STAGE 7 SPOTLIGHT Healthe at Cerner: Using Clinical Data to Empower Patients

HIMSS Analytics

Achieving EMRAM Stage 7 is no simple task. Stage 7 requires a near-paperless environment; the use of clinical data to improve the quality, safety and efficiency of patient care; quick and secure exchange of information between clinicians, departments and facilities — and more.

However, following the EMRAM roadmap to validation is certainly not impossible, and the potential gains in efficiency, revenue and patient outcomes are unparalleled. As a great testimony to these gains, let's dive into the Stage 7 Achievement process of Healthe at Cerner.

The Challenge

Located in Kansas City, Missouri, Healthe at Cerner provides health and care services to over 34,000 Cerner Corporation associates and dependents in 26 different countries. Four of these include onsite health clinics that are tightly integrated with a retail pharmacy, capturing 60% of member prescriptions filled in the Kansas City Area.

When Healthe began their Stage 7 validation, they were struggling with low adherence rates for their members diagnosed with a chronic Asthma or COPD condition, due to the expense of filling prescriptions. As a result, expenses from services such as urgent care, ER visits and hospitalization increased.

The Implementation

In 2015, Healthe began enrolling members in a pharmacist-led Asthma or COPD management program. Using EMR system data, pharmacists were able to target members based on their past usage of rescue inhalers. During the program, the patients met with pharmacists for individual Asthma/COPD control tests to assess the patients' current management of the chronic respiratory condition.

After the assessment, pharmacists were able to make suggestions to the patients' primary care physicians, including changes to medications, recommendations for immunizations and other devices to help patients self-manage their conditions. Patients enrolled in the program had their inhaled corticosteroid (ICS) prescriptions covered 100 percent by the health plan. In the first year, 1,504 health plan members joined the program, growing to about 1,562 by 2017.

The Results

Healthe at Cerner found that giving patients the education and resources they needed to self-manage their conditions significantly decreased the need for urgent care or follow-up appointments. As Dr. David Nill, MD, Vice President and Chief Medical Officer of Healthe at Cerner, said, “These programs are leading to greater adherence of patients to prescribed preventative medications and ultimately to reduced ED visits or hospitalization.”

Other key findings include:

  1. 75 percent of patients who took the control test more than once were able to maintain or improve their scores.
  2. A satisfaction survey found that almost 100 percent of their patients felt empowered to self-manage their asthma after engaging in the program.
  3. Healthe was able to standardize recommendations and use analytics reporting tools to quickly and accurately track clinical outcomes.

Additionally, Healthe was able to rework and optimize some of their processes by expanding their EMR training plan with their pharmacy team and developing a better process for appointment documentation. Physicians, in general, were comfortable giving pharmacists more autonomy in managing these chronic conditions and they were able and willing to make adjustments to meet these new needs.

The Takeaway

Bottom line: The EMRAM validation process is transforming healthcare. In Healthe at Cerner's case, the use of clinical data enabled them to empower their patients to self-manage their chronic conditions; optimize their training, appointment documentation and recommendation processes; and reduce the need for services like ER visits, urgent care or hospitalization. They're now able to direct the money, effort and resources they saved from reducing the need for follow-up care toward other clinical and operational goals.

Like Healthe at Cerner, healthcare organizations can use the EMRAM as a roadmap to define their current needs and challenges, create a plan for meeting those needs and implement that plan as quickly, efficiently and successfully as possible. Ultimately, by working toward Stage 7, healthcare organizations are moving toward the goal of lower cost, better health for populations and increased patient satisfaction.

Case Study