CHOC Children’s CHIO Recognized for Leadership in Health Information Technology

Dr. William Feaster, CHOC Children’s chief health information officer, has been recognized nationally for his leadership in utilizing health information technology to increase positive outcomes for patients.

Dr. William Feaster, chief health information officer at CHOC

Already recognized as an international leader in population health technology and analytics, Dr. Feaster was one of five physicians to receive a Physician All-Star award from Cerner, a leading worldwide provider of health information technology solutions, services, devices and hardware, at its recent annual conference.

“This award further validates the important work underway at CHOC Children’s to use data to save children’s lives,” Dr. Feaster says. “Advancing technology will continue to dramatically enhance how we practice medicine, and I am proud to stand with CHOC on the forefront of a dramatic shift that will ultimately lead to more children having happier and healthier childhoods.”

As CHOC’s chief health information officer, Dr. Feaster leads the implementation and adoption of technologies that support clinical care and data analysis across the healthcare community. His work promotes the application of data science tools on healthcare data for predictive analytics, data mining, and related technologies to support new informatics initiatives.

Dr. Feaster’s work supports CHOC’s population health efforts; innovation and performance excellence initiatives; and clinical and translational research informatics.

At CHOC since 2012, Dr. Feaster has been involved in advancing information technology throughout nearly 40 years of clinical practice in pediatric critical care and anesthesia. He has held several medical administrative positions in hospitals, health systems and universities, and is board-certified in pediatrics, anesthesia and clinical informatics.

The annual Cerner Health Conference, held mid-October in Kansas City, Mo., drew nearly 14,000 healthcare industry leaders, practitioners and employees to discuss the latest innovations for health information technology.

CHOC Children’s at Forefront of Leveraging Data to Enhance Quality of Care

Earlier this year, clinicians, hospital administrators, and other leaders in the medical field gathered for the American Hospital Association (AHA) Health Forum Critical Conversations in health care event in Texas, which focused on leveraging health care data to improve care.

Dr. William W. Feaster, chief health information officer at CHOC Children’s, presented on the ways CHOC is applying intelligence to data and building it into the care process to better understand quality of care and patient satisfaction scores.

Dr. William Feaster, chief health information officer at CHOC

CHOC uses Cerner’s HealtheIntentSM platform to bring in data from different sources, such as EHRs, pharmacies and payers. The system normalizes the data and builds “smart registries” for certain high-cost pediatric conditions. Dr. Feaster explained that these registries go beyond tracking patient status and outcomes for a defined population. Built on top of multiple EHRs and other sources, they extract data and then feed key patient information to clinicians at the point of care, creating a living tool, rather than a more static reporting mechanism. Adherence to clinical guidelines at CHOC has improved progressively with the advent of these smart registries.

CHOC is also using analytics to improve asthma care quality and outcomes. Additionally, CHOC is applying machine learning tools to predict readmissions and to provide this information to case managers to better manage the patient discharge process. For outpatients, CHOC is also exploring how these data science tools can help predict and prevent appointment no-shows.

To learn more about CHOC’s case study, click here for a copy of Cerner’s Transforming Health Care Delivery ebook.

Submit an Idea through the Innovation Lab

Did you know CHOC Children’s has partnered with the Innovation Lab as part of the Innovation Institute to help CHOC caregivers commercialize healthcare product ideas?

Click here for “Turning Your Idea Into a Marketed Medical Device,” by American Association for Physician Leadership.

To learn more contact Suzy Engwall, national director of the Innovation Lab, at 714-234-6349 or at suzy.engwall@ii4change.com.

To learn more about innovation at CHOC, click here.

 

CHOC Leads the Way in Implementing Food Standards for Dysphagia Patients

CHOC Children’s has emerged as a leader in implementing a new global standard for assessing food and liquid consistencies for patients with swallowing difficulties.

CHOC was one of the first pediatric hospitals nationwide to implement the International Dysphagia Diet Standardization Initiative (IDDSI), which aims to establish a standardized system of measuring and labeling the thickness of food and drink.

The goal is to ensure patient safety and improve treatment outcomes, say Jennifer Raminick and Danielle Monica, two CHOC speech language pathologists who spearheaded the system’s adoption.

Established in 2013 by a group of dysphagia specialists, IDDSI was created to standardize descriptions, consistencies and terminology for diet modifications for patients of all ages, locations and cultures.

The initiative is a marked departure from previous guidelines that relied on ambiguous labels and descriptions that often varied across institutions and providers, and required specialized, arcane equipment to measure food consistency.

IDDSI framework indicators and descriptors.
(c) The International Dysphasia Diet Standardisation Initiative 2016 @http://iddsi.org/framework/.

Conversely, IDDSI guidelines are simple and clear; testing is easy and takes 10 seconds or less; and testing tools are easily accessible to providers and at-home caregivers, Danielle and Jennifer say.

Here’s a brief explanation of the flow testing process to assess a liquid’s thickness: Cover the spout of a 10-mL syringe and fill it with the liquid. With a stopwatch in hand, open the spout for 10 seconds, and then stop the flow. The amount of substance remaining in the syringe is then compared to a rubric to gauge its consistency.

If 1 to 4 mL of the substance remains in the syringe, it is considered of “slightly thick”; 4 to 8 mL remaining is considered “mildly thick”; 8 to 10 mL is “moderately thick” or liquidized; and a substance with 10 mL remaining is “extremely thick” or pureed.

Beyond those categories, food is assessed and labeled as, “liquidized” “pureed” “minced and moist,” “soft and bite-sized” or “regular.” These categories are determined by how the food flows off a spoon or fork, or by measuring a food particle against a ruler.

To implement the program house-wide, the rehabilitation services team partnered with several other departments and disciplines.

Jennifer and Danielle worked with CHOC’s Clinical Nutrition and Lactation department as well as the food service team to create a specific menu for dysphagia patients. It included limited options for each level of consistency and easy-to-follow recipes with three ingredients or less. All food is made from scratch.

The rehabilitation services team developed curriculum for multi-level education of current and new dysphagia therapists, physicians, nursing, dietitians, and food service staff members.

Learn more about rehabilitation services at CHOC.

CHOC Heart Patients Among First to Experience Clinic of the Future

A pilot program at CHOC Children’s is giving cardiac patients and their families more peace of mind. Launched by pediatric cardiologist and CHOC’s chief intelligence and innovation officer Dr. Anthony Chang, the CHiP (Cardiopulmonary Health intelligence Program) clinic provides home monitoring equipment to families for the purpose of tracking patients’ vitals, such as blood pressure and oxygen saturation. Through telepresence, families can also connect with their physicians without leaving their homes.

Dr. Anthony Chang
Dr. Anthony Chang, pediatric cardiologist and chief intelligence and innovation officer at CHOC Children’s

“Patients and families feel more comfortable outside the clinical setting. But when away from the hospital, parents can feel very anxious about their children’s health and well-being,” explains Dr. Chang. “Our CHiP clinic ensures continuity of care, while providing great comfort to parents who know they can connect with their physicians without visiting their offices.”

CHiP is based on another innovative idea from Dr. Chang: the iClinic. According to Dr. Chang, the iClinic is a philosophy of leveraging emerging technologies to help create efficiencies, improve workflow and the continuity of care for patients by bringing CHOC expertise to patients’ homes.  The ultimate goal is improving quality care and positive outcomes for patients.

CHOC Children's Heart Institute

There are five key components of the iClinic, all starting with the letter “I”:

  • Instantaneous – Instead of periodic measurements at home, monitoring devices can measure at any time.
  • Intermittent – Instead of being limited to scheduled visits, virtual visits can happen at any time. These virtual visits can include educational sessions, in addition to wellness checks.
  • Individual therapy – Precision medicine is built into the iClinic, including genomics and pharmacogenomics, to find the medicine or treatment best suited for the patient.
  • Intelligent data-driven medicine – All data is compiled and analyzed to make the best possible decisions, including personalized medicine and drug discovery.
  • Intuitive interactions – Through telepresence and the ability to provide instantaneous data with feedback, the iClinic contributes to an experience that feels authentic and intuitive.

Dr. Chang envisions rolling the “clinic of the future” to other specialties at CHOC, beyond CHiP.

“This is the clinic of the future. It is inclusive of wearable devices, avatars, artificial intelligence and genomic medicine. But it’s important to note we’re not using the technology for the sake of just using fancy gadgets.  We are leveraging emerging technologies to really change how we deliver care in the best possible way,” explains Dr. Chang.

Providers who are interested in piloting a similar program at their institutions are free to contact Dr. Chang at achang@choc.org.