgroup for the Missouri Health Connection, a role she has held since 2010.