Duke Health earns HIMSS Davies Award with innovative approach to reducing readmissions

Post-surgical readmissions were halved at the health system, HIMSS says, driven by EHR optimization and decision support tools – it's also helped combat potential opioid dependency.
By Mike Miliard
03:39 PM
Duke Health building in South Durham, North Carolina

The third major health system to win a HIMSS Davies Award over the past month is Durham, North Carolina-based Duke Health. Specifically, the award recognizes the health system for customizing its electronic health record to better serve standardized care processes for improved patient safety and post-surgical outcomes.

Duke Health joins Mercy, which earned its Davies for work fighting against the opioid crisis, Ochsner for arming clinicians with tools connected to its EHR that make them more effective in treating patients diabetes and hypertension, and TriHealth, which achieved it Davies for innovative population health management work.

Duke’s effort to reduce high readmission rates for post-surgical urinary tract infections, led by colorectal surgeon Julie Thacker MD, developed and put into place a standardized care process for patients who had had colectomies or removal of part of their large intestines.

Enhanced Recovery After Surgery, or ERAS, was the protocol Duke developed eight years ago to improve how those patients were managed during the pre-, peri- and post-operative period. Factors such as nutrition, activity and pain control were addressed, and sometimes adjust – ultimately leading to lower lengths of stay, fewer secondary complications and far fewer unnecessary readmissions.

In 2016, ERAS integrated into Duke Health's EHR, giving clinicians visual cues for patients' status, across the care continuum. With these prompts, caregivers could more easily spot patients on the protocol, boosting ERAS compliance across the process.

The near real-time reporting data also led to further outcomes improvements – notably a 50 percent reduction in readmission rates for colectomy patients.

In addition, the health system has "created a blueprint for reducing potential opioid dependency by leveraging IT to standardize patient recovery from surgery," said Jonathan French, senior director of quality and patient safety at HIMSS, in a statement. "The standardized patient care process for colorectal surgery empower periop nurses to order alternative pain management therapies for recovering surgical patients. This avoids unnecessarily exposing patients to opioid treatments, which lowers the risk for dependency."

In addition to the ERAS initiative, Duke Health was also recognized for two other innovative projects. One, an optical character recognition tool, allows computers to capture outside laboratory data discreetly into the EHR, by reading images such as faxes. The tool has led to 25 percent time savings in outside lab data capture.

The other, called the Care Redesign Program is a complex and longstanding initiative – five years and 17 different use cases – that aims to improve clinical integration of the EHR with operational processes toward improving quality, safety, efficiency and cost savings.

Jeff Ferranti, MD, chief information officer for Duke University Health System credits a "spirit of continual learning, teamwork, and ongoing process improvement" for gains such as those.

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Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com

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