California's Sutter Health reaps rewards from investments in innovation

Seven administrative and clinical executives from across the health system discuss efforts from an electronic ICU to an AI symptom checker to ‘smart hospital’ tech.
By Bill Siwicki
12:19 PM

Sutter Health, a health system based in Sacramento, California, has made innovation a part of its mission. It’s made investments in many different technologies, research projects and medical advancements to improve the patient experience and patient outcomes.

From patient safety technology to a virtual symptom checker and more, here is a closer look at Sutter Health’s efforts to innovate, based on Healthcare IT News interviews with executives from throughout the health system and an infographic from Sutter.

The integrated delivery network model

Integrated networks such as Sutter Health foster a more user-friendly healthcare system, promote patient-centered care and drive healthier outcomes by coordinating medical and support services between caregivers, leaders there said. This integration allows doctors and hospitals to share innovations and work together to ensure patients get the care they need when they need it so that they can benefit from faster recovery and reduced costs.

“As a not-for-profit system, our ‘shareholders’ are our communities themselves,” said Chris Waugh, chief innovation officer at Sutter Health. “We’re measured on our ability to provide health outcomes for the populations we serve. That’s a very pure innovation mandate, which is easy to be enthusiastic about.”

The integrated system allows the innovation teams to test in a very diverse population set that is reflective of the U.S. at large. Innovation for Sutter Health is not limited to a certain demographic or disease state, which is very liberating for an entrepreneurial team, said Waugh.

“An integrated health system can handle a wide variety of clinical needs so innovation teams aren’t as constrained,” he explained. “If we see that primary care connects to dermatology or obstetrics, we can design for that rather than pulling back because that’s not part of the system. Integrated health models are the systems that allow innovation to run toward the connection points instead of running away from them.”

Backing up a commitment to innovation

As part of its not-for-profit mission, Sutter Health invests in innovative programs, research and technologies that help pioneer breakthroughs in healthcare delivery, the health system stated. In 2018, Sutter Health invested $54 million addressing a range of health concerns including stroke, breast cancer, diabetes, Alzheimer’s disease and dementia, liver and kidney transplants, and cardiovascular diseases.

“Nearly 70% of U.S. adults are overweight or obese, and are at high risk for diabetes and cardiovascular diseases,” said Robert Romanelli, health systems researcher at Sutter. “These health concerns impose enormous costs on the U.S. health system. Research suggests behavioral changes that promote weight loss are effective, but these are rarely evaluated in health systems.”

Through a study titled ELEVATE-DP, or Evaluation of a Lifestyle Intervention Adapted for Clinical Practice for Diabetes Prevention, researchers at Sutter Health are using electronic health record data to examine the effectiveness of a 12-month lifestyle change program for patients at high risk for diabetes and cardiovascular disease.

The program, which encourages weight loss through healthy eating and increased physical activity, was originally developed by the University of Pittsburgh and is endorsed by the Centers for Disease Control and Prevention as a model curriculum for diabetes prevention.

“Patients who participated in the program achieved sustained weight loss after 24 months,” said Romanelli, who was co-principal investigator of ELEVATE-DP with Kristen Azar, RN. “About 25% achieved clinically meaningful weight loss – 5% reduction in body weight. Engagement with the program, measured by the number of sessions attended, led to even greater weight loss. ELEVATE-DP illustrates how research at Sutter Health helps improve health outcomes of people with some of today’s most common, pressing health concerns.”

eICU patient safety technology

Sutter Health has created and implemented advanced eICU patient safety technology. It’s the first healthcare organization on the West Coast and the second in the nation to do so. It provides 24/7 access to specially trained doctors and nurses and is accessible from all acute care locations in the health system.

“We recognized many years ago that there aren’t enough ICU-trained doctors living in every community,” said Dr. William Isenberg, vice president of patient safety at Sutter Health. “Mindful of this reality, Sutter Health created an eICU, using technology innovations and our consolidated electronic health record.”

From two central hubs in Sacramento and San Francisco, doctors and nurses monitor patients across the health system in intensive care units hundreds of miles away using live interactive video, remote diagnostic tools and other specialized technologies to instantly assess critical changes in a patient’s condition.

“This smart management of resources focused on efficiency and safety helps us deliver high quality care,” Isenberg said.

A special unit for the elderly

Sutter Health’s Acute Care for the Elderly Unit is one of only about 200 nationwide and helps to diminish mental and physical decline, decrease complications and hospital length of stay, and improve coordination and mobility, the health system said.

“ACE is an innovative care approach that emphasizes de-prescribing medications, addresses trauma and isolation associated with hospitalization, and provides means to promote mobilization that can be especially concerning for older patients,” said Dr. Wendy Zachary, a geriatrician and medical director of the ACE Unit at Sutter Health’s CPMC Mission Bernal Campus.

By keeping patients active throughout the day with programs like music and movement therapy, mindfulness classes, and sessions with a psychotherapist, the ACE Unit is designed to address the trauma and isolations associated with hospitalization.

“This activity also helps reduce daytime sleeping, which promotes normal sleep-wake cycles allowing the de-prescribing process to begin with the reduction of sleep aids,” Zachary explained. “For patients who cannot safely move outside of their rooms, our volunteers provide range of motion exercises to get the muscles going to prevent muscle atrophy.”

This innovative care, she added, helps control costs and fosters affordable, dependable healthcare by decreasing the length of hospital stays and reducing readmissions.

Mobile health innovations

Research investments have driven mobile health service innovations in remote primary care, health screenings, and lab tests and results counseling.

“Highly trained staff and special equipment to diagnose and treat patients with suspected stroke at the scene of the call are the elements that make the Mobile Stroke Unit (MSU) an innovative advance in stroke care,” said Jenny Im, RN, director of the neuroscience service line at Sutter Health’s Mills-Peninsula Medical Center. “In addition to the regular 911 ambulance staff, the MSU has a specially trained stroke neurologist, a stroke registered nurse and a CT scan technologist.”

The team responds to emergency 911 calls when a stroke is suspected, and using the CT scanner aboard the MSU vehicle, obtain an image of the brain, perform a clinical evaluation, and can begin treating with a clot-busting drug at the scene.

“This is critically important for patients because the sooner the type of stroke is diagnosed – whether it’s a ‘bleeding’ or ‘clotting’ stroke – the sooner we can begin the correct treatment,” Im explained.

Every minute a stroke is occurring, potentially 2 million brain cells are dying. With stroke, minutes matter.

“Studies show that the sooner we identify and treat the stroke, the better the chances are for a good outcome,” she said. “In the short term, this means we can break up a clot more quickly and minimize damage to the brain. In the long term, quicker treatment may translate to decreased disability, decreased need for rehab and decreased time off work.”

AI checking patients’ symptoms

Sutter Health created and launched its Virtual Symptom Checker, a new artificial intelligence program to check symptoms based on severity and medical history. It reveals potential causes and next steps.

“Creating human connections is one of the most important things we can do as an integrated health system, being whenever our patients and their families need us the most,” said Dr. Albert Chan, chief of digital patient experience at Sutter Health. “Thus far, more than 50% of our symptom checker interactions happen after hours.”

With AI, the health system can take something meaningful like answering patients’ questions in the wee hours of the morning and make that systematic, he added.

“When you are concerned or sick, we aim to connect you to the care that you need – reducing friction one human interaction at a time,” he said.

Patient experience technology

On the patient care technology front, the health system’s facilities use innovative tech to bring a higher quality, more satisfying experience for patients and providers, Sutter Health contended.

For example, the CPMC Mission Bernal Campus opened in August 2018 to serve diverse San Francisco neighborhoods. Tracking software allows teams to locate clinical equipment in seconds. Interactive wayfinding kiosks help patients and visitors easily navigate their way around the hospital. Interactive room technology allows patients to order meals, relax to music, meditate or watch television.

“At Sutter’s CPMC, we offer a glimpse of the type of smart technologies that enhance patient care at facilities across Sutter Health,” said Bob Andrews, client services director, Sutter Health Information Services. “These systems include interactive room technology, equipment tracking software, an interactive campus map and staff workflow.”

What makes the approach innovative is the way that the provider organization has used all of the technologies, through cross-system integration, within one hospital setting, Andrews said.

“It’s one large step forward to creating the ‘smart hospital’ of the future, moving us toward the goal of improving patient access, safety and satisfaction,” he explained. “The technology investments made today are the foundation for future innovations that will be implemented to create an even smarter hospital tomorrow.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com
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