Truman Medical Centers

Project Q6 Readies TMC for Reform

In 2009, Truman Medical Centers (TMC) began project Q6 to improve clinical quality and outcomes through advanced technology. TMC believes that investing in health information technology (HIT) is a key element to fulfilling its safety net mission of delivering accessible, state-of-the-art health care to some of Kansas City’s most vulnerable, chronically ill populations. Now, as TMC assesses the results of this initiative, it finds an organization that not only provides better patient care, but also promotes new, productive staff roles and stands ready to meet the requirements of health reform head on.

Q6 involved upgrading TMC’s electronic medical records (EMRs) from Healthcare Information and Management Systems Society (HiMSS) level 3 to HiMSS level 6. “Our goal was to move from a mixed mode of using both paper and electronic records to becoming fully electronic throughout all of TMC’s facilities,” explained Rob Jones, TMC’s chief technology officer.

To achieve its goal, TMC began to build its technology infrastructure, first by assessing mobile device usage across the organization and performing a wireless upgrade to enhance mobility. Physicians were given laptops, document imaging was introduced, and electronic devices were added to patient rooms for nurse documentation at the point of care. These changes enable health care providers to deliver faster, more informed care, improving patient outcomes. For example, since implementing Q6, TMC was able to reduce hospital-acquired pressure ulcers by more than 60 percent, resulting in cost avoidance of more than $1.8 million annually.

Q6 also addressed the need to reduce medical errors. “We incorporated biomedical device integration, which helps eliminate human error during data entry,” Jones said. Data that comes from devices such as patient monitors, anesthesiology gas machines, and fetal monitoring strips is populated directly into the EMR system, instead of being typed in by hand. TMC is also using electronic barcode scanning on patient wristbands and medicine containers to reduce errors related to bedside medication administration. In a single month the system supported the administration of 140,000 medication orders, for which 6,200 alerts were triggered informing caregivers to cancel or amend the order due to a potential for overdose or adverse medication interaction. “The sophisticated intelligence embedded in our system supports an unparalleled level of safety through technology that vigilantly protects and drives positive
patient outcomes,” Jones said.

While TMC initiated Q6 before U.S. health reform began requiring hospitals to integrate more technology into their organizations, the organization has begun to embed those required reform components into its changes. “We have focused heavily on security risk,” Jones said, “and we are doing a number of infrastructure assessments required by HIPPA for wireless security.” Areas of focus include data security, risk management, and data encryption in accordance with the Health Information Technology for Economic and Clinical Health (HITECH) Act, which promotes the adoption and meaningful use of HIT. TMC has also ramped up its risk assessment plan to perform assessments more frequently and on an ad hoc basis. According to Jones, “We should be prepared for any official review done at any time.”

TMC celebrated Q6’s complete implementation in August 2010, and has already seen results on many levels. In addition to being named most wired, TMC has received HiMSS level 6 certification. In the area of compliance, “we are hitting the mark for stages 1 and 2 of meaningful use and are prepped for the next layer of reporting,” Jones said. “While we are proud of our accomplishments, this represents the beginning of a journey that will enable us to be on the cutting edge of health care reform.”

Changes are also apparent within staff roles. As the medications process has greatly improved with autochecking, the pharmacist’s role has been redefined, becoming increasingly clinical. “The pharmacist can now manage medications, spend more time as an integrated member of the care team, and educate patients versus solely check inventory,” Jones said. Doctors have adjusted to the changes at varying speeds, but TMC has provided on-the-spot training for those in need. “We developed a support group they can call for help at any time, and can even schedule one-on-one training,” Jones said.

As Jones reflects on Q6 and TMC’s most wired recognition, he notes the truly important meaning behind the award. “This award has become increasingly meaningful because it has evolved from implementing individual components of technology to rewarding the application of integrated technology solutions that improve patient outcomes and will ultimately drive the efficiencies needed to sustain lower price points and the current level of care for our entire population.”

For more information about TMC’s HIT innovations, please contact:

Rob Jones
Chief Technology Officer
Truman Medical Centers
[email protected]  
(816) 404-2013