Children’s Hospital of Pittsburgh tailors HIT to support care

Electronic health records and other health information technology are helping Children’s Hospital of Pittsburgh of UPMC tailor care to its patients.

The health organization, the pediatric service provider for UPMC, has been fine-tuning its technology to meet the needs of patients, and the caregivers that take care of them both in the hospital and in post-acute care settings.

Srinivasan Suresh MD, chief information officer and chief medical information officer at Children’s Hospital, contends that "children are not little adults" and their care is tailored at the facility to their unique needs, and the facility has designed and used information systems to support patients’ special care needs.

In recognition of its efforts, Children’s Hospital has revalidated its Stage 7 certification on the HIMSS Analytics Electronic Medical Record Adoption Model. Its Cerner electronic health record system was first implemented at the facility in 2002, and in 2009, it became the first pediatric hospital in the country to achieve a Stage 7 Award from HIMSS Analytics. Overall, less than 5 percent of hospitals in the United States have achieved Stage 7 certification.

In addition, the facility has been recognized by KLAS, an independent healthcare research organization, as the top pediatric hospital in the country for its use of healthcare information technology.

In 2015, the facility reported more than 12,000 inpatient stays, nearly 80,000 emergency department visits and more than 1 million outpatient visits.

Also See: Children’s Healthcare reaches HIMSS Stage 7 of EMRAM

Embedded clinical decision support tools in the hospital’s EHR have significantly reduced potential medical errors and streamlined care delivery processes for pediatric patients, Suresh says.

"We have a tool to identify sepsis in children, which is itself different than sepsis in adults," he says. "The screening system in our emergency department, which is the busiest in Pittsburgh, serves as an indicator for our physicians and nurses that a specific patient may be at risk for sepsis."

Further, Suresh notes that Children’s Hospital has a similar tool used in screening patients for child abuse. On the inpatient side, he adds that the facility leverages a scoring system to better predict clinical deterioration in pediatric patients, based on vital signs, lab tests and other metrics.

“The hospital’s use of analytics to assist physicians in performance review has clearly improved their quality metrics,” said Philip Bradley, regional director of North American healthcare advisory services and operations at HIMSS Analytics. “As an example, incorporating the appendicitis care dashboard in their workflow has reduced the mean length of stay for children with complicated appendicitis by 29 percent, and readmission rates for appendicitis have dropped from 6 percent to 2 percent.”

Children’s Hospital has successfully worked with its surgeons to create a standardized way of managing appendicitis, Suresh adds. "We were able to monitor that by building a dashboard," he observes. "Our plan is to apply this care model to other conditions, such as asthma and pneumonia."

Also See: Nicklaus Children’s Hospital gets HIMSS Stage 7 award

In addition, he says the hospital's Neonatal Intensive Care Unit has developed a human milk tracking application for newborn patients by leveraging barcode technology.

"Human milk is a medicine and needs to be treated as such," claims Suresh. "It needs to have all the precautions like any other medication administered to a child, including the 'five rights' of medication administration--make sure it's the right patient, right medication, right dose, right route and right time. We barcode the milk and store it so the right mother's milk goes to the right baby."

Looking ahead, Suresh says the technology area that the hospital continues to explore is patient-generated health data.

"When kids go home, we want to find a way to monitor them and get infomation so that we can actually prevent a (future) hospital stay. That's where wearables and sensors come into play," he says. "For you and me, we could just use a Fitbit and it will be fine to get the data. But we have to think differently ·with our patients) because these are children."

Children’s Hospital will be recognized later this month at the 2017 HIMSS Conference and Exhibition in Orlando, Fla.