Leaders at Northern Light Health, Brewer, Maine, know that to continually improve patient outcomes, the 10-hospital, fully integrated health system must squeeze every ounce of efficiency out of its EHR system.
“When we maximize our EHR, there are revenue cycle gains, there’s an increase in end-user satisfaction and, most importantly, it produces a product that will assist in equitable quality care for our patients and delivery of an excellent patient experience,” says James Douglas, DO, regional medical informatics officer, Mid-Maine Region and Mercy Hospital, and co-chair, Clinical Stakeholder Group, Northern Light Health.
Validation of the organization’s success is seen not only in its delivery of care but also in other ways. Northern Light Health has reached Stage 7 on the HIMSS Outpatient Electronic Medical Record Adoption Model. Participation is a sign of an organization’s commitment to excellence.
The health system has undertaken numerous EHR optimization initiatives such as focusing on ease of use for consumers and closing gaps in care, which improves outcomes, according to April Giard, DNP, APN, NEA-BC, senior vice president and chief digital officer. Northern Light Health also aims to bolster clinician efficiency and reduce clinician and staff cognitive burden, including decreasing “alert fatigue.”
“We have found that better patient outcomes often are directly tied to a better clinician experience,” Giard says. “After eliminating certain alerts in the EHR, we reduced medical errors and, at the same time, decreased cognitive burden for our clinicians.”
Being what Giard and Douglas describe as a “clinically led organization” has meant all the health system’s EHR optimization efforts and strategic plans have buy-in from clinicians. Douglas co-chairs a clinical stakeholder group comprising representatives from across the health system, which provides governance and guides the effectiveness of technology services and solutions.
Following are examples of the EHR optimization initiatives that aim to deliver optimal outcomes and excellent patient and clinician experience at Northern Light Health.
Making mammograms more convenient. One current initiative is a streamlined process for online routine mammogram scheduling. Patients can pick times convenient for them and complete registration intake questions beforehand rather than in the provider’s waiting room. Answers to the patient’s questions appear directly in the Cerner EHR platform for immediate review by clinicians. A hands-free check-in process offers another convenience: After completion, patients receive a QR code on their smartphones, which can be scanned when they enter the provider’s office, allowing them to bypass waiting in line at the front desk.
“Overall, these initiatives will help increase access to women’s healthcare,” Douglas says.
Improving blood pressure control. This project identified EHR optimizations and new tools to alert clinicians to patients with high blood pressure. A newly created “smart zone” alert can be viewed by medical assistants or clinicians upon opening a patient’s chart. The alert reminds clinicians to repeat the blood pressure test during the appointment if needed and to make sure high blood pressure is addressed.
Patients also can track and document home blood pressure readings in a patient portal. This can help capture more accurate blood pressure information for patients with “white coat syndrome” or other stress-related factors that can result in higher readings in the doctor’s office versus at home. These initiatives have resulted in an increase of blood pressure control from 73% to 75% in five months, according to Douglas.
Optimizing a vaccine rollout. Being able to innovate and add new tools within its EHR also proved essential to the health system’s COVID-19 response. “Our response was extensive and required significant optimizations within our EHR,” Douglas says.
Working with Oracle Cerner, Northern Light Health built a mass vaccination tool. Using barcode scanning technology, the health system records all vaccinations on a vaccine report in the EHR, which is then shared directly with Maine’s immunization information system.
“The tool was so efficient our patients would complete their immunization process within 30 minutes, including the 15-minute wait time,” Douglas says. “It was critical to the seamless rollout of our mass vaccination sites, and our process was viewed as a model for the state.”
Setting the Standard
Achieving Stage 7 O-EMRAM status has set the standard the team at Northern Light Health continues to hold itself to as it looks to expand existing initiatives and develop new ones.
“I know there’s not a HIMSS level eight, but it’s important to keep in mind that we are at level seven,” Douglas says. “We continue to expand on the work we’ve already done, and we expect the quality of what we’re producing to be at that level. We’re holding ourselves to that.”
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