Mount Sinai Medical Center - Davies Enterprise/Organizational Award

Mount Sinai Medical CenterThe Mount Sinai Health System combines the Icahn School of Medicine at Mount Sinai and seven hospital campuses to provide the highest quality health care throughout the New York metropolitan area.

Our integrated resources and expertise offer patients comprehensive care from birth through geriatrics, including complex cases. This newly established system significantly expands our geographic footprint and increases our number of beds to 3,571.

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Return on Investment

The Mount Sinai Medical Center (MSMC), located in New York, New York, is an internationally recognized medical teaching, patient care, and research facility. MSMC is in the final stages of implementing an ambulatory and inpatient electronic health record (EHR).

Since beginning the ambulatory implementation of the EHR in 2006, MSMC has documented an enormous amount of hard and soft return on investment (ROI) evidence. More importantly, the long-term benefits of this new “backbone of our care” (as characterized by CEO, Kenneth Davis, MD) are even greater.

The new EHR enables new reimbursement models, improvements in safety and quality, and accelerated research and innovation.

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Clinical Value

The Mount Sinai Medical Center (MSMC), located in New York, New York, is an internationally recognized medical teaching, patient care, and research organization. Continually striving for clinical excellence, MSMC’s focus is on fully integrating its medical center, ambulatory healthcare information technology (IT), and processes. Computerized Physician Order Entry (CPOE) and Clinical Documentation were implemented first in the ambulatory practices and in the inpatient setting starting in 2010.

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Leadership/Governance

Key traits of the governance structure included a mandate for physicians to use the EHR, “overwhelming” communication from the C-suite, and organizational fortitude to convince the vendor to make changes to their long-standing methodology to better align with MSMC needs. Critical success factors included intensive C-suite involvement, the inclusion of 20 physician champions and 20 front-line nurses on the project, and early collaboration with the nurses’ union.

MSMC deployed the Epic ambulatory EHR to 120 clinics during 2005 to 2010 and the Epic inpatient EHR in 2010 to 2011, successfully attesting to Meaningful Use Stage 1 in 2011. The program had a total budget of $127.5 million.

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Innovation: PACT

The ability to prevent avoidable readmissions by patients with certain chronic conditions within 30 days of discharge is a primary success factor for hospitals to be able to adhere to forthcoming changes in the reimbursement model used by Medicare. The Mount Sinai Medical Center (MSMC) set out to establish an electronic health record (EHR) based process whereby patients at risk of being readmitted into the hospital are efficiently and accurately identified and managed.

Once identified, these patients are enrolled into MSMC’s Preventable Admissions Care Team (PACT) program, where psychosocial drivers of readmission are assessed and addressed through a 35 day social work-lead intervention that begins upon discharge. By incorporating the identification process into the design and implementation of the Epic EHR, MSMC has effectively been able to hard wire key workflow processes required to reduce readmissions, improve care, and lower the costs of care.

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Change Management

Change management plays a critical role in health information technology (HIT) implementations because it takes into consideration the human side of the implementation.

The Mount Sinai Medical Center (MSMC) focused on an encompassing change management program right from the beginning of its Epic electronic health record (EHR) implementation. Beyond the usual complexities of implementing an EHR in an academic medical center (AMC), MSMC faced the challenges of 60 completely redesigned workflows, clinician skepticism as a result of previous uneven information technology (IT) implementations, and a history of not using best practice change management processes.

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