Meeting quality metrics – on top of other competing priorities in a healthcare setting – can add up to a tremendous workload for staff. That’s why HIMSS Davies Award recipient, University of Texas Southwestern Medical Center (UT Southwestern), set out to improve their quality metrics processes. Part of their efforts focused on improving data delivery through the implementation of specialty-based registries in their electronic health records (EHRs).
Implementing Specialty Registries
UT Southwestern staff engaged four groups in the overall development process: ambulatory quality outcomes and performance improvement (AQOPI), information resources, clinical operations, and data analytics. The collaboration among these groups built a strengthened line of communication that improved the efficiency of implementation.
The specialty registries developed by these groups employed a common EMR framework for specialty-specific population management tools, allowing the EMR to suggest personalized intervention at the patient level and reporting at the registry level. The registries also allow clinicians to better understand how their population of at-risk patients are doing, while not having to leave the EMR where they normally work.
As a result, UT Southwestern was able to better capture data as a byproduct of patient care, while reinforcing optimal use of their EMR and leveraging their existing technology tool kits.
One area where the registry model showed marked improvement on patient outcomes was for a rheumatoid arthritis project. The registry was leveraged to collect patient-reported outcomes of arthritis treatment, monitor proper medication prescriptions, analyze physician behavior, and demonstrate clinical improvement. Over the course of the project, the rates of patient-physician co-assessment of their arthritis disease activity nearly doubled, to 80%. Most importantly, a higher percentage of patients reported feeling the best, with low arthritis disease activity on the CDAI (Clinical Disease Activity Index) scale while the percentage of patients with highly active arthritis symptoms and findings declined.
UT Southwestern also employed automated testing software to daily validate the integrity of their software configuration for registry features and other healthcare software. Doing so helped the team develop registries in an agile, rapid-development cycle approach, constructing 43 specialty registries in the first year of the project, including 163 electronic clinical quality measures requiring no manual abstraction. At present, over 80,000 patients at UT Southwestern are now actively monitored on one or more patient registries.
HIMSS Analytics Stage 7 Revalidation
HIMSS Analytics is proud to recognize UT Southwestern for its revalidation as a Stage 7 healthcare system, as tracked by the EMRAM/O-EMRAM. The organization was also recognized earlier this year by HIMSS for achieving the HIMSS Enterprise Davies Award of Excellence.
“Our team-based approach between our clinical partners and IT has helped us produce high-quality, reliable data that goes well beyond the creation of a paperless environment,” said Mark Rauschuber, associate vice president and chief information officer of health system information resources at UT Southwestern. “It has helped us improve and ensure overall patient safety and outcomes, and create a more positive patient experience.”
“UT Southwestern’s approach to software integrity is unique and moves bug identification from reactive to proactive,” said Philip Bradley, regional director of HIMSS Analytics for North America. “The tools constantly run scripts within the environment looking for variations from expected results, then alert the team. This allows for diagnosis and root cause prior to the users reporting an issue.”