December 19, 2017

Assembly highlights eStar launch, IT ecosystem

With the liftoff of eStar accomplished, it’s time to set the course for optimizing the new information technology ecosystem for Vanderbilt University Medical Center (VUMC), but not without first thanking all those who delivered seamless patient care during the transition, said Jeff Balser, MD, PhD, President and CEO of VUMC and Dean of Vanderbilt University School of Medicine.

Jeff Balser, MD, PhD, talks about the Medical Center’s successfull eStar transition during last week’s Clinical Enterprise Leadership Assembly. (photo by Anne Rayner)

With the liftoff of eStar accomplished, it’s time to set the course for optimizing the new information technology ecosystem for Vanderbilt University Medical Center (VUMC), but not without first thanking all those who delivered seamless patient care during the transition, said Jeff Balser, MD, PhD, President and CEO of VUMC and Dean of Vanderbilt University School of Medicine.

“We’ve trained 17,000 people, and all that preparation led to a truly successful Go Live that was on time and an amazing success for this Medical Center,” Balser said at the December 2017 Leadership Assembly.

Throughout his remarks Balser focused on eStar, the Medical Center’s new Epic-based clinical IT system that was launched Nov. 2.

During the two-and-a-half hour assembly Medical Center leaders highlighted other accomplishments, including an expanding population of patients, such as small business owners and members of Nashville’s entertainment industry, who will be served in 2018 through new agreements with insurance companies. They also celebrated the achievements of individual employees recognized for Five Pillar, Elevate and Credo Awards. John Esposito, chairman and CEO of Warner Music Nashville, delivered the keynote address.

Balser praised people throughout the organization for going above and beyond to address unexpected challenges during the eStar transition, regardless of their roles, and demonstrating poise throughout the process.

“There are hundreds and hundreds of people who did whatever was needed, and their can-do attitudes were key to this success,” he said, encouraging VUMC leaders to individually thank these employees.

“Patients saw us confident and strong, and that made them confident,” Balser said. “That made a huge difference.”

The new clinical system positions VUMC for future innovation and improved efficiencies. He compared the transition process to moving into a new home, which typically results in culling what’s no longer needed.

“We did that,” Balser said. “If you think about all the workflows and order sets that we had to look at hard, in order to install eStar and get it right, we pulled out the things we just don’t need anymore. What this is going to do is make us a lot more nimble. It’s going to reduce variability, and is going to make us operate a lot more efficiently and effectively into the future.”

After further stabilizing operations under eStar, a next step will be to engage more patients to interact with an improved My Health at Vanderbilt, which will offer new features such as an expanding list of clinics where appointments can be easily scheduled through the portal, and the opportunity to reduce paperwork during clinic visits by completing forms in advance online.

“We have 600 clinics that now have online forms through eStar, and we have 40 requests for specialty forms that are being developed right now,” Balser said. “Then we have 20 different clinic locations that are live with scheduling return appointments — including pediatric urology, primary care, and mammogram appointments at the Vanderbilt Breast Center. There will be another 110 by the end of this fiscal year.”

To take advantage of the new capabilities, he asked everyone to promote use of the My Health portal to patients. Balser called on those attending to help with a new goal to have 50 percent of patients enrolled in My Health by end of the fiscal year.

“We’re going to need your help to do this,” he said. “We’re going to need to embed registration for My Health into the clinic intake and inpatient discharge process to get them registered.”

VUMC is already leveraging its capacity for innovation to improve eStar in ways that have the potential to change the use of health records worldwide. REDCap (Research Electronic Data Capture), the Vanderbilt-developed application, is being incorporated by Epic into its suite of products to provide clinicians and hospitals everywhere the ability to accelerate clinical research, Balser said.

During his remarks, C. Wright Pinson, MBA, MD, Deputy Chief Executive Officer and Chief Health System Officer for VUMC, talked about what was learned during Go Live and actions taken to meet operational and technical challenges that arose.

C. Wright Pinson, MBA, MD, talks about the importance of collaboration during EpicLeap Go Live at the assembly. (photo by Anne Rayner)

“It is very important for us as leaders to pause and reflect, and even celebrate this important milestone,” he said. “We have successfully ushered in a new era at VUMC with the largest investment in transformative change in our history. And the people of VUMC have been the Most Valuable Players of this experience. The planning was excellent.”

The collaboration that went into EpicLeap will serve as a guide for future projects.

“As an area where we have shined, let’s talk about collaboration,” Pinson said. “Many organizational silos seemed to just evaporate. Starting more than two years ago, the Operational Readiness Advisory Group brought together leaders from the Adult, Children’s and Behavioral Health enterprises, resulting in a cohesive system and structure. In fact, we are so pleased with how this worked we will carry this new level of collaboration forward with other projects. Additionally, the Operational and Technology Command Centers served as the hub for real-time updates throughout our health system, identifying, prioritizing and resolving concerns, and providing daily reports to the entire VUMC community.”

VUMC employees delivered on patient care during the transition, Pinson said.

“Our patients were and are our No. 1 priority. Our teams stayed focused on patient care even during scheduled downtimes. The operating rooms were in continuous action. Those who interacted with our patients and families gently shared updates on the changes. From our observations, our quality measures were relatively unaffected compared to peer institutions during their implementations.

“We need continued Epic focus to get the most out of our huge investment for all of us, and most importantly, our patients.”

While VUMC was implementing the new eStar system, it was also expanding its reach, Pinson said. Eight additional hospitals in Tennessee joined the Vanderbilt Health Affiliated Network. Two new agreements with insurers will begin Jan. 1. Aetna Whole Health—Tennessee, a new accountable care product, will be available through Vanderbilt Health Affiliated Network to self-insured and fully insured businesses in Nashville, Memphis, Chattanooga, Upper Cumberland and Jackson metro areas. VUMC will also serve patients enrolled in Cigna Connect, an Affordable Care Act-compliant individual insurance plan available on the federal exchange. Also, VUMC opened another Walk-in clinic and 14 Vanderbilt Health Clinics in Walgreens stores.

In his quarterly Pillar Goal update Pinson said that through the end of October the Medical Center was meeting 10 of 17 measurable goals and three goals will be measured at year’s end.

“Where we are meeting threshold, we need to keep up the good work. Where we are not, we need to act now so that we can finish the year strong. We especially need to focus on access and throughput,” he said.

Under the People Pillar, Employee Retention was very good; the best first quarter result in five years.

“Patient Experience has rated well for the first quarter compared to the prior year, which is about treating patients and families how we would want to be treated,” Pinson said.

Observed-to-Expected Mortality is on track.

“The collaboration between Population Health, Quality and Safety, Risk Prevention and our clinical teams is making sure patients are getting all the right preventive services they need, measured by the clinical effectiveness metric.”

Financial metrics are on track as well.

Pinson reminded leaders that this year’s All Organization Goals remain Employee Retention and Patient Satisfaction or Academic Performance for those in the academic and research enterprises.

Warner Music Nashville’s John Esposito delivered the keynote address at the assembly. (photo by Anne Rayner)

Carrying forward on the theme of transformative change, Warner Music Nashville Chairman and CEO John Esposito talked about how the music industry has adapted to a streaming model for music sales instead of albums. He brought along country music star Frankie Ballard, who shared a newly written song before an audience for the first time. Balser thanked Esposito for his years of support for the Vanderbilt-Ingram Cancer Center and for his help in securing a $3 million donation from the Country Music Association for the expansion of Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“Music and healthcare are the two greatest industries in this great city, and Vanderbilt Health is the heartbeat of the city,” Esposito said. “We in the music business and Warner Music are proud to be your civic partners. Keep doing what you’re doing. Continue to lead, and, together, our little town — the epicenter of music and healthcare — can change the world.”

Sarah Moore, MBA, CNMT, RT (CT), director of Radiology and Radiological Sciences, received the Five Pillar Leader Award.

The organizing team for Flulapalooza received the Elevate Team Award.

Credo Award recipients included Phronda Buckely, a business intelligence analyst for HIM revenue cycle; Rose Tinch Calvert, RN, a patient care coordinator for the Spina Bifida Clinic, and Tonya Remington, LPN II, a surgical specialties nurse.