Texas Health Resources - Davies Enterprise/Organizational Award

texas health resources logoTexas Health Resources, (THR) is one of the largest faith-based, nonprofit health care delivery systems in the United States and the largest in North Texas in terms of patients served. The system's primary service area consists of 16 counties in north central Texas, home to more than 6.2 million people.

Texas Health has 25 acute-care and short-stay hospitals that are owned, operated, joint-ventured or affiliated with the system. It has more than 3,800 licensed beds, more than 21,100 employees of fully-owned/operated facilities plus 1,400 employees of consolidated joint ventures, and counts more than 5,500 physicians* with active staff privileges at its hospitals.

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In 2004, Texas Health Resources had the vision to implement a full electronic health record (EHR), incorporating existing ancillary clinical systems, while looking for a vendor-partner to provide the clinical centerpiece. We selected a vendor, and together, with the existing systems of Patient Management, Laboratory, Radiology, Revenue Cycle, and document imaging, THR implemented a fully integrated EHR in 13-wholly owned hospitals between 2006 and 2011.

In 2012, THR built a new, full-service hospital and opened with a fully integrated EHR, and received HIMSS Stage 7 designation within its first 90 days. THR’s commitment to patient care and advancement of technology through the EHR is evidenced by the initial and ongoing capital investment to implement and maintain the EHR, as well as the financial commitment to operational sustainability.

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Clinical Value

Texas Health has experienced significant value in the electronic health record (EHR), known as CareConnect, within our 14-wholly owned hospitals. CareConnect provides a conduit to better manage and support safety and quality initiatives through robust clinical decision support tools and reporting and analytic capabilities. The value of the EHR is significant in cost savings, cost avoidance and improving outcomes.

For example, we have seen a 53% reduction in medication errors through our closed loop medication administration process, and a 36% decrease in adverse drug events due to the increasing use of CPOE by physicians, resulting in $1,853,410 in cost avoidance. In addition, we have reduced falls by 34%, with a cost avoidance of $1,003,950. More importantly, these outcomes have improved the lives of our patients.

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Clinical Business Intelligence

Texas Health Resources is a large, integrated healthcare system that has grown and diversified  through acquisitions. As a result, THR has multiple electronic health records (EHR) and patient  management systems, as well as a home-grown financial system. While THR now has all 14  wholly owned hospitals on the same platform, the acquisition of a large physician network  introduced a variety of different EMR installations.

THR, like most health care organizations, has a variety of systems that support the delivery of  health care. To obtain a complete 360-degree view of a patient’s care, data from disparate  systems must be integrated, including data from physician practices, hospitals, and post-acute providers.

THR has invested $7,000,000 in capital with a budgeted $1,000,000 annual operating costs, in a clinical business intelligence (CBI) solution. Through our initial ACO dashboard, we have already seen an increase from less than threshold at 92% to the maximum score at 99%. We expect an annual return of $5-8 million from better decisions on surgical materials, reduced practice variability, more efficient processes, and higher data quality through our ability to extract complex data requirements for advanced analytics.

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Menu Case Study

The mission of Texas Health Resources is to “Improve the health of the people in the communities we serve.” In keeping with this mission, we continuously explore ways to better and more proactively manage our patients before they experience significant clinical events that impact their recovery. CareConnect, the electronic health record (EHR), has facilitated the clinician’s ability to aggregate patient information to make care decisions sooner, and with the best possible data. However, it often is difficult to assimilate the information and accessible to the clinicians in a way that allows them to act quickly.

The Modified Early Warning System (MEWS) project was designed to bring relevant information to the registered nurse (RN) to obtain timely and critical information with which to make immediate care decisions in critical situations. The success of this project has been beyond expectations.

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Reducing Venous Thromboembolism (VTE) Using Clinical Decision Support Interventions

In 2008, Texas Health Resources (THR) launched a program to prevent venous thromboembolism (VTE), one of the leading causes of preventable hospital deaths. We saw immediate change in practices, and by 2011, post-operative VTE rates were less than half of pre-program rates. Lowering post-op VTE rates has helped THR to satisfy Surgical Care Improvement Project requirements, and to meet measures set forth by Centers for Medicare and Medicaid Services.

The VTE prophylaxis program was awarded a 2011 HIMSS Story of Success, which also was used as a case study to show the effectiveness of CareConnect, THR’s electronic medical record (EMR), for the Texas Health Alliance hospitals’ EMRAM Stage 7 award designation.

Between 2008 and 2010, THR had 404 preventable VTE events, which resulted in an overall cost avoidance of $6,060,0004 This represents approximately a 50% decrease in the number of VTE’s over 4 years.

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