Executive Notes

Report from Vice President of Medical Affairs, Norwalk Hospital Lewis Berman, MD

First, it has been an eventful 3 months at Norwalk Hospital:

Our new inpatient Palliative Care program kicked off in April. This program, a multi-disciplinary effort led by Myra Skluth, MD , and Iris Nagin, APRN, in collaboration with Oncology, Care Management, Nursing, Chaplaincy, Pain Management, Critical Care and the Hospitalist program is focusing on hospitalized patients with non-oncologic diagnoses.
We are excited that Anton Trinidad, MD, has been selected as our new Chairman of Psychiatry. He is currently at the University of Texas at Houston and will be starting on September 2, 2014.
Our free lung cancer screening program has been very successful. So far this year, we have performed 939 CT scans which have identified 16 lung cancers!
Norwalk Hospital physicians have been supporting the Hospitals transformation to a high reliability organization. Many physicians have already completed their high reliability training, we have instituted a regular telemetry safety huddle with our nocturnist and nursing staff, and the medical staff is actively participating in our daily, hospital wide safety huddles.
Shawn Tittle, MD and Jason Orlinick, MD have been leading a multidisciplinary team focused on assuring that patients receive high value care while minimizing waste. Due to their efforts, we have seen more efficient use of the OR robot and decreased utilization of unnecessary blood tests and IV medications on the medical / surgical floors.

Second, a Report on Horty Springer Bylaws Committee:

Hospital medical staffs are governed by written documents including Bylaws, Credentialing and Peer Review policies. As with other legal documents, these policies require periodic review and revision to ensure that they are current. We have created a Bylaws Subcommittee at Norwalk Hospital to do this. Members include Drs. Charles Adelmann, Yoni Barnhard, Lewis Berman, Marvin Den, Kathleen Lavorgna, Stephen Michaelson, Jason Orlinick, Nicholas Polifroni, Vicki Smetak, Klaus Thaler and Kristen Staikos (the Hospital's General Counsel). This team will work with the Horty Springer law firm which specializes in Medical Staff issues. With Horty Springer's extensive experience and perspective and taking into account recent changes in medical practice, we anticipate review of many areas including the types of hospital privileges, integration of Allied Health Professionals, and the Peer Review process. Please keep an eye on your emails for further information. We will also update you at the Quarterly Medical Staff meetings and plan to solicit your feedback.

Third, our Patient Portal

(A report from Stephen P. O'Mahony, MD, FACP, Chief Medical Information Officer)

As Stage 2 of Meaningful Use looks to advance clinical processes of care towards improved healthcare outcomes, it is simultaneously demanding transformative technology while challenging us to optimally integrate these new workflows. Given the increasing complexity, it is estimated that fewer than 20% of eligible hospitals will successfully meet Stage 2 measures by the year’s deadline next month. Great news, however, is that the Norwalk campus was one of the few hospitals in the country to successfully attest so far.

Our Meaningful Use project has established key tools in improving healthcare for our patients, and ultimately laying a foundation to increase value, manage populations, and succeed in healthcare transformation. Highlights include electronic sharing of patient information, e-prescribing, and most visibly the patient portal.

The patient portal has been recognized as a transformative tool in engaging our patients in their own healthcare. Portals have been shown to not only improve patient satisfaction, but quality outcomes as well. With the Norwalk portal, named “My Health Notes,” patients are able to view their laboratory results, medications, allergies, diagnoses, patient education and documents. So far, documents include ED visit and inpatient summaries, but has the potential to expand as needed. Not only can this information be viewed, it can be downloaded for patients to bring to their providers, or even transmitted via secure “direct” email. Currently, viewing has been the dominant mode for patients, however as more providers acquire their own secure direct email accounts along their own path to Meaningful Use, electronic transmission will rise.

One of the biggest challenges to meeting Meaningful Use has been having at least 5% of patients discharged actually sign on and use the portal. Despite kicking off the patient portal in April targeting the entire community at local events and health fairs, surprisingly few patients took initiative early on. In addition to brochures, a multi-disciplinary team was needed to register patients upon admission, assist patients in signing on while in the hospital, and making phone calls to encourage those at home who missed the opportunity.

So far, the project has been positive. Patients calling the hospital for results have been very pleased to sign on and retrieve results themselves. Although the volume of questions has not been high, after being received and reviewed by the proper staff, updates have resulted in better quality of information. Since the portal views the same information in the EMR as providers, we are thus acting on improved data.

Accompanying this celebration of the portal, we thank all of you for acceptance of this new way to practice and the substantial adjustments to workflow. For the benefits of patients, many are taking the time to answer the new questions that arise while learning ways to communicate with patients that can even improve efficiency. However, as portals continue to expand, IT is committed to integrating these workflows to make it as easy as possible for both you and your patients to benefit.

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