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Coming: A PIVOT transformation of patient care

January 30, 2017 News and insights By Donald Klingen, MD

There’s an organizational transformation underway at Main Line Health that will enable us as physicians to profoundly impact how we provide care to patients.

The PIVOT initiative—Promoting Innovation by Valuing Organizational Transformation—is building a new technological infrastructure that will seamlessly integrate inpatient and ambulatory care with clinical and financial systems, and fully support value-based care and population health.

More than just a massive IT project, it’s a clinical boon for physicians—one that will substantially enhance our capacity to offer exceptional patient care with greater ease and efficiency, thanks to substantial physician input.

Across Main Line Health, the six Clinical Environment Workgroups (medicine, surgery, ER, mother/baby, rehabilitation and outpatient) are evaluating, redesigning and standardizing how we deliver care. The goal is to improve every process we have, so that—no matter what office or campus a patient visits—the experience is the same: whether scheduling an appointment, undergoing a procedure, or being discharged home.

The heart of PIVOT is the Epic electronic health record system, to be launched on March 3, 2018, meticulously customized based on ongoing input from physicians across Main Line Health. More than 50 physicians, core leads from every department and campus, are involved in building, testing and signing off on Epic components—from ensuring ease of navigation to validating clinical content.

Epic will fundamentally change how we as clinicians interact with our patients and significantly improve patient engagement. Some examples:

  • There will be one record for each patient across the continuum of care, from the ER to the patient floor to the outpatient visit. Epic will integrate inpatient and outpatient clinical records, plus integrate ancillary and support services such as operative notes, making everything visible in one convenient place to all who are caring for a particular patient.
  • Comprehensive, individualized care plans—from nursing assessments to hospital discharge instructions—will be visible to the patient and permitted family members.
  • For primary care physicians, an enhanced health maintenance and care gap module will alert both clinicians and patients when it’s time for routine screenings and office visits, and send tailored reminders for patients with chronic conditions. Current time-intensive, manual processes will become obsolete. PCPs will have greater insight into population health, as well as the tools to more effectively engage patients in their own care.
  • For surgeons, Epic will provide a unified approach to preadmission testing, ensuring that patients are properly prepared for surgery and greatly reducing same-day cancellations and delayed start times.
  • For cardiologists, Epic will mean an upgrade from the current Legacy imaging system to Cupid, which will better meet their needs thanks to cardiology team input.

I am immensely impressed with and grateful to the clinical leaders who have taken ownership in the complex decision-making and issue resolution processes as we develop the new system. Such strong engagement will surely lead to the successful launch of Epic in 2018 and serve to position Main Line Health as an increasingly strong competitor in the changing health care market.

Donald J. Klingen, MD, is chief medical information officer for Main Line Health.