STAGE 7 SPOTLIGHT Loma Linda: Decreasing Mortality Rates of MRSA Patients Through Technology
Recent technology advancements have improved nearly every aspect of human life, and nowhere have those advancements made such an impact as in the healthcare industry. The HIMSS Analytics Electronic Medical Records Adoption Model (EMRAM) has proven to be a highly effective and transformative roadmap for the health information technology landscape at hospitals around the world.
Using the eight-stage model to measure the adoption and utilization of EMR functions within their health systems, healthcare leaders can improve the cost, quality and outcomes of patient care. Let's dive into the EMRAM Stage 7 achievement of Loma Linda University Health of Southern California.
Established in 1905, Loma Linda University Health is a faith-based Seventh-day Adventist organization aiming to "continue the teaching and healing ministry of Jesus Christ" through healthcare. Comprised of eight schools, six hospitals and over 900 faculty programs, Loma Linda offers more than 100 academic programs and provides quality healthcare to 40,000 inpatients and 1.5 million outpatients every year.
Despite being a global leader in education, research and clinical care, Loma Linda had a challenge: The mortality and morbidity rates of MRSA-infected patients was higher than the national benchmark, due to a slow and inconsistent process for attaining and administering vancomycin trough concentrations. These concentrations, critical in the treatment of MRSA, need to be administered as quickly as possible for effective care.
The EMRAM Implementation
To solve for this challenge, the IT team at Loma Linda programmed their Epic EMR system calculations to allow for more rapid and consistent results. At the same time, implementation leaders trained the pharmacists to use the calculator and provide the service; later, pharmacists were given competency tests to ensure the training stuck.
First, they trialled the new calculators on pediatric patients in the ICU and oncology units. When they were able to successfully reduce the time to reach goal blood levels on a consistent basis, they slowly expanded the practice to all adult inpatient units. Loma Linda has begun to implement the same process in pediatric units.
By prioritizing treatment calculations as an EMR function, healthcare professionals were able to quickly, easily and accurately conduct complex calculations that improve the quality and outcomes of patient care. Without this EMR function, the calculations would be too time consuming to be worth the effort.
Groups of patients who were treated using the new calculations saw significantly better results than those treated without the calculations. More than half of patients treated without the calculations reached their blood goals within seven days, as opposed to patients treated using the calculations, of whom 50 percent reached their blood goal levels in the first 24 hours — almost 20 times more effective than the treatments without the calculations. After seven days of treatment with the calculations, 100 percent of the patients had reached their blood goals.
In adult ICU units, the Epic calculator resulted in similar improvements. Sixty percent of patients treated with the new method reached their blood goals within 48 hours, versus only 26.1 percent of patients treated with the traditional method. Clearly, the new method showed superior results.
In achieving EMRAM Stage 7 validation and incorporating treatment calculators into the EMR patient charts, clinicians at Loma Linda were able to improve drug dosing, reduce drug toxicity and reduce the mortality rates of MRSA patients significantly. By rolling out the program with abundant education and support for clinicians and pharmacists, the implementation was highly successful across units and locations.
Loma Linda's EMRAM Stage 7 validation has saved lives, avoided prolonged or additional damage to patient health and significantly reduced the length of inpatient stay. Like Loma Linda, healthcare organizations around the world can use the EMRAM to improve the quality, accuracy and efficiency of their clinical and operational processes for better patient outcomes.