“We’ve succeeded in getting our clinical teams to engage directly with the data and learn from the data. Every time I hear how the electronic data warehouse is referenced by clinicians and how the organization is using a rich repository of data to improve quality outcomes, all I can do is smile and say, wow, mission accomplished.”
—Myra Davis, Chief Information Officer, Texas Children’s Hospital
Texas Children’s Hospital is internationally renowned for caring for children in the United States and in other countries. US News & World Report ranked it the nation’s fourth best children’s hospital and the best in Texas in 2012. Founded in 1951, Texas Children’s resides in the largest medical complex in the world—Texas Medical Center in Houston—and provides primary and tertiary care for children through the hospitals, affiliated practices and health plan. Together, these facilities manage more than 1 million patient encounters each year.
“Today, we have a solution that integrates data management with evidence-based practice, operational data and financial metrics to allow us to understand the bigger scope of care delivery. We have never had the opportunity to do that before because so many silos of data existed. Now we can put patients first because we can see the data.”
—Charles Macias, MD, Director of Evidence Based Outcomes, Texas Children’s Hospital
The core of Texas Children’s success lies in its commitment to raise the quality of patient care in part by implementing evidence-based care guidelines and measuring outcomes. The hospital is committed to meeting the Institute of Medicine’s goal of providing care that is safe, equitable, effective, patient-centered, timely and efficient. As a result, Texas Children’s has invested heavily in information systems that enable the delivery of higher quality, lower cost patient care.
The Challenge
In 2006, with the impending transition to value-based reimbursement on the horizon, Texas Children’s began to examine its quality improvement program with a strong emphasis on evaluation of data management capabilities. To succeed under a value-based system, the hospital’s leaders knew they needed the ability to analyze and better manage specific populations of patients, especially those most-costly patients with chronic problems such as asthma. They also knew they needed to identify areas of inefficiency and waste in their care programs, but lacked the hard data to pinpoint the suspected problems and to uncover other, hidden inefficiencies and safety issues.
To address this challenge, Texas Children’s launched an overall quality and safety strategy in 2006. The goal was to develop a comprehensive and integrated enterprise-wide data management infrastructure. The key foundational element involved implementation of an electronic health record (EHR) from Epic Systems, Inc. in order to collect raw clinical and financial data from across its enterprise. This was a critical first step in the data management strategy to transform data into meaningful information needed to guide its clinical quality interventions and waste reduction efforts.