Critics backed, in part, by research published recently in PLoS Medicineand the Archives of Internal Medicine, have raised questions about the benefits of health information technology. But one program suggests that -- if deployed correctly and on a large enough scale -- HIT can improve care and perhaps help bend the cost curve.
The 100,000 Babies Campaign, launched in 2009, is a national clinical quality initiative designed by Pediatrix Medical Group physicians. The goal is to improve neonatal outcomes nationally by incorporating continuous quality improvement practices.
The core is Pediatrix’s Clinical Data Warehouse (CDW), which houses clinical information from 900 neonatologists who care for approximately 20 percent of U.S.-born premature babies. Patient information is de-identified and then used to assess treatment outcomes, develop strategies to improve care and promote meaningful changes in clinical practices. Pediatrix physicians document the care they provide by capturing, in realtime, a consistent set of information about their NICU patients using an electronic health record system.
The 100,000 Babies Campaign, which is being carried out in more than 125 U.S. NICUs, targets five areas: enhancing nutrition (increasing the use of breast milk); improving medication use; reducing central-line infections; minimizing mechanical ventilation to lower rates of chronic lung disease; and reducing suboptimal admission temperatures.
Preliminary results from the 100,000 Babies Campaign look promising, says Alan Spitzer, MD, senior vice president and director of Pediatrix’s Center for Research, Education and Quality. He pointed to two examples–one related to infections, one to nutrition:
- By using the BabySteps EHR system--including consistent use of checklists and closely following evidence-based practices--several NICUs have achieved the campaign goal of a zero infection rate for more than 365 consecutive days. Fewer infections can lead to reduced time in the hospital, better outcomes and lower overall costs, he notes.
- By increasing the use of breast milk, one Florida-based NICU has reported significant decrease in the incidence of necrotizing enterocolitis, the most common and most serious gastrointestinal disorder among premature babies in the NICU, he says.) In 2010 alone, the campaign has helped this NICU team reduce the rate of NEC for preterm babies by approximately 40 percent, he tells HealthLeaders Media.
Other HIT-driven quality-improvement initiatives have resulted in significant wide-scale improvements in neonatal patient outcomes, Pediaitrix reports.
For example, Pediaitrix reports improved weight gain during the first 28 days of life for very low birth weight newborns, from an average 12 grams per day to 15.5 grams per day from 2000 to 2008. Others include reduced rates of both overall and severe retinopathy of prematurity (rates of severe ROP were reduced by nearly half during the prior decade in participating NICUs); a significant reduction in the use of medications for which little clinical evidence exists to support their use in premature babies; optimized use of antibiotic therapy, and reduced rates of chronic lung disease.