Electronic Records Boost DMC Safety, Save $5 Million

The Detroit Medical Center said Monday that it had achieved significant improvements in patient safety and quality of care, while also saving more than $5 million in costs last year, thanks to efficiencies created by its electronic medical record system.

For the eight hospitals in the DMC system, it was the second year in a row in which computer-based health care information processing created major improvements in quality of care and cost-savings.

The windfall in savings -- triggered by highly effective electronic monitoring of such important hospital tasks as treating pressure ulcers and preventing medication errors -- was clear evidence that the DMC's EMR system is providing a healthy return on investment, according to DMC officials.

DMC caregivers said they were greatly encouraged by the striking cost savings from EMR. The $50 million system has gone online throughout the DMC in gradual stages over a 12-year period, starting in 1998.

"The latest numbers are in, and we continue to see great strides in improving quality, treating patients more quickly and preventing error, which translates to dollar savings as well. This work with these results is very exciting," said DMC chief nursing officer Patricia Natale, RN, after reviewing the results of a system-wide study showing the impact of EMR on both costs and patient care. "The savings are only part of the story, because EMR is also a major step forward on the road to better quality of patient care. Thanks to EMR, we're now seeing a dramatic reduction in the length of hospital stays due to pressure sores, along with a dramatic reduction of drug errors through EMR-enabled medication scanning. EMR isn't just about saving money; it's also about improving the quality of care we provide for patients, and that's our primary mission."

Other leaders at the DMC were equally enthusiastic about the upgrades in quality care that are now flowing from "leveraging" the EMR.

"The latest surveys show that EMR has helped to reduce medication errors by up to 75 percent," said DMC chief medical information officer Dr. Leland Babitch. "Obviously, that's a major gain for patients -- especially given the fact that medication errors account for the majority of accidental deaths and injuries at U.S. hospitals."

The U.S. Institute of Medicine has estimated that up to 100,000 patients die as a result of hospital errors annually.

The impact of EMR on treatment of pressure ulcers was especially noticeable, said DMC quality-of-care administrators. They noted that the chronic sores often require extended hospital stays and thus drive up costs. But the most recent DMC Patient Care Services study of severe pressure ulcer cases showed that close EMR monitoring of bedsores reduced the average length of stay required to treat them by nearly three full days last year, compared to the average length of ulcer-triggered stays before EMR monitoring of the problem began in 2008.

The DMC study concluded that the reduction in the length of pressure ulcer-related hospital stays -- in a system that admits more than 75,000 patients each year -- was now helping to generate more than $4.5 million in yearly cost savings.

"The data on electronic medical records and patient safety and quality of care are clear and convincing by now," said DMC vice president for quality and safety Michelle Schreiber, M.D. "Those data demonstrate beyond a reasonable doubt that EMR is an extremely powerful tool when it comes to protecting patients from hospital errors. But EMR is also proving to be an effective method for promoting quality of care -- and the new numbers on bedsores and length of stays show how computer-based recordkeeping helps caregivers to take better care of patients day in and day out."

The hospital cost savings are especially significant, said DMC caregivers, because the soaring cost of healthcare in this country each year (more than $2.5 trillion) is now equal to 17.3 percent of the nation's entire Gross Domestic Product.

In spite of the savings to be had from hospital-based EMR, however, recent studies show that the majority of U.S. hospitals have either failed to implement top-to-bottom EMR systems or are cutting back on IT programs already in place.

As of August 2010, fewer than 4 percent of U.S. hospitals had implemented the level of system-wide electronic patient recordkeeping that is now in place at the DMC. In addition, a recent study at the University of Michigan School of Medicine showed that more than one-fourth of the nation's recession-affected hospitals have been cutting back on their existing IT programs.

The cash-strapped hospitals were slashing IT budgets, reported the study in the Journal of Hospital Medicine, in spite of the fact that the Obama administration has recently made available more than $2.73 billion in Medicare and Medicaid bonuses for clinicians and hospitals that spend to improve their electronic medical records systems.

"Installing and upgrading effective EMR systems makes very good sense for both hospitals and their patients today," said Michael Duggan, President and CEO of the Detroit Medical Center. "The data contained in our new Patient Care Services study show clearly that EMR can lower hospital costs significantly, even as they greatly improve the quality of care. The DMC has spent $50 million on building a powerful EMR system over the past five or six years, and we did it because we like to think of ourselves as the 'hospital of the future' -- as a state-of-the-art healing center where patients know they can get the best healthcare available anywhere today. At the same time, the ability to greatly reduce healthcare costs via electronic medical records is an added bonus -- which makes implementing EMR a win-win situation for everyone involved."

The Detroit Medical Center operates 10 hospitals and institutes, including Children's Hospital of Michigan, Detroit Receiving Hospital, Harper University Hospital, Huron Valley-Sinai Hospital, Hutzel Women's Hospital, Kresge Eye Institute, Rehabilitation Institute of Michigan, Sinai-Grace Hospital, DMC Surgery Hospital, and DMC Cardiovascular Institute.

More at www.dmc.org.

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