HCA Healthcare, one of the leading providers of care in 20 states and in the United Kingdom, has smartly been investing to improve the quality of the health data they collect. This investment made it possible to deploy an innovative sepsis detection project that has enhanced patient safety across the entire organization. That same project also had an unintended beneficial impact – it helped HCA facilities react faster during hurricanes and other emergencies.
Healthcare IT Today sat down with Dr. Jim Jirjis, Chief Health Information Officer at HCA to discuss the value of data quality in healthcare and find out more about the link between their sepsis project and better emergency preparedness.
Good Quality Data
According to Dr. Jirjis, before healthcare leaders can be convinced to invest in data quality, everyone must agree to a common definition of what that is.
“When you say the words ‘data quality’ to people, they interpret it differently,” said Dr. Jirjis. “For example, they think that the potassium value in the lab result is not correct. Technically, yes, that is poor quality data. But poor quality data also happens when every facility uses a different term for a social security number. That is a much more complex data quality challenge.”
With 185 hospitals, it takes effort for HCA to maintain good quality health data across their entire organization. It means carefully mapping the data that is collected in its warehouses so that it is accurate, normalized, and semantically interoperable (the ability for computer systems to exchange data with unambiguous meaning).
With good data quality, HCA was able to implement an innovative sepsis detection application.
Sepsis Project
The CDC defines sepsis as: The body’s extreme response to an infection. It is a life-threatening medical emergency. Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Detecting sepsis early reduces harm to patients and drastically improves outcomes.
“If you don’t catch it early, there’s a 50% death rate,” explained Dr. Jirjis. “So, we implemented an algorithm to help detect it early based on a handful of important data elements. One of those elements is lactic acid. High amounts of lactic acid is a sign that a patient may have sepsis.”
The sepsis detection algorithm could only be implemented at HCA because they had invested in good data quality. For example, for just lactic acid. there were 708 different terms for it across their 185 hospitals. Dr. Jirjis and his team had to build the data equivalent of the “Rosetta Stone” to properly interpret the information. Once this was done, insights from the collected data could be drawn.
As part of the sepsis project, HCA worked to streamline nurse documentation because some of the information needed for sepsis detection was collected manually by nurses. By eliminating redundancies and leveraging technology the HCA team was not only able to eliminate 20% of unnecessary documentation, but it also standardized how that information was entered by nurses.
“We did everything to help reduce the burden on our nurses,” said Dr. Jirjis. “But we found out that the data could help us in another way – a way we never anticipated.”
Unintended Benefit
Approximately 40% of HCA’s facilities are in hurricane zones. HCA has to be ready to evacuate those facilities when hurricanes pass through. To prepare for an evacuation, nurses would have to run from room to room to make note of the mobility of each patient and the medical equipment they needed. This information was used to arrange for proper transportation during the evacuation.
Since HCA had invested in streamlining nursing documentation as part of their sepsis project AND because the team had created their “Rosetta Stone” to effectively map all the information so that it was semantically interoperable, they had all the information about patients already in their data warehouse.
So the next time a facility had to prepare for an evacuation, the data team was able to produce the information for nurses so that they no longer had to run around the hospital to gather it.
“We learned that we needed a good partner that has experience with mapping the entire laboratory domain,” shared Dr. Jirjis. “There are companies out there like Clinical Architecture that are able to automate 90% of that mapping so you don’t have to do it one map at a time.”
Committing to Good Quality Data
Investing in improving the quality of health data may seem like a daunting task, but the benefits to patients and staff are significant. Good quality data can also be a catalyst for other data-based innovations in care delivery. Investing in data quality is not just a matter of compliance or good governance – it is a strategic imperative that can help healthcare organizations stay ahead of the curve in an ever-evolving healthcare landscape.
Watch the interview with Dr. Jim Jirjis to learn:
- Tips on how to get healthcare executives to fund good data quality
- How data quality is a lifestyle not just a technical challenge
- How many post it notes it would take to represent the amount of health data at HCA
Learn more about HCA at: https://hcahealthcare.com/
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