Mt. Sinai ups care for cancer patients

2012 Davies Award winner believes oncology-specific EMR makes the difference
By Bernie Monegain
12:00 AM
A survey at Mount Sinai Hospital showed that most clinicians believed the instit

A majority of clinicians at The Mount Sinai Hospital using Epic's Beacon module, an electronic medical record (EMR) system designed specifically for cancer treatment, indicated the system improved patient care quality and safety. 

The hospital is part of Mount Sinai Medical Center, which also encompasses Mount Sinai School of Medicine.

HIMSS recently named Mount Sinai Medical Center the 2012 Davies Enterprise HIMSS Award of Excellence, citing several ways Mount Sinai had put its EMR to work on boosting patient care and reducing costs.

On the oncology front, Mount Sinai administered a survey developed by Epic in November 2012, eight months after it rolled out its oncology-specific Epic Beacon module. 

Lead researcher Kerin Adelson, MD, assistant professor of medicine at Mount Sinai School of Medicine, presented the results in December at the ASCO Quality Care Symposium in San Diego.

The Beacon module enables clinicians to chart evidence-based treatment plans and provides the capacity to store a database of approved treatment protocols, including supportive care for side effect management, says Adelson.

To take advantage of the database feature, he says, Mount Sinai created a council of experts, including oncology physicians, nurses and pharmacists, who spent more than a year and hundreds of hours clinically validating more than 400 treatment protocols. The council then grouped the protocols by cancer type and noted which supportive care treatments, such as anti-nausea medication, paired well with each protocol.

The Mount Sinai team found that nearly 80 percent of people using Beacon believed the system increased their day-to-day efficiency and improved the quality of patient care.

"Treatment plans and chemotherapy cycles for cancer patients are complicated, requiring multiple medications given at various intervals," says Randall Holcombe, MD, professor of medicine, Division of Hematology and Medical Oncology and director of Clinical Cancer Affairs for The Mount Sinai Medical Center. "Each patient's complex schedule needs to be planned out over a course of six to 12 months. The Beacon system makes that long-term plan available to any member of the patient's medical team and automatically adjusts a patient's schedule when the treatment plan is modified."

Storing a patient's medical information in one secure electronic location accessible to any of the patients' clinicians results in a number of benefits, Holcombe says. Most importantly, Mount Sinai clinical leadership is able to enter evidence-based treatment protocols for their care practitioners to follow, which include supportive care for side effect management, he adds. EMRs also decrease the possibility of notes or test results being misplaced, reduce orders for duplicate tests, and vet prescribed drugs and doses in each patient to prevent life-threatening medication errors, he says.

"The major takeaway from our Beacon implementation is the opportunity to continuously improve and update treatment plans based on published research and guidelines for all practitioners to follow," says Adelson. "Ultimately, it allows us to provide higher quality, more comprehensive care to individuals by identifying the most appropriate treatment course while minimizing side effects." 

Mount Sinai installed the first phase of Epic Beacon in March 2012 in the chemotherapy infusion suites and then expanded to inpatient and ambulatory services over the course of four months.

"Mount Sinai is among the top medical institutions in the country leading the way in the EMR revolution," said Kumar Chatani, senior vice president for information technology and CIO at The Mount Sinai Medical Center. "The successful implementation of Epic's Beacon module demonstrates Mount Sinai's continued commitment to using cutting edge information technology systems to elevate quality care and patient safety," Chatani added. 

The Mount Sinai Hospital has invested $120 million in its transition to EMRs. In November 2011, Mount Sinai received Stage 6 designation from HIMSS Analytics, the second-highest designation on a scale evaluating hospitals' commitment to fully incorporating health information technology into every aspect of clinical care. Mount Sinai is actively pursuing reaching Stage 7. 

The 2012 HIMSS Davies Award spotlights Mount Sinai's accomplishments on many fronts. 

 "The long term benefits of our expansive EMR system, which I consider the backbone of our care today, are far reaching," said Kenneth L. Davis, president and CEO, The Mount Sinai Medical Center. "It enables new reimbursement models, improvements in safety and quality, and accelerated research and innovation."