Electronic Health Records

What healthcare technology helped contain MERS in Indiana?

The first reported case of Middle East respiratory syndrome (MERS) in the United States occurred at Community Hospital in Munster, Ind., but thanks to the thorough the implementation of three healthcare technologies and collaboration of the organization’s staff it was swiftly contained.

There three systems were video surveillance, an Epic EHR, and a Versus real-time locating system (RTLS). As the hospital’s CMIO Alan Kumar, MD, told EHRIntelligence.com in an interview this past week, the ability of these technologies to work in concert identified potentially dangerous information gaps.

“That’s where the combination is additive and not conflicting,” he explains, “The EHR picked up some folks who didn’t have tracer tags and the tracer tags picked up some folks who didn’t document in the EHR. And the tracer tag system is sensitive. If you stand right in front of the door, it will say you went into the room even if you didn’t. It doesn’t always but it might trigger that you went in. That’s where video surveillance was of some value in going and making sure.”

Each of the three systems provided valuable information, but none was entirely comprehensive in the information it contained. Video surveillance is obviously limited by the number and location of cameras; the EHR only provides details when documented in the system by an end-user; and the RTLS assumes that a clinician is wearing her tag and is where it claims her to be.

What the hospital’s response to the MERS patient illustrated was its commitment to understanding and documenting flow, for providers and patients. The EHR adoption process at Community Hospital may only be a few years in, but it is already yielding serious benefits.

The Indiana hospital has already achieved a Stage 6 designation on the HIMSS Analytics EMRAM and is poised to demonstrate Stage 2 Meaningful Use soon. Its design was driven by a strong emphasis on what Kumar calls “flow dynamics.”

Once the diagnosis was made, the question was how to best identify the healthcare workers who had been exposed prior to full isolation precaution.

“The EHR was very valuable in terms of how we designed the process in the build to help us with flow dynamics,” he reveals. “It’s very important as the institution grows to develop flow dynamics that help you get the patients in, through the system as efficiently as possible, and then home or to other healthcare as needed. Because of that, we were able to track touches with the patient by a multitude of providers.”

Although its Epic EHR played an important role, it was its use of radio-frequency identification (RFID) that was truly unique during the hospital’s interactions with the Centers for Disease Control (CDC).

“The CDC was particularly impressed and thrilled that they had data on the exact amount of contact per provider,” Kumar continues, “which is data they never had before in any investigation of this type because they never had a GPS- or RFID-style system that tracks time in room.”

According to Versus President HT Snowday, that system is likewise focused on flow.

“What we’re able to do is optimize every single moment in a caregiver’s environment by providing situational awareness information, by providing up-to-date information about where a patient is in a process or where a caregiver, equipment, or piece of information is,” he says. “In doing so, you make patients safer and reduce costs for the healthcare facility.”

The fact that the first American MERS patient was released from the hospital this past weekend and that healthcare staff will be making their way back to work is a testament to the organization’s commitment to quality for patients and providers.

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