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Commentary

Penn Medicine's Tech-Enabled Culture

Six steps to making technology an integral part of a large healthcare organization.
4. Project Management: We assigned dedicated project managers to each of our physician practices during IT implementations. This approach showed physicians we cared about their success and built positive relationships. Our IT employees learned about their clients, ensuring that the solutions we proposed were the right ones for each practice.

5. Executive Support: Our CEO, Ralph Muller, has identified information services as vital to supporting the organization’s strategic goals. IS holds a place of prominence in our strategic plan and Clinical Blue Print for Quality. Muller regularly cites findings from the Annals of Internal Medicine that a 10-point increase in automation is associated with a 15% decrease in the mortality rate for myocardial infraction and cardiac surgery, and that higher automation is associated with lower complication rates and costs. Muller has been key in transitioning IS from a predominantly outsourced and decentralized organization focused on service levels to an in-sourced, centralized department focused on service. He also supported a more than doubling of investment in IS from $46 million in FY2006 to $95 million in FY2011.

6. Solid Infrastructure: We've created a comprehensive infrastructure, including WAN, wireless, and mobile, that ensures reliable, high-speed, and stable connectivity. Access to patient information can now take place from virtually anywhere.

The investment in and commitment to a world-class IS operation has generated a number of positive results, including:

>> A 38% decrease in preventable deaths over several years, ranking the Hospital of the University of Pennsylvania as a national leader in this category, due in part to electronic alerts in patients' EMRs. For example, the system requires clinicians to consider the risk of venous thromboembolism for all patients they admit and offers support ordering prophylactic medications.

>> Reduction in many hospital-acquired infections by introducing evidence-based initiatives whose outcomes are built into the inpatient CPOE system.

>> A 50% improvement in the appropriate use of blood thinners and a 10% reduction in complications through the introduction of evidence-based order sets that were designed by physicians and IS staff.

>> Increased internal hospice referrals within the health system by more than 24% in a 12-month period supported by changes to inpatient discharge documentation and electronic referrals.

>> Increased ambulatory patient volume by 6.8% through the opening of the new Perelman Center for Advanced Medicine facility, which uses an EMR system throughout the facility.

>> Improvements in patient flow based on IS interventions that have resulted in significant decreases in length of stay, transport time, and bed-turnaround time.

Penn Medicine continues to build on its efforts to use technology to improve patient care and research. IT use in these areas has become ingrained into the Penn culture. While the investment isn't inexpensive, and the time involved is significant, the results have made it all worthwhile.

Michael Restuccia is VP and CIO of Penn Medicine, a $3.8 billion-a-year academic health system with nearly 2,100 physicians providing services to the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Pennsylvania Hospital, and more than 250 ambulatory practices.