ST. JOSEPH'S/CANDLER (SJCHS)
NANCY N. AND J.C. LEWIS CANCER & RESEARCH PAVILION
In 2001, St. Joseph's/Candler (SJCHS) in Savannah was in the process of launching the new Nancy N. and J.C. Lewis Cancer & Research Pavilion and searching for metrics to track and monitor their own progress. At the same time, the Georgia Cancer Coalition had received the IOM report and was seeking to validate the use of the dashboard of metrics they developed in a clinical setting.
With a strong commitment to technology, including electronic medical records, an automated cancer registry, and a progressive decision support system, SJCHS was a good fit for The Georgia Cancer Quality Information Exchange (The Exchange)'s first demonstration project.
Vital to accomplishing the project was engaging the support of hospital leadership in administration, information technology, oncology, health information management, tumor registry, the breast center, research, quality assurance and liaison with physician offices. The next step was developing a retrospective baseline for select IOM metrics so that SJCHS could determine whether the data was already being captured or if not, how to capture it; how to retrieve it and how to calculate the indicator. The working team developed a standardized framework or “toolkit” that includes:
- data definitions
- data sources
- collection methods
- processes for analysis and reporting
The SJCHS Demonstration Project focused on 21 of the 52 indicators—those having to do with breast cancer and overall cancers.
This premier demonstration project validated the use of the metrics in a clinical care delivery setting and established the foundation for demonstration projects to follow.
ROME, GEORGIA
Health care providers in Rome—the Harbin Clinic, Floyd Medical Center and Redmond Regional Medical Center—together became the state's second demonstration site for The Exchange in January, 2007. They designed a plan to gather data on metrics specific to lung cancer as well as other metrics that apply to all types of cancer. Tom Fricks, Chief Information Officer for Harbin Clinic, is the Project Executive and Dr. Matthew Mumber, a radiation oncologist, is the Physician Executive. All partners made a significant investment of resources and expertise to become a demonstration site
With the ultimate goal of The Exchange being community-wide implementation, Rome provides an interesting microcosm of the state. Demonstration Partners there include a multi-specialty physician practice, a not- for-profit hospital and a for-profit hospital. The implementation of electronic medical record keeping is at various stages in the three facilities, so the gathering of data requires alternative approaches. The Exchange must also work together with many stakeholders, and the cooperative efforts, level of collaboration and joint development of initiatives in Rome could demonstrate results that other regions of Georgia can replicate, thus serving as a model for state-wide implementation.
The Rome Demonstration Partners' role in developing methods for the design, access and retrieval of clinical information and public health data is moving The Exchange another important step closer to the vision of full-scale implementation.
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Piedmont Hospital, Atlanta, GA
In September, 2007, Piedmont Hospital became a demonstration partner for The Exchange. The organization was already collecting many baseline metrics, had developed a means of mining data, and was making recommendations based on data analysis.
Through The Exchange, a multi-specialty team, including surgeons, oncologists, primary care doctors, oncology nurses, administrators, information technology professionals and data analytics staff, have been reviewing what data is collected and how to best use that data to improve patient outcomes, especially as it relates to colorectal cancer.
Piedmont Hospital’s approach to cancer registry data collection is termed Oncology Analytics. Looking at the full spectrum of patient care, from prevention, to diagnosis, treatment and palliation, they seek to use real-time analytics to more rapidly develop process change. Collecting, mining and reporting data on a timely basis supports the clinical care team in swiftly incorporating process changes related to best practice. Thus, the rate of change in the quality of cancer care is advanced.
Since the demonstration project’s inception, a number of process changes have been discussed:
- prompting primary care physicians to recommend colonoscopies for patients age 50
- checking each inpatient’s smoking status as part of the nursing assessment and recommending methods for quitting
- improving the staging process for colon cancers
- documenting and understanding why patients don’t complete the full course of chemotherapy.
For four consecutive years, Piedmont Hospital has been named one of the nation’s “Most Wired” hospitals by Hospitals & Health Networks magazine, which focuses on how hospitals use information technology for quality, customer service, public health and safety, business processes and workforce issues.
What it means to be a Demonstration Partner:
Demonstration Partner Fact Sheet