STAGE 7 SPOTLIGHT Children's Mercy Kansas City: Achieving a 0% Mortality Rate for HLHS Patients
There's a reason healthcare organizations have turned to the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) for guidance as they map out their plans for health IT advancement. The EMRAM provides clear benchmarks for HIT implementation and helps organizations improve the quality of healthcare, organizational efficiency and patient safety.
Achieving Stage 7 validation of the EMRAM means that an organization has achieved a near paperless healthcare environment, and it acts as a testament to an organization's commitment to better patient outcomes, better patient experience and lower costs overall. As an example of these gains, let's dive into the Stage 7 Achievement process of Children's Mercy Hospital.
Located in Kansas City, MO, Children's Mercy Hospital (CMH) has 367 beds and employs more than 750 doctors. Yearly, they experience about 352,286 outpatient visits, 191,500 ER/UC visits and 14,190 admissions across their two hospitals. When CMH began the Stage 7 validation process, they were struggling to reduce the mortality rate of babies diagnosed with hypoplastic
The Clinical Director at CMH knew there had to be a better process, not only to improve the quality of life for babies with this condition, but to also increase their chances for survival.
The EMRAM Implementation
CMH's Clinical Director responded to this challenge with the idea of the Cardiac High Acuity Monitoring Program (CHAMP). This allows families to enter patient information into a mobile app that is connected to a database in the Microsoft cloud. This information is then analyzed in real time via the cloud, and any measurement that is outside of the healthy cardiac parameters will automatically alert the medical team.
After the initial trial began in March 2014, the app was then presented to other HLHS care centers. In January 2016, Seattle Children's Hospital began using the app, and in 2017 seven other children's hospitals enrolled in the program, with a future goal for 12 more hospitals to enroll by the end of 2018.
The use of the CHAMP app for HLHS patients at all sites has resulted in a significant drop in mortality rates; the average rate has dropped from 20 to 4 percent. At CMH in particular, the average mortality rate dropped to 2 percent — and since March 2017, the mortality rate has been at zero percent.
In addition to the many lives the CHAMP app has saved, CMH has documented a decrease in readmission overall, as well as significant cost reductions. Changes in cardiac parameters are able to be monitored in real time, therefore, treatments can be modified at home which helps avoid further hospital visits.
The clinicians at CMH learned that when clinicians and information systems staff work together, an idea can become reality, and patient outcomes can drastically improve. They learned to use the technology, innovation and resources available to them to save lives and encouraged other organizations to actively look for quality improvements in patient care.
CMH's experience and resulting success are just one more example of the proven benefit of the EMRAM Stage 7 validation. Healthcare organizations can use the EMRAM as a roadmap to increase efficiency, improve patient care, reduce overall costs and, like CMH, potentially cut the mortality rate of certain populations down to zero.
“This case study proves the direction that healthcare is moving with an omni-channel experience and the patient/customer as the primary focus,” said David Chou, Vice President, Chief Information and Digital Officer at CMH. “The CHAMP app and the CHAMP program has taken a group of high risk congenital cardiac patients and increased their quality of life as well as improving their chances for life.”
left heart syndrome (HLHS).
With the highest mortality rate of all congenital heart anomalies, HLHS is a condition where babies are born with a single ventricle in their heart. Babies with this condition have an increased risk of mortality (10-25 percent) between the first and second stage of a multistage surgical repair process. Nationally, the post-surgery monitoring standard involves the parents weighing the baby with a scale, using an oxygen saturation monitor and then documenting any changes in a three-ringed binder. However, this process has proven to be ineffectual in decreasing mortality rates.