1. Hospitals, Quality and HIT: Important Issues and Intersections
Gail E. Latimer, MSN, RN, VP, Chief Nursing Officer
Siemens Medical Solutions

2. The Value of Health Information Technology
By bringing IT tools, including EHR and content, to doctors and hospitals.
Inform
Clinical
Practice
Inform
Clinical
Practice
By building an interoperable health information system so records follow patients.
Interconnect
Stakeholders
Interconnect
Stakeholders
By using health IT to give consumers more access to and involvement in health decisions.
Personalize
Care
Electronic Health Record
By expanding the monitoring of public health and bringing research advances more quickly to medical practice.
Improve Population
Health
Improve Population
Health
Personalize
Care

3. Clinical Performance Drivers
Targeted Performance Areas – The Nation is Monitoring
Length of stay
Patient falls
Urinary tract infection
Pressure ulcers
Hospital-acquired pneumonia
Shock or cardiac arrest
Upper gastrointestinal bleeding
Sepsis
Deep vein thrombosis
Central nervous system complications
In-hospital death
Wound infection
Pulmonary failure
Metabolic derangement
Acute MI
Heart failure
Pneumonia
Surgical infection prevention

4. Transparency in Hospital Public Reporting - Clinical Process Measures

5. EHR Business Office Physician's Office Dietary Environmental Services
Patient's Home
Environmental Services
Laboratory
Health Info Mgmt
Pharmacy
Medical Unit
Radiology
Emergency Department
Scheduling

7. Incorporating Evidence Within Clinical Practice
Accelerating role in today’s healthcare
Provides improved quality and reduction in variation
Serves as the basis for many quality management and performance initiatives
Information technology will drive the use of knowledge with the EHR

8. Increase Accuracy and Efficiency of Clinical Processes Computerized Physician Order Entry

9. Incorporating the Capture of Core Measures Clinical Documentation

10. Incorporating the Capture of Core Measures Clinical Documentation

11. Knowledge-driven EHR

12. Knowledge Drives the Patient Plan of Care
Smoking Cessation slide

13. Knowledge Drives the Patient Plan of Care

14. Acute Myocardial Infarction Workflow -

15. Workflow Engine – Listening, Monitoring, and Escalating…….

16. Workflow Engine – The Right Information, To the Right Person, at the Right Time……

17. Leveraging Technology to Measure Quality and Cost
Technology provides real-time access to cost and quality
Technology generates new knowledge to advance healthcare
Technology deployment supports the care delivery process while measuring outcomes
Technology can capture clinical practice, improve processes and quantify the impact on patient outcomes

18. AMI Aspirin at Arrival Goal 100% Aspirin Prescribed at Discharge
90%
80%
70%
60%
50%
40%
30%
20%
10% 0%
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
2003=52
2003=50
2003=63
2004=56
2004=42
2004=54
2004=50
2004=57
2004=39
2004=46
2004=36
2004=47
2004=60
2004=63
2004=56
2005=52
2005=70
2005=55
2005=52
2005=53
2005=60
2005=63
MRMC
HQI Top Decile
Aspirin Prescribed at Discharge
Goal 100%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10% 0%
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
2003=52
2003=50
2003=63
2004=56
2004=42
2004=54
2004=50
2004=57
2004=39
2004=46
2004=36
2004=47
2004=60
2004=63
2004=56
2005=52
2005=70
2005=55
2005=52
2005=53
2005=60
2005=63
MRMC
HQI Top Decile

19. AMI ACE Inhibitor / ARB for LVSD Goal 100% MRMC HQI Top Decile
80%
15/15
8/8
9/9
10/10
13/13
11/11
13/13
13/14
15/16
13/14
12/14
13/14
9/10
60%
9/11
6/8
7/9
6/8
8/11
9/14
40%
20% 0%
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
2003=52
2003=50
2003=63
2004=56
2004=42
2004=54
2004=50
2004=57
2004=39
2004=46
2004=36
2004=47
2004=60
2004=63
2004=56
2005=52
2005=70
2005=55
2005=52
2005=53
2005=60
2005=63
MRMC
HQI Top Decile
Smoking Cessation Advice/Counseling
Goal 100%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10% 0%
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
2003=52
2003=50
2003=63
2004=56
2004=42
2004=54
2004=50
2004=57
2004=39
2004=46
2004=36
2004=47
2004=60
2004=63
2004=56
2005=52
2005=70
2005=55
2005=52
2005=53
2005=60
2005=63
MRMC
HQI Top Decile
denominator may change due to inclusion/exclusion criteria

20. AMI Beta Blocker at Arrival Goal 100% 100% 90% 80% 70% 60% 50% 40% 30%
20%
10% 0%
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
2003=52
2003=50
2003=63
2004=56
2004=42
2004=54
2004=50
2004=57
2004=39
2004=46
2004=36
2004=47
2004=60
2004=63
2004=56
2005=52
2005=70
2005=55
2005=52
2005=53
2005=60
2005=63
MRMC
HQI Top Decile
Thrombolytic received within 30 Minutes of Hospital Arrival (Avg. Time in Minutes)
100 90 80 70 60 50 40 30 20 10
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
2003=52
2003=50
2003=63
2004=56
2004=42
2004=54
2004=50
2004=57
2004=39
2004=46
2004=36
2004=47
2004=60
2004=63
2004=56
2005=52
2005=70
2005=55
2005=52
2005=53
2005=60
2005=63

21. Nursing Dashboard - 5 East

22. Monitoring Clinical Outcomes

23. The Value of Health Information Technology -Monitoring Quality and Cost

24. The Value of Information Technology for Clinical Practice
Achieved more than 90% compliance with regulatory standards for discharge education of stroke patients
Reduction in medication to pharmacy review time from up to 24 hours to within 1 hour
Reduction in prescriber errors by 71%
Decreased harmful events to a six month average of 0.33 per 1,000 doses (compared to a national average of 2-8 harmful events per 1,000 doses)