Recently, Hixny set out to show that when Emergency Department (ED) providers use Hixny, patient care, efficiency and patient satisfaction improve.
In fact, nearly 90 percent of ED patients surveyed agreed that the more information a ED physician has about them, the better he or she can do their job. And the providers reported that having a complete patient history, available only in Hixny, made them feel more in control and empowered to provide the best care.
Tavia Rauch, Account Manager at Hixny helped conduct the survey. Immediately before joining Hixny, she was Practice Manager of the hospitalist, endocrinology and neurology group at St. Peter’s Health Partners. She has four years of experience in Clinical Informatics at two large health systems and spent 14 years as a respiratory therapist. She also was a public health program coordinator, running a three-year grant-funded project to educate primary care physicians and dentists in the best practices of tobacco control.
Rauch worked with 16 providers, including physicians, physicians’ assistants and nurse practitioners, in the ED at St. Mary’s Hospital in Troy in the fall of 2016. She spent early mornings, weekends and late nights—a total of 55 hours—on site as patients presented for care. When patients signed Hixny consent forms, she would compare the information available in the ED’s electronic health record (EHR) to Hixny patient health record.
In 84 percent of the cases Hixny added value by including encounter information, documents or other data not found in the EHR. In 40% of the cases, Rauch saw the information as something that should be passed on to the provider. In 26% of the cases, the provider agreed the data as relevant to the patient’s visit that day. In 15% of all of the cases the ED physician changed the treatment he or she was planning for the patient, based on the new information.
In one case, a patient had recently made multiple visits to two area urgent care centers. Rauch gave that information to the physicians’ assistant (PA), who could then speak to the patient about what was going on. This enabled the PA to do different tests and arrive at the proper diagnosis.
“Otherwise she probably would have repeated everything that was done and probably gotten to the same spot the urgent care centers had,” Rauch said. “But she was able to find something no one else had found, because she saw what tests had been done before.”
In another case, the ED providers were able to “fast track” a patient to the affiliated Samaritan Hospital for inpatient care, because Rauch found the results of labs taken at another facility the previous evening.
These are just two examples of how having complete information improved communication between the provider and patient and resulted in more efficient care and better outcomes.
“Providers told me having more information puts them in control,” Rauch said. “The Hixny data allowed them to drive the care that they knew was best.”
Dr. John Janikas, Chief Medical Officer for the St. Mary’s Emergency Department, told of a patient who was scheduled for a CAT scan until Hixny revealed that he had recently had a complex workup at another hospital. This saved the patient from another round of testing as well as the cost of the screening.
“That to me is huge, and that decision changed because an [ED] scribe pulled a Hixny report and put it in front of me,” he said.
While Rauch was doing her case comparison, Andrew Velasquez, Healthcare Business Analyst for Hixny, was surveying the 16 providers, as well as 107 of their patients, to gauge their perceptions of Hixny’s value.
When providers were asked to rate the value Hixny adds to patient encounters on a scale of 1 to 5, with five being “very high value,” the average score was 4.06. Providers also agreed that Hixny decreases the time it takes to diagnose patients, results in fewer lab tests and radiology procedures, and supports stronger care coordination.
For their part, patients said they wanted their ED provider to “know all of my medical history” and agreed that the more they know, “the better she/he can do their job.”
However, the survey also showed that as much as providers and patients valued Hixny, it was not being used as much as it should be. One issue they cited was time constraints, which Dr. Janikas explained:
“When you’re an ED doc, and you’re running around, the last thing you want to do is log into something,” he said. “It may not seem that if something takes 30 seconds that’s a lot, but if you are seeing 30 patients in a shift, that’s 15 minutes. That’s another patient encounter.”
This was what drove Rauch to spend those 55 hours in the ED, doing the case comparisons and showing the providers the power of Hixny, and how accessing it is valuable.
“Providers have to look at the whole patient and you have to look at the whole record because valuable information is there,” Rauch said.
Velasquez said Hixny plans to expand the provider survey to other EDs in the region, along with the message of Hixny’s value.
“This is the first step in getting people to see what it really means to have all the information you can before you make decisions about patient care, and the results of that effort, in terms of patient satisfaction, savings of time and savings of resources,” he said. “This is why providers need to think Hixny first.”