The Mayo Clinic in Jacksonville, Fla., which has been paperless since 1996, uses data-collection and analysis software called PowerInsight from Cerner Corp. PowerInsight pulls data from Cerner transactional applications such as patient scheduling and laboratory-test ordering software. Last year, clinic administrators began analyzing the data to understand what patients the clinic serves, by age, payer class, and other demographics, and for what ailments.
The clinic is adding more clinical information to the data repository to closely examine such questions as how long patients stayed and the results of their treatments. Once that's complete this spring, a surgeon, for example, can see how many patients had postoperative infections and if they had anything in common. "That way we can get a better view of what our patients experience here," says Reg Smith, vice chairman of the applied informatics department.
The next big step is helping doctors and nurses improve care by combining historical lessons with data about current patients. Washington Hospital Center in Washington, D.C., identifies the risks associated with clinical procedures and treatments using reporting and analysis software from Information Builders Inc. and a data warehouse holding patient information going back five years. The hospital plans to use that data to identify patients for whom certain treatments or drugs may be risky, based on clinical patterns and demographics such as age, and deliver that information to physicians, says Jacqueline Ennis, outcomes-measurement programs assistant VP.
Blue Cross Blue Shield of Massachusetts, which uses software from MEDecision Inc. to process claims data, is installing MEDecision's analysis applications to spot clinical trends such as symptoms of worsening diabetes and even geographic clusters of cancer patients. "This is a pretty new area in medicine--predictive modeling and pattern analysis," says Gary Austin, director of IT strategy and health-management systems. Those findings can be fed back into the operational system to identify at-risk patients.
By analyzing medication orders and feeding the results back to a medication-administration system, Cincinnati Children's Hospital Medical Center has reduced medication errors by half. The hospital uses Invision software from Siemens Medical Solutions USA for clinical decision support and operations management. The hospital also uses the system for research, such as studying how many children admitted to the hospital are obese, says Dr. Brian Jacobs, project director of clinical order entry at CCHMC.
St. John, which also uses Cerner's apps, is continually finding new uses for its clinical data warehouse. Doctors analyze historical data, such as the symptoms of specific types of cancers and their diagnosis, and compare it with diagnoses they make for current patients. Researchers compare lab test results to treatment outcomes to help refine optimal ranges for, say, administering a certain medication. The data warehouse is even used to monitor bacteriology test-order patterns to identify a possible terrorist attack. Says Dolan, "We feel we haven't even scratched the surface of what data warehousing can do for health care."