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  • January 06 2011

    Making Meaningful Use Meaningful

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    John Bluford, President and CEO of Truman Medical Centers, was the keynote speaker at Cerner's first Meaningful Use Summit here in Kansas City last spring. During his presentation, two of his statements struck me. First: he wasn't sure how they were going to achieve all of the MU requirements, that they had to do it, and that he was depending on Cerner and the partnership between the organizations to make it happen. And second: the doctors would not go along with the MU initiative for financial or government requirement reasons alone - there MUST be benefit to them and their patients for them to buy in.

    John's messages were key motivators behind our incorporation of MU into Cerner's Vision Center Experience Theater, our client presentation suite where we showcase our solutions and healthcare model. We wanted to show the participants what it looks like when they achieve each of the MU mandates and help them understand the benefits that others have achieved as a result. Our mantra became “Making Meaningful Use Meaningful."

    One of the Meaningful Use requirements (in my own words) is to implement one clinical decision support rule. In the Experience Theater, we demonstrate how this is possible with the example of sepsis control. Sepsis is a major problem in the US. 300,000 patients develop sepsis per year, and 60,000 of them die as a result. In our presentation, we demonstrate a goal of keeping a patient's temperature below 37.8 C as elevated temperature is one indication of possible sepsis.

    We discuss what Methodist Healthcare in Memphis did to automate detection and notification of probable sepsis development in a patient using clinical decision support rules. By automatically evaluating vital signs as they are documented for a patient, at-risk patients are identified and the Rapid Response Team is notified to take action. Without this rule, the Rapid Response Team has to manually review each patient's chart to look for patterns in vital signs and lab tests that signal a problem - a needle in a haystack, so to speak. They must identify the problem and begin treatment within a 6 hour window before irreparable organ damage and probable death occur.

    By implementing clinical decision support rules, clinicians are automatically alerted when the pattern is recognized for a patient at risk of sepsis. The result: 17% decrease in mortality and a 2.9 day length of stay decrease (17.5 to 14.6 days) on patients that developed sepsis because they were identified early and treatment was started sooner. That is benefit for the physician and the patient. That is making Meaningful Use meaningful.

    Methodist Healthcare shared their process and results with other Cerner clients through our online collaboration tool. Another client picked it up and improved on it, automating the alerts even further by sending them to the iPhones of their Rapid Response Team. Better medicine through collaboration!

    From there, Cerner's consulting team connected with Methodist Healthcare to discuss opportunities for improvement. Methodist wanted a way to help physicians determine appropriate sepsis therapy, which varies depending on the original site of infection. Cerner developed a tool that asks the physician for the site of the infection's probable origin and then provides an evidence-based therapy action choice. Remember John Bluford's need to have benefit to the physicians and to their patients? That's making Meaningful Use meaningful.

    As Director of the Cerner Vision Center Experience Theater, it is energizing to have clients rave about how we have brought Meaningful Use to life with real examples from our own clients. Helping clients achieve the MU requirements will have a very positive impact on our clients' staff, patients AND their bottom line.

    Francie McNair-Stoner, MT (ASCP), Director in Marketing, is responsible for the Experience Theater where Cerner solutions come alive for clients, prospective clients, investors and associates. With 26+ years at Cerner, Francie was a key member of the initial icon Cerner presentation in 1991. She has a diverse clinical background, including lab, radiology, emergency medicine and office management, she has run the product management aspects of design in the early to mid- 90's, designed and delivered presentations in the field, managed Cerner's presentation team, served as Vice President and Managing Director for the Emergency Medicine solution and some of the newer emerging solutions 1999 through 2004. With strong relationships with clients around the world, she enjoys speaking with executives and users about their aspirations and showing them what they can do with Cerner. Francie holds a Bachelor of Arts in Microbiology and a Bachelor of Science in Medical Technology from the University of Kansas.

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