UCLA Health was named a 2018 HIMSS Davies Enterprise Award recipient for leveraging the value of health information and technology to improve outcomes. The three award-winning use cases cover reducing denials of payment through automated notifications to case management, improving depression screening in primary care, and optimizing blood utilization using real-time clinical decision support.
The utilization review process has become increasingly complex and important in the current healthcare reimbursement climate. This presentation demonstrates how UCLA Health leveraged their electronic health record (EHR) to save two million per year in denials. Through automated error detection and notification systems, this project utilized existing resources for cost-effective solutions that do not place additional burden on the provider.
UCLA Health identified a number of obstacles in standard workflows that contributed to the underperformance in depression screening and follow up care. Utilizing continuous Plan-Do-Study-Act (PDSA) cycles, the organization implemented new workflows, developed ongoing training programs, built new web-based and EHR-based tools, and continuously monitored for performance and optimization requests. In this presentation, UCLA Health discusses their optimized workflows and the significant clinical outcomes.
UCLA Health improved appropriate red blood cell utilization through a collaborative effort with hospitalists, Transfusion Medicine, Nursing and IT departments – utilizing IT-enabled strategies to increase the number of guideline-indicated red blood cell transfusions and decrease the number of routine two-unit transfusions. A dynamic order set with embedded real-time clinical decision support based on the patient’s most recent hemoglobin concentration was created to guide providers to order appropriately. This use case illustrates how a complex healthcare organization implemented and sustained a patient-centered, evidence-based multidisciplinary approach to utilizing a rare and limited resource – blood.