STAGE 7 SPOTLIGHT UCLA: increasing faculty satisfaction from 79% to 84%
HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) is globally recognized for helping guide healthcare organizations leverage their health IT capabilities to improve the quality of care, organizational efficiency and patient safety. The EMRAM benchmarks are broken into eight stages (0–7).
Achieving Stage 7 validation of the EMRAM acts as a testament to an organization's commitment to better patient outcomes, better patient experience and lower costs overall.
As an example of these gains, let's dive into the Stage 7 Achievement of UCLA Health.
UCLA Health includes four hospitals on two campuses and more than 160 primary care and specialty clinics throughout Southern California. UCLA Health's inpatient and outpatient clinical records, appointments, registration, billing and other business-related functions are integrated by their electronic health record (EHR) program CareConnect.
CareConnect has approximately 18,000 faculty and staff users in addition to 500,000 active patients on the patient portal and an estimated 1.9 million ambulatory visits per year.
The integrated tools provided by CareConnect allows easy access to information for patients and clinicians and improved UCLA Health's operations in a number of fields including:
- Automatic charge filing for procedures
- Depression screening and follow-up plans
- Overuse of antibiotics
- Blood order optimization
- Health information management
UCLA Health's enterprise go-live was the largest go-live of an Epic Systems Corp. software at the time.
CareConnect was adopted by physicians, pharmacists, nurses, advanced-practice nurses, other clinicians, fellows, residents, medical students and staff working with scheduling, registration, billing, patient placement (ADT) and health information management (HIM) across UCLA's network.
After the initial CareConnect EHR implementation, the software continued to improve to incorporate additional functionality, modules and upgrades over subsequent years.
UCLA Health faculty satisfaction increased from 79% in 2013 to 84% in 2016. The implementation of CareConnect resulted in safer, more effective, timelier, more efficient, more equitable health care. The EHR resulted in enhancements across a number of areas including:
Automatic charge filing for procedures
Task Based Order Completion (TBOC) automatically files the charge for routine clinic procedures like nebulizer treatments and EKGs and requires the task to be complete before the encounter could be closed in CareConnect. This led to a 40% increase in charge compliance at the Santa Monica Bay Physicians group, a 45% increase at the Community Physician Network (CPN) and a 65% increase at the Department of Medicine (DOM).
Depression screening and follow-up plan
The dynamic appearance of a 2-question Patient Health Questionnaire (PHQ-2) for patients who have not been screened for depression that calendar year, an automatic 9-question follow-up (PHQ-9) for positive PHQ-2 results and an alert for positive PHQ-9 screenings that required follow-up action before the chart could be closed resulted in an increase in follow-plan implementation by 45% from 2013 to 2015.
Overuse of antibiotics
Pediatric patients with an upper respiratory infection (URI) should only be given antibiotics after testing positive for group A strep. To ensure this, an intrusive alert reminder was set up to remind providers to order a lab test if there's no recent test for Strep A bacterial infection and antibiotics are ordered for a pharyngitis visit diagnosis. This increased the appropriate testing of children with pharyngitis by 11% from 2014 to 2016.
Health Information Management
UCLA Health Record Center's capacity usage decreased from 97% in 2013 to 53% for health information management and more than 95% of all notes are now completed electronically.
CareConnect improved UCLA's overall patient care process and is another example of how EMRAM Stage 7 validation harnesses technology that leads to better patient experience. Healthcare organizations worldwide can follow in UCLA Health's footsteps and use the EMRAM to improve the quality, accuracy and efficiency of their services network-wide.
"Reaching and maintaining Stage 7 not only highlights our commitment to maximizing the use of health IT to provide a better patient experience; it has also become a requirement to attract and retain the best and brightest minds in health," Dr. Michael Pfeffer, Assistant Vice Chancellor and Chief Information Officer said.