Getting the Recognition You Deserve with Better Data

The Rothman Institute started 30 years ago and has grown to include over 130 specialty orthopaedic doctors. There are locations all throughout Pennsylvania and New Jersey, but for this story we head to Bensalem, PA. A town just outside of Philadelphia. This specialty hospital is known for excellent patient outcomes. But capturing and reporting on those excellent outcomes wasn’t always easy for them.

Rodney Welch, the Director of Quality and Accreditation at Rothman Orthopaedic Specialty Hospital, picks up the story from his office in Pennsylvania. 

Rodney:

When I first arrived here six years ago, we used Medicare’s CART product for our abstracted Core measures. It was an all manual process which included CART download, install, measure selection, keystrokes to build patients followed by keystrokes to complete abstractions. When the abstractions were done, the next step was tabulating cases in preparation for entering Population and Sampling in QualityNet. It was an enormous amount of time spent typing. Then there was the stress – did we install the correct software version? Did we miss a deadline?  Did we abstract everything we were supposed to? There was a lot of anxiety back then.

So, when did you come to the conclusion that you needed help?

I wasn’t looking for a solution to be quite honest with you. My perspective was that the CART solution fit our small hospital – that paying for a vendor to help didn’t make sense with our narrow scope of orthopaedic-only services. But when I saw a demo of the ENCOR product I recognized an opportunity to achieve a comfort level for regulatory compliance that would reduce stress and free up resources.

And did it help?

Yes! Medisolv came in and delivered a product that has dramatically reduced the amount of time that we spend on chart abstractions. The software compiles most of the data, leaving our team with one or two fields to complete. It’s an enormous time saver for us.

On the electronic side, now I have all of these metrics that CMS and The Joint Commission require us to measure and monitor already aggregated in the product. I’m able to go in and look at different time periods and actually see which patients are falling out of the measures. Then I can drill deeper to determine why that patient fell out. ENCOR helps me drive improvement on all of those measures in an incredibly easy way.

So how has the abstraction process changed for you?

As I said, we used to use CART, which caused anxiety. Sometimes you had to wait for Medicare to release the software and meanwhile your patient work is stacking up. The submission window didn’t change either. You still had to meet a certain deadline. It’s important that you try to stay current when you’re doing all of that manual work and it never seemed to end. So, when Medisolv came on site to show us the new product, all of that anxiety was gone. It was so obvious that this was going to save us a lot of time.

The product is so easy to use that we are consistently current with the abstraction piece. It’s always at a 100% completion rate now. The system aggregates all of that patient information automatically. When you go into the product the patient information is already in there. ENCOR has simplified the process for us.

And on the electronic side?

Before ENCOR, we were attempting to extract the data manually from our EMR. We use MEDITECH, which is a fantastic product. The problem is that a lot of reporting you have to build yourself. We just didn’t have that talent on site. The system came with a lot of reports that are very valuable to us, but when we needed unique reports or one-off reports we would have to build those. We’d find ourselves exporting raw data and trying to manipulate that into an excel file, which is a laborious process, especially if you have to replicate that each month.

So, when ENCOR came in, I thought ‘This is the critical stuff that CMS is looking at and they’re going to base payment to us on these particular measures. Now I have a way, in almost real-time, of assessing each one of those measures independently.’

I review both Meaningful Use Objective measures and eCQMs. I look at those measures individually and try to determine why the patient fell out of the measure. I can drill down into the patient details to figure it out.

This allows me to drive process improvement in the hospital. I go to those caregivers and help them understand where they could improve. It enables me to see my data and narrow in on the problem. It makes my life much easier and I can make more of an impact on our hospital’s performance with Medisolv’s ENCOR products.

What was the implementation process like for you?

When we got involved with Medisolv we were really under the gun. It was the end of 2016 and we had to submit our 2016 eCQM data to CMS by February of 2017. That was the beautiful thing about Medisolv coming in and partnering with us; they told us they were perfectly capable and had the resources to pull it off and then they turned around and did exactly that.

Let's wrap this up by sharing an example about how you used ENCOR to improve the performance of your hospital.

Sure. Let’s take Medication Reconciliation for instance. The process we follow at our hospital involves patients coming in for a pre-admission testing visit. In that visit, nurses capture all of the patient’s home medications in the EMR. Then when the patient comes in for surgery, the doctor or nurse practitioner must address each medication during that inpatient stay. That process was not occurring perfectly – we were performing in the 50^th percentile. I knew that our medical staff was engaged in the medication reconciliation process, but their work wasn’t reflected in the measure as shown in ENCOR. Using ENCOR, I was able to look at the measure weekly to provide timely feedback to the medical staff. Using this measure information for ongoing dialogue, we were able to move that needle in a very positive direction – we are currently at a 95% compliance rate for Medication Reconciliation.