Integrating Clinical Alerts into Clinician Workflows: Houston Methodist’s Approach

Data can help physicians and pharmacists make smarter patient care decisions, but the way in which physicians receive that data plays a huge role in whether the information drives higher-value care.

Physicians benefit most from data that is:

  • Current;
  • Easily integrated into their workflows; and
  • Targeted to their specific needs at that moment in patient care.

Many health systems are struggling to meet these three objectives. In fact, turning data into actionable information is the most pressing health IT challenge healthcare organizations face, according to a recent survey of 100 healthcare executives by Managed Healthcare Executive.

At HIMSS 2019, Nicholas Desai, MD, system chief medical information officer at Houston Methodist, shared how his organization is addressing this challenge.

To view his full presentation, click here.

Houston Methodist—which is made up of seven hospitals, eight emergency care centers, and a large network of more than 6,700 affiliated physicians and 675 employed primary care and specialty physicians—recently embarked on a 90-day pilot to test how integrating clinical alerts into its EMR workflow could help physicians and pharmacists make more cost-effective, higher quality care decisions.

About 130 clinicians and 38 pharmacists were involved in the pilot, said Desai, during his presentation at the VigiLanz booth on Wednesday, February 13.

The alerts were pulled from a variety of sources, including Houston Methodist’s own data and data from its partners, such as VigiLanz. The alerts were integrated into the EMR workflow via IllumiCare’s Smart Ribbon.

“The ribbon is an executable file that sits right on top of our [EMR]. It aggregates data and everything right from our [EMR], but the best part is it pulls it all together in one place,” said Desai. “I can call it up when I want it, I can force it to be passive or active.”

Two Tips for Effective Alert Integrations

  • When integrating alerts into the EMR, consider passive and active alerts that you want to make front and center. For example, if there are five drugs your organization is watching and monitoring closely, consider how you can use alerts to highlight those as top of mind for clinicians.
  • Bring various stakeholders to the table to help determine what type of alerts and data should be integrated. For example, if your organization’s PDMP task force is involved, it might reveal that integrating PDMP-related reports is key.

Pilot Results

The results of the pilot are impressive. The organization was able to shift the cost curve within the 90-day mark about $107,000, said Desai.

“Overall, we believe that in 2019, for this hospital, we have an opportunity of 4.5 percent reduction in our costs, which will lead to between $1.7 million and $2.8 million, just for one hospital,” he said. “As an organization, it’s upwards of what appears to be closer to in the ballpark of $18 [million], $19 [million], $20 million dollars.”  

Desai said the VigiLanz alerts in the Smart Ribbon are also extremely helpful to pharmacists, because they can see alerts directly in the EMR without needing to go into the VigiLanz app to view them.

“The reality here is we’re giving [clinicians] tools and working with partners like VigiLanz and Illumicare to really bring together the efficiency tools that our providers need,” said Desai. “That’s what matters.”

To learn how health systems are using clinical surveillance to support high-value care, read: “Clinical Surveillance: The Next Step in Value-Based Care.”

Perhaps most importantly, clinicians responded very favorably to the integrated alerts. “Seventy-two percent of doctors, at the end of our pilot said, ‘This is not just valuable, finally you’re giving me a tool that is meaningful,’” said Desai. “In every one of those conversations, cost was important, but not the only reason why they liked the tool. What they liked about it was that this allowed them to see things in a more holistic view in one place.”