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.

Meet Cynthia Neiman, CHOC Children’s Chief Marketing Officer and Vice President, Marketing and Communications

Meet Cynthia Neiman, CHOC Children’s new chief marketing officer and vice president of marketing and communications. A marketing professional with 30 years of experience, including a special background in digital marketing and branding, Cynthia holds a Master of Business Administration degree from Vanderbilt University, as well as a bachelor’s degree in economics from UCLA.

The marketing, tennis and all things Swedish enthusiast shares why she was inspired to join the CHOC team:

Q: What inspired you to join CHOC?

A: I have spent the majority of my career marketing to kids and young families. From IKEA to Mattel to most recently Ergobaby, I have always enjoyed working for organizations and brands that have strong emotional connections to the target market and to me, personally. As I reached this stage in my career, I knew that I wanted to give back in a more meaningful way by working for an organization that had a strong sense of purpose. When I was approached about the CHOC opportunity, I felt an instant connection because CHOC combined both my experience in reaching families, as well as the purpose-driven opportunity that means so much to me.

Q: How do you envision helping CHOC earn more national recognition as a leading destination for children’s health?

A: I am a big believer in the power of storytelling. As humans, we are hardwired to best understand and retain information when it is told in the form of a story. There are so many amazing stories here at CHOC that center around not only patients, but nurses, physicians and associates. Sharing CHOC stories in more powerful and compelling ways will be a key element in attracting more national attention and recognition for CHOC.

Q: What are a few things you’d like to accomplish at CHOC?

A: First of all, I want to continue the great work that is already happening in so many areas within CHOC, and continue to build on the momentum of opening the CHOC Children’s Mental Health Inpatient Center. Secondly, I want to help launch the Thompson Autism Center at CHOC Children’s that will deliver needed services to those families with children on the spectrum. Lastly, I want to develop and mentor my team so that we can be the best marketing partners possible for the many departments within CHOC, as well as provide marketing strategy and leadership in new areas that we haven’t developed yet.

Q: You enjoy mentoring and inspiring teams. What advice do you have for others wishing to do the same here?

A: Even though I pride myself on my digital experience, I have a bit of an old-school philosophy when it comes to mentoring. If you want to mentor a team, first and foremost, I think it is important to lead by example. Be present and make eye contact during conversations and deliver feedback early and often. My mother was the greatest mentor I ever had and she had one golden rule that I try to live by… “praise in public and criticize in private.”

Q: What three words would you use to describe yourself?

A: Mother. Friend. Competitor.

Q: How has being a competitive tennis player impacted you professionally?

A: Competing in a sport teaches us so many things. How to win.  How to lose. How to be a member of a team. How to overcome adversity and so many other traits that really benefit us in our personal and professional lives. I really love to work with and hire athletes because the drive to succeed while being a member of a team is a truly powerful combination and one that I have leveraged throughout my career. In tennis, like in many sports, you face different opponents and you may have to change your game plan mid-way through in order to win. In business, you may begin with one strategy, but if you find it unsuccessful, you’ll have to change tactics, just like in tennis, in order to be competitive. In addition, I have always been more of a doubles player than a singles player because I’ve always loved the teamwork of doubles and that has translated into my love of being on a team in a work environment.

Q: Why have you devoted your entire career to marketing to families/kids? What do you find most rewarding about that? 

A: I believe that it is the transitions in life that shape who we are. Being an expectant parent and starting a family is one of the most magical moments in someone’s life. I feel honored to play even a small part in a person’s journey during this special time. This period resonates so strongly with me because it reminds me so much of what my life was like when I had young kids…. frantic, chaotic and filled with so much love and great memories…. clearly some of my favorite moments.

Q: What do you consider career highlights to date?

A: At the top of my list (so far) would be launching IKEA in Southern California. At the time of the launch, IKEA was in Canada and on the east coast, but had not yet opened a location in California. There was an entrenched competitor called STOR who had copied IKEA’s concept and had three locations.  The marketing objective was to develop a strategy that would identify IKEA as the originator of the concept and put STOR out of business within one year. The theme of the advertising campaign became “Today the world.  Tomorrow Burbank.” The idea being that IKEA was a 40 year-old company with stores in 26 countries and now we were coming to your backyard.  We never had to mention the competitor and thanks to the multi-pronged approach marketing campaign, 150,000 people visited the Burbank location within the first six days of opening.  We shut down the 5 freeway and STOR went out of business within a year. I am truly thrilled to be at CHOC and look forward to topping my IKEA experience with some new initiatives.

Q: Tell us about the power of storytelling and how our associates/physicians and others can contribute.

A: The human brain is drawn to clarity and away from confusion. If people are confused about what you offer, they’ll look past you for someone who can say it clearly. A real challenge in health care is describing conditions and treatments simply and making the parent or patient the hero. With all of the great stories within CHOC, the real goal is to be able to work with our associates, physicians, nurses and others to tell their stories in a clear and compelling way.

Q: In addition to playing tennis, what do you enjoy doing outside of work?

A: I love to cook and talk about food which is probably why I also love to travel. Thanks to IKEA and being a foreign exchange student when I was 15 years old, I speak Swedish and really love traveling in Scandinavia.

IT Update from the Chief Health Information Officer: Dr. William Feaster

As our current fiscal year comes to an end, I am pleased with all the progress we have made this year and look forward to new and exciting information technology (IT) projects on the horizon. Last February, we welcomed a new vice president and chief information officer, John Henderson, to our organization. He joined us from Texas Children’s Hospital and has been a huge addition to our leadership at CHOC Children’s. A seasoned IT leader, John has a successful track record of guiding cohesive teams in the design, deployment, administration and enhancement of enterprise IT applications and infrastructures. We are also excited to onboard our new chief technology officer, Adam Gold, who will also be a great addition to our team.  The CTO is a new position for CHOC and Adam will be responsible for all our infrastructure including computers, networks, data center, communications and other technologies.

Dr. William Feaster, chief health information officer at CHOC

Currently, our technical staff just finished the roll-out of tap-and-go access to our clinical computers in the inpatient areas, emergency department, surgery (outside of OR and procedure rooms) and Outpatient Infusion Center. Now, when you log-in to our systems from these clinical areas, you can tap-in with your badge.  This has been a huge win, especially for our nursing staff, saving them a lot of time during the day as they frequently log in and log out. We hope to continue to optimize the performance of this technology and implement it in our clinics and other outpatient service areas beginning in July.

Remote access to our systems is also changing with the addition of two-factor authentication (2FA), a security process in which the user provides authentication factors to verify they are who they say they are. This is just as essential for protecting patient medical records as it is your bank account.  While 2FA is not new, it has become more prevalent in the current digital age. Beginning in June, we will be cancelling access to remote.choc.org for those who have already registered for two-factor authentication and over the following months, we will be switching all remote users to secure.choc.org.  Stay tuned for more information coming soon.

We are currently implementing a new Dynamic Documentation build in our Children’s Medical Group (CMG), replacing their current PowerNotes documentation. Beginning in July, we will be implementing our Cerner EMR in our other primary care practices, along with Cerner Pro Fee billing, and a new version of Cerner’s registration and scheduling called Cerner Practice Management (CPM).  CMG and our specialty care clinics that are part of CHOC Children’s Network will also be going to the new Pro Fee billing and CPM over the next year.  These enhancements are a huge undertaking, which are currently consuming our IT resources and may delay some of the requests that are frequently submitted.  We ask for your patience over these next several months.

In addition, we are continuing to advance our work in population health, data science and analytics. We are also continuing to develop new technologies to improve the care of our patients with chronic diseases, advance home monitoring technologies, better support our care management staff both in and out of the hospital, and develop predictive models for readmission and patient deterioration, among other things.

Lastly, we are eagerly awaiting the final word on our capital budget for FY19 to determine what new projects are approved for next year. Our highest priority right now is to implement E-prescribing for controlled substances (EPCS), which we hope to do in the first half of FY19.

Should you have any questions about any of these developments, or other issues related to current information technology systems, please feel free to contact me at wfeaster@choc.org, or at 714-509-7637.

William Feaster, MD

CHOC Children’s Chief Health Information Officer

Mental Health Nurse Manager Shares How Nursing is the Art of Caring for People

CHOC Children’s wants its community providers to get to know its staff. In recognition of National Mental Health Awareness Month, meet Lisa Schneider, nurse manager in CHOC’s new Mental Health Inpatient Center.

Q: What is your education and training?
A: I have a degree in nursing from The Ohio State University, and I am in the last semester of completing my master’s degree with a focus on Nursing Administration. In addition, I am a board-certified psychiatric-mental health registered nurse.

Q: What are your special clinical interests?
A: I am very passionate about pediatric mental health. I have a strong interest in trauma-related diagnoses and crisis prevention, as well as serving as an advocate to de-stigmatize mental health.

Q: How long have you been on staff at CHOC?
A: I am new to the organization and so excited to be here! I have been with CHOC since January 2018.

Q: What diagnoses are most common among the patients you care for?
A: As the community is beginning to recognize mental health disorders sooner, children and adolescents can present with a wide range of diagnoses such as depression, anxiety, eating disorders, psychosis, autism, PTSD, and ADHD, among others.

Q: What myths about mental health would you like to dispel?

A: Many people believe that talking to kids about suicide can put the idea into their heads. However extensive research has shown that this is not the case. Suicide is currently the second leading cause of death in children and young adults ages 10-24. Start the conversation now and talk to your kids about suicide – it could save their life.

Q: What excites you most about the Mental Health Inpatient Center?

A: The opening of the Mental Health Inpatient Center is so exciting because we will be providing innovative care and services to children and their families. The unit will consist of private rooms, group activity rooms, an expansive outdoor play area, along with daily programming such as music therapy, art therapy, pet therapy, and classroom education. The Center is designed around aspects of nature to promote a holistic and healing environment.

In addition, every child will receive a comprehensive treatment plan which will include individual and family therapy sessions while inpatient, and care continuation at discharge. I am so excited for the positive impact this Center will have on the kids in our community, especially since we will be the first to offer inpatient mental health services to children under the age of 12 in Orange County.

Q: What inspires you most about the care being delivered here at CHOC?
A: I am inspired by the tremendous amount of dedication that CHOC has shown in our mission to provide quality healthcare to children. Specifically, we are taking a leadership role and setting a high standard through our commitment to de-stigmatizing mental health and expanding services. It is important to remember health does not solely rely on physical health, but strongly depends on mental health as well. In order to achieve overall health and well-being, mental health must be cared for with the same emphasis that is placed on physical health.

Q: Why did you decide to become a nurse?
A: I chose to become a nurse based on the philosophy of nursing. Nursing is known not only as a science, but also as an art in caring for people. I have a passion for creating strong nurse-patient relationships, which can promote the healing process. I chose pediatrics because I’m inspired by the resiliency I see in children, and mental health specifically because I strongly believe in the concepts of prevention and early intervention.

Q: If you weren’t a nurse, what would you be and why?
A: If I wasn’t a nurse, I think I would probably be a police officer. I enjoy serving others and building strong relationships within the community.

Q: What are your hobbies/interests outside of work?
A: Outside of work, I love spending time with my husband and 4-year-old son. We are new to California so we have been spending a lot of time exploring this beautiful state!

Learn more about CHOC’s mental health services at www.choc.org/mentalhealth.

Meet Dr. Micaela Thordarson

CHOC Children’s wants its referring physicians to get to know its specialists. Today, meet Dr. Micaela Thordarson, lead psychologist, ASPIRE® (After School Program Interventions and Resiliency Education) Intensive Outpatient Program at CHOC Children’s. 

Q: What is your education and training?

A: I earned my bachelor’s degree in psychobiology from UCLA with a minor in Spanish. I earned my PhD and master’s degree in clinical psychology from Palo Alto University with a specialization in children, adolescents and families. I completed my pre-doctoral internship with Nationwide Children’s Hospital in Columbus, Ohio, and my post-doctoral fellowship with Geisinger Health Systems in Pennsylvania.

Q: What are your special clinical interests?

A: I am particularly passionate about working with high-risk pediatric patients. I have done a great deal of work with suicidal and self-harming youth and their families. As a bilingual clinician in Spanish and English, I am also very interested in the interactions between mental health and cultural identities, for example, race/ethnicity, gender, religion and age.

Q: How long have you been on staff at CHOC?

A: I joined CHOC in October 2017.

Q: What are your most common diagnoses?

A: Depression, anxiety, and major life stressors are the most common difficulties our patients face.

Q: What would you most like community/referring providers to know about the ASPIRE® Intensive Outpatient Program at CHOC Children’s?

A: Our eight-week intensive outpatient mental health treatment program – the only pediatric-dedicated one of its kind in Orange County — is designed to serve a broad range of emotional and behavioral difficulties for high-school aged teens 13-18. It includes individual and family sessions, and crisis support as needed. If the teens and families you serve could possibly benefit from an intensive program, please don’t hesitate to reach out to me. Additionally, we aim to collaborate closely with all the important stakeholders in our patients’ lives. This includes primary care physicians, psychiatrists, therapists, educators and coaches.

Q: What would you most like patients and families to know about ASPIRE®?

A: While our program is hard work, it’s pretty fun to be a part of! The daily after-school programming for teens and their families is all interactive, including art and other expressive therapies, and designed to teach and practice new skills in fun ways.

Q: What excites you most about the program?

A: I am so excited to be able to offer a very important service to teens and families who are in crisis and need extra support. The program we offer is guided by research and has been carefully constructed to generate the best outcomes possible.

Q: What inspires you most about the care being delivered at CHOC?

A: I have worked with a number of different organizations and teams since I began my career in the mental health field. The team at CHOC is unparalleled in its enthusiastic dedication to innovation and excellence in the care of children.

Q: Why did you decide to become a psychologist?

A: I fell in love with the field of psychology immediately after taking my first job at a crisis shelter for teens. Getting to witness, and even participate in, the incredible changes these youths made in their lives in a few short weeks was inspirational. I knew that was work I wanted to be a part of for the rest of my career.

Q: If you weren’t a psychologist, what would you be and why?

A: Either a zookeeper, so I could spend time with cool animals every day, or a Disney princess at one of the theme parks so I could wear awesome costumes and play with kids all day.

Q: What are your hobbies/interests outside of work?

A: I love spending time with my family, hiking with my dog, and eating delicious food. I have a huge family and we have a lot of fun together!

To contact Dr. Thordarson, or to refer a patient, please call 714-509-8481.