The MetroHealth System (MHS), a safety-net/essential healthcare system in Northeast Ohio affiliated with Case Western Reserve University’s School of Medicine, started to implement the Epic electronic health record (EHR) throughout MHS ambulatory clinics in 1999. By 2009, the MHS had fully deployed Epic enterprise-wide: throughout all ambulatory clinics, inpatient areas, and the emergency department. Over the last five years the MHS has focused on enhancing the use of the existing EHR foundation to do things not possible without a fully deployed, enterprise EHR and to meet ongoing MHS needs.
The MHS views the EHR as a critical component of administrative, clinical, operational and quality activities. As such, numerous areas of the healthcare system are continually asking if/how the EHR can help issues/opportunities their areas are interested in. Additionally, information services and informatics staff are always looking for opportunities to leverage existing and new EHR functionality in ways to improve the MHS.
The health information technology (HIT) value examples described in this section represent a broad sampling for the local problems the EHR has been used to address within the MHS.
The HIT value examples include:
- Health information exchange
- Heparin (high risk medication)
- Code status reconciliation
- Vaccine adverse event reporting
- Outpatient depression screening
- Automated patient clinical messaging
- Internal referral completion
- Common high risk/high cost hospital acquired infections
- Core measures
- Blood pressure diagnosis research and improvement