Posted on: January 16, 2017

Dan Marra, Hospitalist Nurse Practitioner at Samaritan Hospital

With the growth of data and the depth of this data, providers are rediscovering the value of Hixny. Healthcare professionals are discovering the need to implement new tools offered by Hixny to improve workflow efficiency.

See how Hixny is lowering readmission rates in two area emergency departments.

In 2016, Dr. Daniel Silverman, Chief Medical Officer for Acute Care-Troy, decided it was time for “Hixny 2.0” in his organization.

Providers at Samaritan and St. Mary’s Hospitals, which make up Acute Care-Troy, had access to Hixny for some time, but were not using it to its full potential. Therefore, “we needed to do a restart on it and reinvigorate the process,” Dr. Silverman said.

Since then, use of Hixny has risen 23 percent, and both inpatient readmissions and average length of stay have decreased. While Dr. Silverman could not say the declines are solely because of Hixny, “it has been a main contributing factor.”

Furthermore, both Dr. John Janikas, Medical Director for the Emergency Department (ED), and Dan Marra, a Hospitalist Nurse Practitioner at Samaritan, say using Hixny has improved their efficiency and the quality of care they can provide to patients.

“That is the best care for the patient, to have [their] information at your fingertips,” Dr. Janikas said.

Marra agreed, noting that “we have to wait sometimes three, four, five hours to get health records on a patient. For patients who participate in Hixny, we are able to eliminate the gap almost completely.”

Dr. Silverman said that previously Hixny was primarily used by Samaritan’s inpatient pharmacists to do medication reconciliation upon admission or during the patient’s stay. It began about two years ago with a project aimed at improving the discharge process, and “I believe there has been a decrease in medication adverse events because of this,” he said.

They were all very surprised by how much Hixny has grown, and how much valuable patient information we have.

He was already seeing the value of Hixny when Account Manager Tavia Rauch approached him about increasing its use at Samaritan and St. Mary’s EDs. He agreed it was time to reintroduce Hixny to certain parts of the organization, including the hospitalists and ED physicians.

A simple demonstration by Rauch showed the value of Hixny. She selected five patients who were seen that day, and compared their records on Samaritan’s native electronic health record (EHR) system to what was available in Hixny. Three of the five showed important gaps in the native EHR, including drug allergies, lab work and test results. For one patient with comorbidities,
there were several records in Hixny from recent stays and procedures at Albany Medical Center and Ellis Hospital.

“They were all very surprised by how much Hixny has grown, and how much valuable patient information we have,” Rauch said. Over the following weeks, she worked with 78 people, including hospitalists, case managers and emergency room scribes, to train them in the use of Hixny.

The scribes, who are responsible for capturing clinical information into the patient’s chart, did not have Hixny access before. Dr. Janikas said that was a “game changer.”

Pictured from left to right: Dr. Daniel Silverman, Chief Medical Officer, Acute Care-Troy; Tavia Rauch, Manager of Population Health & Data Quality, Hixny; Dr. John Janikas, Medical Director, Emergency Department at Samaritan

 

Now we have the scribes pull information while we are doing our clinical work. I have access to records I never had before—radiology reports, prescriptions, discharge summaries and notes on people who are not in our [EHR] system—and that is changing the decision making that is going on in the ED.

“When you’re an ED doc, and you’re running around, the last thing you want to do is log into something and lose your efficiency,” 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. Now we have the scribes pull information while we are doing our clinical work. I have access to records I never had before—radiology reports, prescriptions, discharge summaries and notes on people who are not in our [EHR] system—and that is changing the decision making that is going on in the ED.”

Dr. Janikas told of a patient who was scheduled for a CAT scan, and admitted to the hospital for observation, until Hixny revealed that he had recently had a complex workup at another hospital. The patient was screened and released.

“That is huge, and that decision changed because a scribe pulled a Hixny report and put it in front of me,” he said.

Marra, who said he used and saw the value in Hixny before Rauch’s visit shared a story of a patient who was admitted to Samaritan’s mental health unit. The young woman had just been transferred from Albany Medical Center, where she had undergone a crisis evaluation and some bloodwork. While the transfer was taking place, one of her blood screenings came back positive for HIV. The information was passed from nurse to nurse but paper documentation was necessary for Marra to act.

“So I went into Hixny and I pulled all her records and found the positive blood test. Now I could make a plan with the psychologist for HIV counseling and start treatments,” he said, “That was very helpful.”

Marra said he uses Hixny most often when working with patients in the mental health unit. His searches include records from other hospitals and EDs, medications patients are taking, and the identity of primary care physicians or specialists patients have seen. Dr. Silverman is happy with the way his organization has embraced Hixny and what it is doing for efficiency and
care delivery.

“Communication is care, and one form of communication is data and patient history,” he said. “You can’t take care of a patient without knowing their history, and Hixny provides that history. It helps you complete the picture to take care of your patient. It is bringing fragmented care into focus.”

Hixny will be performing extended maintenance beginning Thursday, December 31 through Friday, January 1. During this time, all services
will be impacted and unavailable—including access to the provider portal.
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