Value-Focused Hospitals Look Beyond EMRs For Clinical Surveillance
By David Goldsteen and Erik Johnson, VigiLanz
More hospitals are adopting clinical surveillance solutions, but those that report the highest interest and involvement in value-based care are adopting third-party solutions rather than relying solely on EMRs or in-house solutions.
Hospitals and health systems that rate quality above all other priorities are looking to third-party clinical surveillance solutions, rather than solely relying on EMRs, to drive improvements in care quality. They also say these solutions help improve patient outcomes and their bottom lines.
That’s according to a new survey of 100 healthcare executives at hospitals of various sizes across the country. The survey, conducted by Baltimore-based consultancy Sage Growth Partners, sought to identify how organizations are using EMRs and clinical surveillance solutions to support higher-value care. Most survey respondents were CEOs, CFOs, CIOs, CMOs, and CNOs.
Clinical surveillance solutions offer insights that support patient care interventions and more optimal patient care decisions. The most impactful solutions are those that foster real time, actionable insights in the clinical workflow. The clinical surveillance field and implications are broad. For example, information shared with physicians, nurses, and pharmacists via the technology might lead to preventative or more rapid interventions related to medication errors or medical errors, inappropriate use of antimicrobials, infection control and prevention, and efforts to reduce readmissions, according to survey respondents.
Most hospitals (96 percent) are using some form of clinical surveillance, such as capabilities built into their EMR, an in-house solution, or a third-party solution, according to the survey. Some survey respondents reported using a combination of these methods, such as an EMR and a third-party solution.
Regardless of the solution used, most survey respondents agreed that, unlike many other IT investments, clinical surveillance technology has a true return on investment and a positive impact on quality. Still, there are some noteworthy differences between the type of clinical surveillance solution used, and how involved respondents said their organizations are in value-based care and to what extent they said clinical surveillance impacts quality.
Here are four of the most noteworthy findings:
- Higher quality and the use of third-party clinical surveillance tools have a strong correlation.
Survey respondents who said their hospital uses a third-party solution for clinical surveillance (either alone or in combination with another solution) ranked delivering high quality care as their top strategic priority, followed by increasing efficiency and reducing care costs. For their third priority, they cited improving patient safety.
Respondents who said they solely use an EMR for clinical surveillance, on the other hand, pointed to increasing efficiency and reducing costs as their top priority. Delivering high-quality care came in second, followed by increasing patient safety.
The survey also found that respondents who were using third-party solutions for clinical surveillance were nearly twice as likely to say that clinical surveillance leads to a definite impact on quality than survey respondents who were not using third-party solutions for clinical surveillance.
- Investments in third-party clinical surveillance solutions show strong returns.
The survey found that respondents who were using third-party solutions for clinical surveillance were also more likely to say clinical surveillance leads to a definite return on investment than respondents who were not using third-party solutions (87 percent versus 76 percent).
- Hospitals and health systems that have more revenue tied to value-based payments are more likely to use third-party clinical surveillance solutions.
Of respondents who said they use a third-party solution, nearly 37 percent said more than 31 percent of their revenue will be tied to value-based contracts in 2019. Only 16 percent of respondents who said they rely solely on an EMR for clinical surveillance said this much of their revenue will be tied to value.
In addition, nearly 16 percent of respondents who use a third-party solution said more than 51 percent of their revenue will be tied to value in 2019, while only 4 percent of those who rely solely on an EMR said this much will be tied to value.
- Hospitals and health systems (regardless of what clinical surveillance technology used) cite several ways the technology supports higher-value care.
The three most common uses of clinical surveillance technology reported by survey respondents are:
- Identifying adverse drug events;
- Advancing antimicrobial stewardship initiatives; and
- Patient safety alerts.
But hospitals and health systems are finding a myriad of other uses for clinical surveillance, according to the survey. For example, between 70 percent to 80 percent of all survey respondents said clinical surveillance is also helpful in:
- Preventing inpatient infections;
- Managing readmissions;
- Pharmacy surveillance; and
- Managing communication alerts.
While hospitals have been using clinical surveillance activities associated with infection prevention and medication management for several years, they have only just recently begun recognizing that the value of clinical surveillance goes far beyond these activities.
As Michael Patmas, MD, chief medical officer of Avanti Hospitals in El Segundo, California, says, “When I think of clinical surveillance, I always think first in terms of surveillance for hospital acquired infections, and the microbial flora in a hospital, and knowing what's going on in your hospital from a microbial point of view. But clinical surveillance can actually be much broader, and many areas might benefit from it.”
In a healthcare landscape that changes almost daily, the challenges faced by hospitals are daunting. But tools like clinical surveillance can help. Being good stewards of how care is delivered, measured, and monitored can only improve quality and outcomes, reduce unnecessary utilization, and prevent adverse events.
About The Authors
David Goldsteen, MD, is the cofounder, chairman, and CEO of VigiLanz. He is an industry veteran, practicing clinician, technology leader, and entrepreneur. With more than 20 years of experience as an emergency and administrative medicine physician, David is passionately focused on improving the quality and efficiency of patient care.
Erik Johnson is vice president of marketing and business development at VigiLanz. He is a veteran healthcare technology executive with a broad background in marketing, business development, and digital transformation. For almost two decades, he has worked with hospitals to improve their clinical workflows through the use of technology, ultimately impacting patient care and outcomes. Connect with him on LinkedIn: https://www.linkedin.com/in/erikjohnson22/.