At New York-Presbyterian, it’s not just about implementing an electronic medical record system. It’s about putting patients first, improving their experience and care by using the latest advances in health IT. To support this “patient-first” philosophy, New York-Presbyterian has invested in an innovative real-time data aggregation solution and personal health platform to build the first truly connected health system, empowering patients to more effectively and efficiently manage all aspects of health, wellness and care.
This connected health system, called myNYP.org, offers patients the ability to view and control personal medical information that’s typically only controlled in the enterprise setting. Lab results, EKG scans and other data can be proactively copied, with built-in security and privacy measures, into a patient’s PHR.
Made available without charge, myNYP.org is now open to cardiology and cardiac surgery patients at New York-Presbyterian Hospital/Columbia University Medical Center as part of the pilot. Patients can use myNYP.org to manage the health of their families, learn about their health and healthcare, and interact with the hospital, for example, requesting appointments and paying bills online.
“The myNYP.org personal health record represents a significant step in the journey to create a completely connected healthcare system, from hospital to community, with the patient at the center,” says Dr. Herbert Pardes, president and CEO of New York-Presbyterian. “When patients can easily share their medical record with their physician or hospital, it reduces the need for excess paperwork and testing, which could mean lower costs, improved outcomes, reduction in medical errors and better care.”
The health information provided by myNYP.org is annotated with customized explanations to help patients understand their medical tests and procedures, providing information about normal and abnormal test results, in an interactive way, as if the physician was there to answer questions.
As a part of this connected health system, NewYork-Presbyterian launched the Sternal Wound Infection Tracking project to help decrease infections of post-op cardiac surgery patients. With visibility to real-time data, physicians realized they could make improvements, including:
- Conduct data review in weekly quality group.
- Revise clinical protocols to address findings.
- Develop new targeted order sets to reduce variations in care.
- Monitor patient returns to intensive care.
While still early in its journey, what NewYork-Presbyterian has accomplished sets a new bar in the industry. According to KLAS, no other hospital has successfully opened up the data in its myriad back-end systems, combined it and delivered it in one consolidated record to the patient. And this has been done in six months and for a fraction of what most hospitals spend.
Craig Smith, a cardiac surgeon at New York-Presbyterian Hospital, insists that “medicine is a performing art, and you’ll never end variance.” He concedes that he used to see HIT as more of a nuisance than a help. But in the past year, patient-centric EHRs, clinical-decision support systems and hospital-analytics software have become so user-friendly and useful that he is now an enthusiastic convert: “When you get HIT right, a doctor is no longer limited by the lessons of personal experience.” (Economist, April 2009)
Currently, the project requires resources including three project leads, four database managers, and several people overseeing the strategic direction of the rollout and management of the ongoing program. Additionally, New York-Presbyterian works closely with the vendor that developed the technology infrastructure. While the infrastructure exists to use the technology across the entire spectrum of clinical services, developing the specific analytics for different clinical teams requires further build out.
New York-Presbyterian also formed a user group comprised of nurses and physicians that provide feedback to ensure the technology has the right fit with the user base. As the rollout continues institutionwide and across all service lines, New York-Presbyterian expects increase resources to 15-20 people. This will include the addition of analysts, database experts and clinical staff.
The institution has a long-range IT strategic plan, reviewed and approved by its board of trustees, calling for hundreds of millions of dollars in spending over seven years. This well-planned and strategic approach will be funded through numerous sources including vendor partnerships, the institution’s capital plan, grants, and harvesting technical improvements to redeploy resources to new areas. As part of New York-Presbyterian’s strategy to obtain funding from the American Recovery and Reinvestment Act, they have a dedicated group actively looking at monies as they’re released, determining requirements for applications.
New York-Presbyterian also works collaboratively with its universities in obtaining various challenge grants, and is interested in work on comparative effectiveness. The organization has a roadmap in place so that it can hit the ground running as soon as it is awarded additional funds, and is closely tracking funds awarded at the state level.
The foundation of New York-Presbyterian’s EMR dates back to 1995, meaning the institution has had more than 10 years to work with its vendors to perfect training, rollout, support and workflow/business redesign. And, since this is not a homegrown system but rather utilizes widely available vendor products, it is one that can be obtained and implemented by other healthcare institutions so they can benefit and learn from New York Presbyterian’s groundwork.
In combination with the successful implementation of an enterprisewide EMR with CPOE, MD/RN documentation, and quality/benchmarking metrics, a data aggregation solution and personal health record; great steps have been taken towards the improvement in the quality of patient care. From New York-Presbyterian’s perspective, this is an important aspect of “meaningful use.”
