August 15, 2008

VMC’s informatics acumen gains notice

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Beth Price, M.B.A.

VMC’s informatics acumen gains notice

Vanderbilt Medical Center's status as a leader in health care informatics keeps growing.

Recently, VMC achieved Stage 6 classification in HIMSS Analytics' Electronic Medical Records (EMR) Adoption Model. HIMSS collects and analyzes health systems' use of informatics.

The EMR Adoption Model is divided into eight stages, ranging from Stage 0 to Stage 7. VMC is one of only 14 health systems in the United States to reach Stage 6. No hospital or health system has reached Stage 7. To advance, specific criteria must be met and proved.

For Stage 6, there must be a full clinical decision support system in place, full physician documentation with structured templates in at least one patient care service area, and full radiology picture archiving and communication. VMC had to meet 11 criteria from the preceding stages.

In order to reach Stage 7, there must be complete interoperability between health systems and their EMR software.

“On a national level, we have not reached that next stage because we don't all store our data the same way,” said Neil Patel, M.D., chief medical information officer for inpatient areas, and co-medical director for Pediatric Critical Care Services.

“There are no agreed upon conventions,” said Jim Jirjis, M.D., M.B.A., chief medical information officer for outpatient areas, and director of the Adult Primary Care Center. “There is this tremendous fragmentation in how people are storing information.”

A Stage 7 EMR would resemble a Google-like search environment with the security and confidentiality of online banking. Vanderbilt, by striving to standardize and streamline EMR, is leading the nation in reaching Stage 7.

“The goal is that if you are on vacation in Maine, and you come in with a health problem, the doctor in Maine has access to your full medical record no matter where you've seen any other doctor,” said Jirjis.

Beyond information storage, Vanderbilt has utilized the Internet to grow outpatient services.

My Health at Vanderbilt, in 2007, saw between 1,500 and 2,000 visits each day.

Just one year later, the Web site is seeing 3,300 visits each day.

Preliminary results are indicating the site has significantly improved disease management. Vanderbilt, in primary care, is now 90 percent in hitting targets for quality of care — 40 percent better than the national average. It is this type of application that speaks to the purpose of Vanderbilt's focus on informatics.

My Health at Vanderbilt, however, would not have been possible without an efficient EMR system. The EMR system is completely integrated with the Web site and is essential to its function.

Reaching Stage 6 is a milestone in Vanderbilt's informatics goals, but the Medical Center is looking forward.

“We are always looking forward and trying to improve upon what we have already accomplished,” said Harry Jacobson, M.D., vice chancellor for Health Affairs. “I commend all those involved in reaching Stage 6 for their efforts — what they have done, and what they are still doing,” said Jacobson.