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An EHR-agnostic dashboard technology that displays a ribbon of information featuring prescription and lab costs, opioid tracking, patient risk and other clinical data at the bottom of a provider's work screen at the point of care has helped hospitals in Texas reduce patient discharge costs
The dashboard technology, developed by Alabama-based startup IllumiCare and called Smart Ribbon, caught the eye of Fernando Martinez, chief digital officer at the Texas Hospital Association (THA), in 2015. THA is an organization that advocates for the state's hospitals and healthcare systems and includes around 500 member hospitals.
EHR-agnostic dashboard technology benefits THA hospitals
Martinez said what "fascinated" him about the technology was that it was EHR-agnostic and could be implemented without having to be "literally integrated" into the EHR.
"To the best of my knowledge, no one else is doing anything like that," Martinez said. "What I saw was a technology that was EHR-agnostic that would provide physicians or caregivers at the point of care important information that they did not have, which would allow them to deal with two of the biggest problems we have in hospitals across the country, which is managing affordable spending ... and reducing variability of care," Martinez said.
The Parkland Health & Hospital System in Dallas, Texas, became the first hospital where the EHR-agnostic dashboard technology was installed, Martinez said. Now, the technology is deployed in dozens of Texas hospitals.
Fernando Martinezchief digital officer, Texas Hospital Association
Martinez said every THA member organization that implemented the dashboard technology has seen "significant positive impacts" due to medication costs and lab tests being brought to the forefront for providers at the point of care.
"Not only to the overall cost of the organization, we've seen reductions in cost per discharge in excess of $100 per discharge, which is very significant," Martinez said. "The value to our hospitals has been without exception stronger than any of the models predicted they would be."
Houston Methodist is in the process of piloting the technical components of the technology in one of the system's eight hospitals before deciding whether to install the EHR-agnostic technology system-wide.
Ryan Arnold, Houston Methodist's project director, said Houston Methodist leadership sees the dashboard technology as an opportunity to address the "Triple Aim" in healthcare, "improving the health of our patient population, improving the patient experience, including the quality of care and their satisfaction, as well as addressing the cost of healthcare."
"We felt that by providing the information to physicians about the quality of care, the tests that they've performed, as well as the cost of those resources, that they can better address and manage the resources to the betterment of our patients," Arnold said. "We also found that we have physicians who are interested in a better understanding of what has generally been inaccessible information -- what are the costs of certain drugs, the cost of certain tests, so we felt this was a good way to make that transparent to our physicians."
How the EHR-agnostic dashboard technology works
The technology runs alongside the EHR without requiring actual integration, IllumiCare CEO G.T. LaBorde said. The company wanted to offer a platform that could display information not typically found in the EHR, such as medication costs, how many tests had already been run on a patient and how much blood had already been taken, that might be useful in guiding decisions being made at the point of care, LaBorde said.
LaBorde said IllumiCare's approach was to make the Smart Ribbon technology EHR-agnostic, user-friendly and feature applications, or "apps," along the ribbon.
One of the apps within the ribbon displays the wholesale cost of scheduled medications, while another app displays lab tests a patient has already undergone. The apps provide lower cost alternatives, giving providers the opportunity to order fewer or less expensive tests and medications for a patient. While IllumiCare has developed its own apps for the Smart Ribbon, he said the ribbon allows developers to build other apps that can be added to the EHR-agnostic ribbon of information because the technology has the "infrastructure that enables that kind of development."
LaBorde said the Smart Ribbon technology is currently deployed in more than 100 hospitals, including 65 Epic and 28 Cerner hospitals. Both Epic and Cerner officials declined to comment on implementing the Smart Ribbon technology.
IllumiCare CEO predicts additional innovation
LaBorde said two big pain points of any new technical integration are hospital IT departments that are too busy to implement and upgrade existing systems and not enough bandwidth to do heavy integration work, making it "painful" for new innovation to quickly diffuse in a hospital system.
With the EHR-agnostic Smart Ribbon dashboard technology, LaBorde said new, innovative apps can be easily added to the ribbon of information and can be displayed on different EHRs without hospital IT departments having to do integration work. LaBorde said he feels the Smart Ribbon technology is "game-changing."
"Our hope is, by lowering both of those burdens, it will make it easier for both health systems to try and adopt new things and for developers to build new things."