Harris County Hospital District

Transformation, Utilization, Optimization: Three Ingredients for Better Care

“We saw health care reform coming,” said Tim Tindle, Harris County Hospital District’s executive vice president and chief information officer. With about 60 percent of patients being unfunded, taxpayers are the largest single payer in their system. “We view the world like an HMO,” Tindle explained, “which drives you to these types of constructs.” So, after working to transform and modernize its processes and systems over the last 7 years, Harris County now boasts streamlined operations, improved patient safety, and proactive, patient-centered health management, all of which translate into better care at a lower cost for Harris – and its taxpayers.

Modernization began with an enterprise resource planning (ERP) system that covers a broad range of functions, including financials, supply chain, and human resources. By allowing the organization to effectively manage and access information, the ERP has produced “the kind of optimization that has changed our world,” according to Tindle. For example, in the supply chain, the ERP has reduced the procure to pay cycle time from 138 days to 34 hours for hospital supplies and completely eliminated the need for a central supply. The cycle time for nonhospital supplies has gone from 138 days to 31 days. More than 70 percent of orders and 65 percent of invoices received are electronic, and the organization is receiving discounts for rapid payments.

Harris County also implemented an electronic medical records (EMR) system and already boasts 100 percent utilization. “Roughly 3,400 physicians, residents from two medical schools, 3,000 nurses, and 2,000 other health professionals are viewing patient files in a single database, which they can access from anywhere in the world,” Tindle said. Even for truly wired organizations, 100 percent utilization is rare. A 2010 study by KLAS, a health care technology research and information services organization, found that only 32 hospitals out of 6,000 in the United States have the level of adoption seen at Harris County Hospital District.

Moving beyond utilization, Harris County has put its EMR system to work in reducing medical errors and improving patient safety, an example of which is the organization’s use of palm vein scanning for enrollment and procedures. “We have 2,280 patients with the name Maria Garcia,” Tindle explained. “And more than 230 of them have the same birth date.” With such overlap in patient identifiers, palm vein scanning provides a much higher level of safety. Harris also developed a large business and clinical intelligence program that provides the workforce access to the clinical and business information they need to make better decisions. “It supercharges our process and quality improvement initiatives,” Tindle said.

The transformation has reached the Hospital District’s ambulatory care network as well. Each of the organization’s primary care centers is recognized by the National Committee for Quality Assurance (NCQA) as a level 3 patient-centered medical home, which is the highest level of recognition. “The Hospital District was the first safety net health system to achieve this designation across all of the system’s heath centers,” Tindle said, “and we are very well positioned to support new business and care models such as the accountable care organization.”

Modernization has also enabled Harris to help patients become more involved in their own wellness. The Hospital District has recently implemented a patient web portal that gives patients access to all of their medical records and simplifies many procedures, such as communicating with doctors and paying bills, which previously required multiple, time-consuming steps. Next up – an iPhone version of the portal.

At the heart of this transformation is the Hospital District’s move from providing episodic patient care to population health management. “We now look at the whole lifecycle of health care,” Tindle said. “We have a better understanding of how patients are doing and we can provide disease management and health maintenance services.” For example, the Hospital District is using EMR to provide case management for patients with a chronic disease who aren’t managing their condition. In doing so, the Hospital District has reduced emergency center visits by 25 percent overall for patients enrolled in the case management program. “A primary care visit focused on wellness and prevention is far less expensive than an emergency center visit or a hospital stay, and it improves our patients’ quality of life.” Tindle said. “Our investment in and adoption of a systemwide electronic health record has enabled the organization to better serve our community as an efficient, quality-driven organization.”

For more information about Harris County Hospital District’s heath information technology innovations, please contact:

Tim Tindle
Executive Vice President and Chief Information Officer
Harris County Hospital District
[email protected]  
(713) 634-1111