Dr. Banas Helps His Medical Center Harness the Power of Health IT
Dr. Colin Banas is an internal medicine hospitalist and Chief Medical Information Officer at Virginia Commonwealth University (VCU) Medical Center, a major academic health system located in Richmond, Virginia. The medical center is comprised of over 800 beds and has over 500,000 outpatient visits per year. As the leader of the Office of Clinical Transformation, Dr. Banas is part of a unique group of clinicians and support staff who drive innovation and health care quality improvement at VCU Medical Center.
Integrating Data from Multiple Sources Led to Data Overload
In 2004, the medical center adopted a system-wide electronic health record (EHR) platform. Despite some noticeable improvements in efficiency, Dr. Banas and his fellow clinicians felt overwhelmed. “We found ourselves awash in a sea of data from multiple sources, including laboratory values, pharmacy data, and vital signs as well as documents from nurses, physicians, therapists, and other clinical providers,” explained Dr. Banas. In a health system with nearly 500 eligible outpatient providers and an 800 bed inpatient facility, teasing out the data providers needed to deliver more consistent care and improve health care quality was a major challenge for Dr. Banas and his colleagues. The Office of Clinical Transformation was tasked with finding meaningful ways to put VCU Medical Center’s EHR data to use.
Health IT Dashboards Make Vital Information Available and Actionable
VCU Medical Center’s EHR enabled the organization and its providers to access an incredible amount of patient data, but the data was not always useful or actionable. Dr. Banas believed he and his colleagues could make VCU Medical Center’s EHR data more digestible by distilling important patient information into simple, easy-to-understand Health IT dashboards. “We created a custom, homegrown, and real-time safety dashboard,” explained Dr. Banas. The Safety Dashboard pulls data directly from the EHR system and displays the data so providers can quickly and efficiently review patient safety information for each of the medical center’s patients. The dashboard includes several data points – such as fall risk, whether the patient needs physical restraints, and overdue vaccinations – on a single screen. “The dashboard is intuitive and easy to use. You don’t have to struggle to understand it,” said Dr. Banas. This dashboard is used by clinicians during rounds and safety huddles.
In addition to the Safety Dashboard, Dr. Banas and his colleagues created a dashboard called the Medical Early Warning System (MEWS). MEWS aggregates vital signs data and other critical health indicators to help VCU Medical Center’s providers identify patients with the highest risk for serious complications and potential decline. Using MEWS, the medical center’s rapid response team targets high-risk patients and intervenes before complications occur. “The rapid response team uses the dashboard as a compass to determine who to visit and intervene upon,” explained Dr. Banas. “The rapid response team does not wait for a distress call; they help to prevent it from ever occurring.”
Both the Safety Dashboard and the MEWS are vital for VCU Medical Center because they enable clinicians to quickly and efficiently understand each patient’s story and “deliver more consistent, higher quality care.”
Dashboards Improve Patient Outcomes
The Safety Dashboard and MEWS are part of the triad of “people, process, and technology,” which is improving health care quality and patient outcomes at VCU Medical Center.
- Patient falls with injury have decreased by 50%.
- Use of physical restraints has decreased by 50%.
- In-house mortality has decreased by 8%.
- “Code blues”– incidents when patients are in need of immediate medical attention/resuscitation – have decreased by 10% in the health system as a whole and by 23% outside of the Intensive Care Unit.
After seeing the many benefits of Health IT, Dr. Banas and VCU Medical Center are planning to continue using EHRs to improve patient outcomes and health care quality. One of Dr. Banas’s main goals is to help many of VCU Medical Center’s outpatient primary care offices become National Committee for Quality Assurance certified Patient-Centered Medical Homes. “Patient-Centered Medical Homes are in line with our vision as a health system to continually improve patient outcomes,” explained Dr. Banas. Dr. Banas and VCU Medical Center are also interested in aggressive population management to reduce readmissions and the overall cost of health care.