(TNS) -- Even in this digital age, doctors may have no idea that the patient they just saw in the emergency department showed up in another hospital’s ER across town the day before.
It may take five minutes of combing through pages of electronic medical data to learn essential information about a patient in the intensive care unit. Often lost in the shuffle is the patient’s humanity.
Two technology projects are under way at Bay Area hospitals, working toward solving those problems and reducing preventable medical errors, which claim about 250,000 lives a year in the U.S. and are the country’s third-leading cause of death, according to a recent study.
In San Francisco, UCSF has developed software with Johns Hopkins University School of Medicine to create an app that collects important information from patients’ medical records with data from equipment in the intensive-care unit to give doctors and nurses an immediate snapshot of an ICU patient’s condition.
In the East Bay, Sutter Health hospitals in Oakland, Berkeley, Castro Valley and Antioch are connecting with Highland Hospital in Oakland and San Leandro Hospital, which are in the public Alameda Health System, through a secure data-sharing platform designed to identify people who frequently visit the region’s emergency departments.
Both efforts are trying to bring together fragmented pools of data, give clinicians the information they need to make decisions, and tend to the patient’s social as well as medical needs.
“They may show up in one ER, or another ER or another within one geographical area,” said Dr. Arthur Sorrell, a Sutter Health information specialist and emergency physician. “Their care record isn’t really following them. Their care record is trapped in these boundaries.”
While emergency-room overuse accounts for an estimated $38 billion in wasteful spending each year, Sorrell said it’s about far more than saving money. “If we could each know what each other is doing, we could use our scarce resources and focus them better and to help take better care of the patient,” he said.
More than 5 million Americans wind up in an intensive-care unit every year, and many of them suffer harm that could have been prevented.
“The ICU is the place where the most medical errors happen. It’s not that it’s a bad place, but it’s where patients are the sickest and the most complex,” said Dr. Michael Gropper, chairman of the anesthesiology department and principal investigator of the UCSF-Johns Hopkins effort funded by the Palo Alto nonprofit Gordon and Betty Moore Foundation.
The academic medical centers started developing the system, dubbed Project Emerge, about three and a half years ago. “This has been a huge challenge. I don’t think anyone has done anything quite like this,” Gropper said.
The East Bay’s “virtual safety net” collaboration attempts to break through the information silos that clinicians say impede care.
The hospitals are using PreManage ED, a secure communications tool developed by Collective Medical Technologies that is widely used in Oregon and Washington. The system, which is designed to protect personal health information, works with the hospitals’ electronic health records.
“It’s like an intermediary between all those systems,” said Dr. David English, Alameda Health System’s associate chief medical information officer and a emergency physician at Highland.
But instead of dumping the patient’s entire medical history — which can be pretty lengthy for frequent emergency room users — the doctor or nurse clicks on a green icon on the screen that gives them pertinent and recent health information. An alert pops up if the patient has used the emergency department more than five times or visited three ERs in the past year.
“It certainly can reduce unnecessary services and has the opportunity to save lives, as well advise us about very real and serious medical conditions the patient has,” English said.
In the first 60 days after putting the system in place in March, providers at Highland and Alta Bates Summit Medical Center in Berkeley and Oakland learned they shared more than 2,000 patients. Of those, 1,448 patients had three or more ER visits in the past year, 730 had six or more visits and 248 identified themselves as homeless.
In one case, the system identified a 57-year-old patient with a history of mental health and chronic substance abuse who visited emergency rooms, including Alta Bates Summit and Highland, more than 900 times over the past three years, official said.
In another case, it alerted Highland doctors that a 48-year-old homeless woman who showed up in their emergency room with a rare abdominal tumor had been seen recently at Sutter Health’s Summit campus and already had a case manager.
The project, funded with a $75,000 grant from Oakland’s California HealthCare Foundation and a three-year $925,000 investment from Sutter Health’s philanthropic arm, goes beyond just the emergency department. Ultimately, PreManage ED will link up with primary care physicians, behavioral health clinicians, social workers, case managers and others trying to manage the care of patients in the two systems.
“Clinicians want to feel some sense of success, that they’re making a difference,” said Jim Hickman, president and CEO of Better Health East Bay, Sutter Health’s philanthropic foundation. “When you see patients go through a revolving door, you don’t always feel that way.”
UCSF’s Project Emerge, which also began in March, has been implemented in two of the hospital’s five intensive-care units. The system has cost upward of $20 million to create and implement at the two hospitals, Gropper said.
The system gives doctors and nurses a simple wheel-shaped chart that alerts them to potential harms to the patient in the ICU — like delirium, weakness and blood clots — and the status of the necessary tasks to prevent them from happening. If a field in the circle is green, all the steps have been done. Yellow signals action that needs to be taken. Red indicates potential risk.
In addition to medical complications, the “harms monitor” wheel also includes fields like shared goals about when a patient might be able to get out of the hospital and harms to the patient’s “respect and dignity.”
When families enter the ICU, they are given an iPad that they can use to enter information about their loved one’s life and health, as well as upload photos and list their likes and dislikes, fears and other concerns.
Humanizing the patient and involving the families are other ways hospitals can improve care, just like closer monitoring of equipment and following checklists.
“We tend to treat a patient like ‘This is a 65-year-old with pneumonia and sepsis,’ but this offers the opportunity to say ‘This is a retired woman with a family,’” Gropper said. “When I started out more than 20 years ago, it was a very physician-driven process.”
The new systems hospitals are introducing, in other words, at first glance may seem like they’re about the hardware. But they’re actually about flesh and blood.
©2016 the San Francisco Chronicle. Distributed by Tribune Content Agency, LLC.