Speeding Up the Abstraction Process

Today, we feature Melissa Folse, quality review clinician at Thibodaux Regional Medical Center and long-time Medisolv client. Here we ask her a series of questions about her use of the Medisolv product ENCOR for abstracted and electronic quality measures.

Cher [sha]: A term of endearment usually used with women, similar to ‘dear’ or ‘sweetheart.’

Sha Bae Bae: From the French and Cajun, Cher Baby, meaning, Dear Baby.

Thibodaux Regional Medical Center is a 180-bed hospital located just south of New Orleans. Can you tell us a little bit more about your hospital?

That’s right. We are located in the small town of Thibodaux, in Southeast Louisiana – right along the Bayou. The current hospital was built in 1975 and has grown tremendously over the last 25 years.

The hospital is a very friendly place to work. It’s almost like a family. We have great support from administration. They do the things they know are going to better the hospital for the benefit of our patients. Our goal is to provide the highest quality of care while also being cost efficient.

So, let’s talk about your current position. When did you start doing abstraction for Thibodaux Regional Medical Center? What was that process like?

I’ve been here for 25 years (I can hardly believe it), but I’ve been abstracting the quality measures since 2009. I actually started out on the Medical Surgical floor for the first nine years or so, then I went into Case Management. After that, I transitioned to Hospital Admissions and when the Core measures started to come to everyone’s attention in 2009, they created my current position.

My goal is to provide high quality patient care with lower readmission rates, lower mortality rates, lower costs and improved patient outcomes all while maintaining a high level of patient satisfaction.

So, you primarily use Medisolv’s ENCOR product for abstraction, right?

Yes, I use ENCOR-a for core measure abstraction. We abstract every admitted patient on a daily basis. And as soon as the patient charts are final coded, they come into the ENCOR product with certain pre-populated data. So, we’re able to abstract them rather quickly. I don’t have to wait until the end of the month, which also means I can educate the staff quickly too.

You have been with Medisolv for quite a while now, can you remember what the abstraction process used to be like before using Medisolv?

Before, it was confusing and time-consuming. With the previous product we were using, we had to actually run a report once the charts were final coded. Then we had to upload that report into the product to get the information there with the codes. Once it was there we could start abstracting measures. 

We had to enter insurance information, adjust the admit date and adjust the discharge date and time. All of that was time consuming. It took three or four steps before the measures were ready to be abstracted. And once it finally populated, we were left with just a long list of patients. You had to click on each patient to see what measure you needed to abstract.

Whereas with ENCOR, everything just pulls in because it interfaces with MEDITECH. And you can sort by what’s completed and what still needs to be abstracted. It saves so much time.

Who initiated the process of searching for a new vendor?

At that time, we had recently hired a new CIO, Bernie Clement. He is great and was really the one that led the charge. He worked primarily with our IT department to figure out what the entire team needed – from the clinical and technical perspectives. 

When it came time to launch the product it was all very seamless. The product was easy to use, very user friendly. Medisolv trained us well. So, it made for an easy transition from one product to the next.

How has the abstraction process changed with the ENCOR product?

Because ENCOR pre-populates select information and the charts are available as soon as they are final coded, we are able to abstract very timely. We don’t have to wait until the end of the month or even the end of the week.  Being able to timely abstract allows us to monitor our results and identify issues. It’s great to be able to meet with a physician and discuss a patient that was discharged last week not three months ago. 

We spend less time on the back end entering demographic information for the patients. Now we can concentrate our time on reviewing the actual measures and abstracting those measures. It also leaves us time to educate the staff for timely improvements to measure performance.

Have you seen any growth personally or within the hospital?

Personally, ENCOR helped me to learn the measures. Particularly when the Sepsis measure came out. It was hard to understand what was or wasn’t considered a failure because it was so new. But when you’re entering the data into the ENOCR product, it will turn red immediately and won’t go any further, meaning the patient failed the measure. When that happened, I would stop and figure out what happened. Why didn’t the patient pass at that point? The real-time visual feedback within the ENCOR product helped me to learn the Sepsis measure. 

We’ve also been able to use the tool to track our progress with one of our care transformation projects we were working on. Our goal was to reduce the number of labor inductions overall and reduce the number of primary C-sections. We implemented evidence-based protocols and used ENCOR to track our results.

We actually were able to decrease our PC-01 Elective Delivery rate by 82% from 4.21 to 0.75. Obviously, we were very happy to offer a safer delivery experience for mothers and newborns.

And, I should also mention our eCQM rates.

Oh, that’s right. Because you also use ENCOR for electronic measures too, right?

Yes, our department has recently been involved with validating our hospital eCQMs. The IT department set it up for us back in 2013 and since then we’ve been working on improving our measure performance.

And even though CMS has not set any goals as to what percentage we should be at for our measure results, we set an internal goal of 90%. Right now, we’re hanging around 97-99%, so we’re happy.

Medisolv always submits our eCQM data to the CMS IQR program way before the deadline and helps us resolve any technical errors or misalignments. It’s always great to be done and not have that hanging over our heads. Now, I just continue on with our validations as usual.

Thibodaux Regional Medical Center is nationally recognized for quality care and service. Tell us about some of the recent awards you received.

We have received HealthGrades Patient Safety Excellence Award four years in a row and Outstanding Patient Experience Award for ten years in a row. We most recently received the Louisiana Hospital Association Safety Star Award for transforming care of the labor and delivery patient for the PC-01 measure that I mentioned before.

I believe that ENCOR has helped us in part with these achievements. In our case, ENCOR gave us great visibility into measure performance and decreased the time we spent entering data. We have more time to be out educating our staff and making sure the patients are getting what they need. By decreasing our abstraction time, it has allowed us more time to be proactive in helping to make the measures successful.