By Eduardo Conrado
Executive Vice President, Strategy and Innovation, Ascension
The last year in healthcare has been both challenging and transformative. Facing a once-in-a-generation pandemic, our public health infrastructure, health technology services and care delivery models were called to make dramatic changes to better serve our communities and fulfill our commitments to improving the lives of our patients and the experience of our caregivers.
We have learned a lot over the past 11 months. We have listened to our patients and our caregivers, and inspired by their insights, we have challenged our teams to take bold steps to improve our practices, systems and services to better address the imperatives of today and the future.
The COVID-19 pandemic has reinforced the significant impact that complex, and often confusing, electronic health records (EHR) systems and the fragmentation of patient health data have on delivering effective care to individuals and rapidly responding to the needs of populations during healthcare crises. Our current systems do not provide adequate tools and support for patients, consumers or caregivers.
In current EHR systems, clinical information too often is buried in siloed records scattered across hospitals, clinics, urgent care centers, pharmacies, physician offices, labs, and other sites of care, making it challenging for physicians and caregivers to efficiently deliver coordinated and precise care. When information is finally retrieved from these disparate EHR systems, it is usually poorly organized and fragmented. Most clinicians work in an environment where data is incomplete, inaccessible and delivered in disjointed bursts of information without context. The challenges of working this way have become even more visible as complex care processes have increasingly moved to remote care environments during the COVID-19 pandemic.
In 2018, recognizing a meaningful opportunity to improve patient experience, clinician satisfaction, and quality of care, Ascension and Google began collaborative work to reimagine the organization of clinical data in order to make Ascension’s information more effective in supporting the care delivered by our providers. We sought to deploy an integrated longitudinal record that provides a complete clinical history for each of our patients, and make that record accessible and searchable by our clinicians. This approach will organize each patient’s historical diagnoses, laboratory tests, medications, treatments and progress notes, so that our clinicians can surface the relevant information needed when it's needed. This capability is the essence of delivering effective and efficient care.
In the last year, we have made remarkable progress and are excited to begin a clinical pilot of this new tool -- Google calls it “Care Studio” -- that improves both clinician experience and patient care. This approach is grounded on a foundation of clinician user research, involving feedback from our physicians and nurses from a variety of specialties. It provides new functionality and a simple user interface that allows clinicians to see information from both inpatient and outpatient Ascension facilities, and to quickly search through that information to find what is needed at that moment. This clinical search capability surfaces the specific information requested and additional contextually relevant information that might otherwise require significant time and effort to uncover. This contextualization will directly enhance the provider experience by enabling quick access to patient information and enriching the information that is available. In short, clinicians will more quickly and more completely understand the clinical condition of patients, and thus be able to more effectively care for them.
As we begin to share this new tool with caregivers in clinical settings, it is important to note that this tool is an optional support tool and does not replace existing EHR systems. Rather, it complements existing EHR systems and provides a single interface to search varied, and previously siloed, data systems and streams.
Additionally, as promised when we began this work, Ascension’s use of Care Studio tool complies with all applicable regulations, including the Health Insurance Portability and Accountability Act (HIPAA), and the work with Google is covered by a Business Associate Agreement (BAA) that governs Protected Health Information (PHI). With this new tool and Ascension’s privacy and security protections in place to protect patients’ health information, Ascension clinicians will have the search capability that brings information from a patient’s entire medical record to their fingertips. Clinicians will be able to find the exact information they are looking for, quickly and in combination with other clinically relevant data.
The clinical pilot of this tool will begin with a small group of clinicians in Ascension’s Nashville, Tennessee, and Jacksonville, Florida, locations. Caregivers in the pilot will be supported by Ascension clinical informaticists focused on improving clinical technology and workflow. As we get feedback from pilot clinicians, we will work with Google as they continue to enhance the usability and effectiveness of the tool and deliver additional features. Once this period of quality assurance and improvement is complete, our goal is to make this clinical search tool available to all of our caregivers.
The COVID-19 pandemic has been a long and challenging time for healthcare organizations and the caregivers and clinicians who care for our communities. Now more than ever, we believe it is our duty and responsibility to find better, innovative ways to support our incredible team of caregivers. This smart search capability is one step along that journey. We are looking forward to seeing it fulfill its promise as a critical part of our effort to improve patients’ lives and caregivers’ experience.