While many hospitals contemplate starting up innovation centers, Children’s National Health System in Washington, D.C., is showing concrete results from its three-year-old Bear Institute for Health Innovation. Now, with the help of electronic health records vendor Cerner, the organization is preparing to commercialize some of its projects from the Bear Institute.
Children’s National and Cerner founded the institute in September 2013, and the center now has about 160 employees in IT innovation and IT operations, including some from the North Kansas City, Missouri-based IT vendor. The Bear Institute has worked on projects related to quality of care, telehealth, patient engagement and, recently, precision medicine.
The health system said that the institute helped reduce IT-related operating expenses by $1 million in 2015. Nearly a quarter of that came in transcription savings from using Nuance Communications’ Dragon Medical speech-recognition software. (These improvements are detailed in an e-book the Bear Institute published.)
A major focus now is the creation of “quality boards” because clinicians, patients and families don’t always relate to traditional quality measures, according to Children’s National CMIO and CIO Dr. Brian Jacobs. An electronic board has been integrated into the EHR to supply real-time metrics.
“It allows people to act right now to improve quality,” Jacobs said.
For example, to prevent ventilator-associated pneumonia, it reminds clinicians to keep the head of the bed elevated and to scrub the mouth area of intubated patients.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“We simply display those on the board,” Jacobs said. “Even families can see it.”
And the displays are simple, either a red X or a green check mark to indicate whether a task has been performed.
A study of a real-time compliance dashboard in the pediatric ICU showed big gains in medication reconciliation and a 49 percent decline in the time from PICU admission to obtaining treatment consent. The hospital published these results in the September 2015 edition of the Joint Commission’s Journal on Quality and Patient Safety. Children’s National is in a pilot phase to commercialize these processes via Cerner.
“We’re starting to disseminate to other hospitals,” Jacobs said.
Other projects to come out of the Bear Institute include the MyBearGuide mobile app, launched in January 2015 to help families navigate the hospital, find parking and clinics and look up wait times for the emergency department.
“We developed the app fairly quickly,” said David Pierre, vice president of the Bear Institute. “It’s really been a great patient satisfier.”
Another is the integration of telehealth into both the EHR and the patient scheduling system.
“One of the things that no one is doing very well is integrating telehealth into the workflow,” said Jacobs, a critical care physician.
Children’s National took on the task to permit physicians to launch video consultations right from the Cerner EHR to link primary care doctors with specialists and subspecialists.
Soon, the hospital will enable telehealth between subspecialists and consumers, Pierre reported.
“It’s a more patient-friendly, patient-centric way,” he said.
Next up, the Bear Institute is tackling genomics and personalized medicine. The hospital gets about 4,000 patient visits a year for genetic testing, which is done in-house.
“We are integrating genetic information into the electronic health record,” Jacobs said.
Photo: Children’s National Health System
