EMR 2.0: Harnessing data to give new life to a legacy system

NorthShore University HealthSystem in Chicago implemented its electronic medical record system in 2003. It included lots of bells and whistles, such as computerized physician order entry, and was deployed big-bang style at the system's four hospitals and at physician offices and ambulatory care centers.

"Is there life after that event?" President and CEO Mark Neaman, speaking at a "Masters Series" session at the annual congress of the American College of Healthcare Executives (ACHE) in Chicago yesterday, asked the audience.

There is, of course--and much of the power of EMR 2.0 lies in the vast amounts of data EMRs create. That data, if used in an analytical way, can be used to track and monitor public health, Neaman said. But even more importantly, it can be used to do predictive modeling and aiding preventative medicine--to create a "mini CDC" in the system's region.  

Some examples of the way NorthShore has used its data include the following:

  • Predictive modeling helped the organization identify patients who are most likely to be carriers of MRSA. As a result, they've been able to identify 99 percent of those patients by testing only 50 percent of the patients, rather than having to survey them all.
  • The organization used data analytics to identify the normal temperature ranges of post-op patients. Historically, anything above 98.5 degrees is cause for concern. But for surgical patients it turns out the norm--based on multiple data points gathered through its EMR--is actually 100.3 degrees. Using that metric, the organization has cut down on antibiotic use.
  • One third of NorthShore patients had undiagnosed hypertension--compared to a national average of 8 percent--even after three visits. Docs were taking and recording pressure almost by rote. Recognizing the problem, they were able to adjust workflows to change that.  

Neaman and co-presenter Christopher Durovich, president and CEO of Children's Medical Center in Dallas, also talked about the return on investment of their EMRs. In addition to quality improvements, Neaman said, there is a small but positive economic ROI.

Financial returns, both men said, come at least in part from the fact that less paper means less paperwork and fewer support staff to process it. They've also seen benefits in fewer rejected claims and shorter accounts receivable cycles. Meaningful Use dollars and vendor incentives also help defray the cost of implementing and maintaining an EMR. For NorthShore, that number totals more than $19 million.

Money isn't the focus, per se, Neaman said. "But our board is asking that and so we're answering" the question.

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