Truman Medical Center | Davies Enterprise Award

A multifaceted, not-for-profit health system, Truman Medical Centers (TMC) consists of two academic acute care facilities with 600 total beds, more than 50 outpatient clinics, a behavioral health program, the Jackson County health department and a long-term care facility. TMC serves a number of low income, high risk patients that generate some of the highest costs when compared to the general population. TMC is the provider of 11 percent of all uncompensated care within the State of Missouri, at a cost of $130 million.

TMC’s use of an EHR-enabled automated interpreter requests and streamlined workflow has enabled TMC to provide a more personalized care experience for each unique patient while providing the correct care in the fastest time possible. Best practice adherence and analytical review of clinical decision support best practice protocols have resulted in a significant reduction in the number of episodes of venous thromboembolism and hospital acquired pressure ulcers. These clinical improvements have resulted in cost avoidance of nearly $8 million since implementation. As much of the care delivered by TMC is uncompensated, cost avoidance through clinical improvement is critical for remaining financially sound.

The Clinical Value Case study describes how Truman Medical Center achieved significant reductions in hospital acquired conditions while using EHR-housed best practice alerts and technology enabled workflows. Truman Medical Center observed significant reductions in VTE, Pressure Ulcers, and CLABSI, resulting in over $8.4 million in cost avoidance.

Read the Truman Medical Center Clinical Value Case Study

TMC has tracked a wealth of benefits that are directly attributable to the EHR. Since the launch of eCare and Q6, TMC leadership regularly reviews system-generated
performance data and quality reporting with its Board of Directors to gauge its return on investment. True to TMC’s vision, the majority of benefits are in improved
clinical outcomes.  All the same, more than $40 million in cost avoidance, savings and revenue has been realized sinceDecember 2009 - including Meaningful Use payments, cost avoidance from clinicaloutcomes, FTE reduction, real estate optimization and transcription cost savings.

Read the Truman Medical Center Return on Investment Case Study

Using the EHR to enableMC has successfully eliminated the need for a dispatcher to facilitate requests between the clinician and interpreter. As a result, four steps that were previously part of the manual process are no longer necessary in the new workflow

Critical patient data including race, ethnicity and preferred spoken language is captured consistently across all clinical values, and patients are receiving timely language services from qualified interpreters. While the ultimate outcome is more personalized and satisfactory care for the patient, the new eCare Interpreter workflow has also generated the following quality and operational improvements across our health system: Standardized Data Collection, Reduced Patient Wait Times, Improved Clinical Documentation, and Enhanced Productivity

Read the Truman Medical Center Interpreting Services Case Study

Using EHR-enabled best practice alerts and workflows, Truman Medical Centers compliance with the prophylaxis protocol continues to grow beyond the 80-90 percent range. The conjunction of a preventative protocol, evidenced-based guidelines and data analysis has proven to be a powerful strategy for HAPU prevention. Since the onset of the project in 2012, these interventions reduced the prevalence of HAPUs by 78 percent across our downtown and suburban campuses and corresponded with savings exceeding $4 million. As of September 2014, the corporate percent of discharged patients with HAPU is at 0.58. Most importantly, patients are receiving safer care and TMC is achieving improved clinical outcomes.

 

 Read Truman Medical Centers Hospital Acquired Pressure Ulcers Case Study

Truman Medical Centers VTE CDS program resulted in a reduction of VTEs by 75%. Patients identified as at-risk for VTE following the implementation were 35 percent less likely to acquire a VTE. According to the CDC, one-third of deep vein thrombosis (DVT) progress in to PEs and one-fifth diagnosed PEs result in death. Over the study length, it is estimated that 32 DVTs were prevented. As result of these improvements, TMC avoided approximately $1.1 million in additional expenses since the program launched in 2010.

Read the Truman Medical Center VTE and Clinical Decision Support Case Study

Keywords: 
EHR, Hospital, Quality Improvement, ROI