The modern era of medicine holds the promise of personalized patient care and improved patient outcomes. Personalized medicine can take many forms but can best be described as providing disease-specific care that focuses on treating the right patient at the right time with the right treatment, according to Duke University Health System (Duke Health). Translating the ongoing medical advances into the practice of medical care at the patient level presents a challenging hurdle that health technology can support.
Duke Health is utilizing their electronic health record (EHR) technology to meet these challenges through standardized care processes that emphasize patient safety and quality of care contributing to improved patient outcomes.
Standardizing the Post-Surgical Patient Care Process
In 2010, Duke Health recognized a pattern of high readmission rates and post-surgical urinary tract infections (UTIs) among their patient population that had colectomies or removal of part of their large intestines. Julie Thacker MD, a colorectal surgeon at Duke Health, worked with her team to implement a standardized patient care process for these patients called Enhanced Recovery After Surgery (ERAS). The ERAS protocol improved how patients were physically managed before, during and after surgery in regards to nutrition, activity and pain control. These standardized changes resulted in reduced length of stay (LOS), decreasing secondary complications of UTIs and a significant decrease in unnecessary readmissions.
In 2016, the ERAS protocol was integrated more tightly within the EHR to provide visual markers of patient ERAS status across the care continuum. As a result of these visual clues, caregivers at every part of the surgical process could easily identify patients on the protocol which supported increased compliance. Additionally, near real-time reporting data for compliance with the protocol and use of these new tools in the EHR led to additional improvements in patient outcomes including further decreases in average LOS, post-operative complications like UTIs, and a 50 percent reduction in readmission rates for colectomy patients.
2018 Davies Award use case submission: Improved Surgical Outcomes
HIMSS Davies Award of Excellence
The HIMSS Davies Award of Excellence recognizes outstanding achievement of organizations that have utilized health information and technology to substantially improve patient outcomes and value. The HIMSS Davies Award of Excellence is the pinnacle of the HIMSS Value Recognition Program and highlights organizations promoting health information and technology-enabled improvements in patient and business outcomes through sharing evidence-driven best practices on implementation strategies, workflow design, change management and patient engagement.
“Duke Health has created a blueprint for reducing potential opioid dependency by leveraging IT to standardize patient recovery from surgery,” said Jonathan French, senior director of quality and patient safety at HIMSS. “The standardized patient care process for colorectal surgery empower peri-op nurses to order alternative pain management therapies for recovering surgical patients. This avoids unnecessarily exposing patients to opioid treatments, which lowers the risk for dependency. HIMSS is proud to recognize Duke Health as a Davies Award of Excellence winner for their thoughtful application of information and technology to address clinical and public health challenges for their patients.”
"Duke Health is committed to providing the highest quality patient-centered care to the community we serve,” said Jeff Ferranti, MD, chief information officer for the Duke University Health System. “This commitment is predicated on a spirit of continual learning, teamwork, and ongoing process improvement. We are honored that the Davies committee has recognized the close collaboration between IT and clinical operations that is necessary to support this goal."
Duke Health will be recognized during the 2019 HIMSS Global Conference & Exhibition, which takes place February 11-15 in Orlando, Florida.
Learn more about how Duke Health has embraced the value of health information and technology: explore three award-winning use cases.