August 24, 2020

2020 has been an unprecedented year filled with many challenges. We’ve engaged in social distancing practices like we have never done before. We are wearing protective face masks, both at work and in public, in an effort to protect ourselves, each other, and prevent the further spread of the coronavirus.

But despite the uncertainty and daily disruptions caused by the COVID-19 pandemic, this health crisis has prompted our physicians, nurses and other patient care staff to explore innovative, non-traditional approaches to patient care processes – like e-rounding – to enhance the provider/patient experience.

Daily patient rounding has been around for centuries, and is an important part of the patient care process. Before COVID-19, a group of multidisciplinary staff would gather in or outside a patient room to discuss the patient’s condition and plan of care with the patient’s family, taking into account the experience, concerns, questions and needs of the patient. Through this multidisciplinary, family-centered approach, each team member would then contribute their expertise to support the best possible care/outcomes for the patient.

To adapt to COVID-19 and to ensure social distancing practices are followed, our critical care teams began conducting patient e-rounding in April, which has been a beneficial change from the norm.

“E-rounding has been a big change for us,” said Dr. Jordana Goldman, attending physician in Critical Care. “Rounds are as old as time in medicine and so it takes a little bit of practice to get use to it. But once you get the flow of it, it really works well. Our physician and nursing leaders, and the e-Health and IS teams have been very supportive in helping us leverage new technology to make e-rounding possible.”

Through the VidyoConnect platform, virtual “rooms” are created that are then available for all rounding team members to join. During e-rounding, an attending physician, bedside nurse and family member, can be outside the patient’s room in front of a computer screen while maintaining social distancing, and can communicate virtually with remote team members including our consultants, the provider team (consisting of APPs, fellows and residents) dietitian, pharmacy, Respiratory Therapy support and other members.

“We facilitated the implementation of e-rounding by working with Dr. Goldman and Dr. Aarti Bavare to integrate their ideal workflow using the software and hardware that we already had available,” said Dr. Robert Ball, medical director of e-Health. “It was the team work of Information Services, e-Health and the physician champions that made it a reality. When you have amazing innovators in every corner of our organization working together to enhance this process, there are no obstacles that cannot be overcome.”

Since e-rounding was first introduced in the PICU and CICU in April, e-rounding has expanded to other parts of the hospital including the acute care cardiology floor. PHM has been working on the acute care side on a version of e-rounds to help with the education of the residents and medical students. Plans are underway to expand e-rounding capabilities to the Pavilion for Women and NICUs with the option of e-rounding being made available to all inpatient areas at our three hospital campuses in the coming weeks.

Our e-Health teams are also working on the ability to leverage VidyoConnect to communicate with families in a HIPAA compliant way so they can join rounds when they are not able to be at the bedside.

“The disruption of COVID-19 has allowed us to take a closer look at our rounding practices and see how we can improve them for our patients, team, learners and consultants,” Goldman said. “This is a very new process for us, but our team’s willingness to engage in this novel approach has been pretty phenomenal.”

January 6, 2020

Texas Children’s has achieved HIMSS Stage 7 designation for Inpatient and Ambulatory across the system, which demonstrates the organization’s successful implementation of health care information technology to address quality initiatives and improve the delivery of patient care, efficiency and safety. In 2019, only 7 percent of hospitals in the U.S. achieved Stage 7 designation.

“Our hospital is among a small, elite group of health care organizations in the nation that have been awarded Stage 7 designation for inpatient and outpatient facilities,” said Myra Davis, senior vice president of Information Services. “This collaborative milestone is a culmination of nearly a decade of implemented technological solutions and data gathering to advance patient outcomes and further differentiate Texas Children’s from other hospitals that provide care for children and women.”

Reviewers from HIMSS Analytics visited Texas Children’s Medical Center Campus on December 16 and 17 to validate the organization’s achievement of Stage 7 in our inpatient and outpatient facilities, including Texas Children’s Pediatrics on Kirby Drive. Staff answered questions about the hospital’s use of technology to support patient care including processes for clinical information documentation, tools for quality metrics and analytics, and the handling of paper documents.

“It was wonderful to hear reviewers acknowledge our Quality and IS collaboration as being ‘best in class’, among other notable mentions,” said Texas Children’s Chief Medical Information Officer Dr. Carla Giannoni. This has been a goal that we, as an organization, have been actively focused on achieving.

HIMSS reviewers noted several key IS achievements that contributed to our Stage 7 designation:

  • Optimizing clinical workflows – This has improved the quality of care across the system whether in the emergency center or at a primary care practice. Epic’s electronic mobile application suite allows providers to e-prescribe medications and improves the safe and secure transmission for patient health information among providers.
  • System integrations – Integration of the PACS link in Epic for imaging review and lab results has provided our providers with a holistic view to determine a more personalized plan of care. A system integration that was implemented is MyDining, a new room service feature that offers healthier menu options for patients during their hospital stay.
  • Electronic health record (EHR) enhancements – Examples of enhancing the EHR include decision support in the form of Best Practice Alerts that automatically notify staff of certain conditions such as the risk of Sepsis or the need for an influenza immunization.

“The maturity of health information technology and data analysis are key to advancing outcomes and experience for our patients and providers,” said Julie McGuire, director of Enterprise Systems for Information Services. “We are so grateful to have completed this last step in our Stage 7 journey. We were able to achieve this designation through the collaborative support from our dedicated partners.”

The tireless leadership of the planning team members from several departments that contributed to Texas Children’s obtaining Stage 7 designation included Quality, Radiology, Pharmacy, Texas Children’s Pediatrics/Texas Children’s Urgent Care, Health Information Management, Nursing Clinical Informatics, Chief Medical Information Officer and Associate Medical Information Officers, Mission Control, subspecialty services (Pediatrics, Surgery and Women’s Services), Pathology, Emergency Management and all employees and staff who hosted the site visits in their respective areas.

“Our goal is to optimize the digital tools that surround the providers so we can radically improve our performance and deliver better care,” said Texas Children’s Chief Quality Officer Dr. Eric Williams. “We are proud of the Stage 7 designation, but we are more proud of how our digital transformation has improved patient care.”

September 30, 2019

October has been designated as National Cyber Security Awareness Month by the National Cyber Security Alliance. Each year, the campaign encourages safe online behavior by educating users on the importance of cyber security and how to be cyber safe.

Texas Children’s activities

We are excited to kick off Security Awareness Month. Your Information Security team at Texas Children’s will share valuable information and resources throughout the month to educate, enable and empower employees to be more cyber aware and secure. Watch for weekly newsletters from Information Security throughout the month. Together, we can be good online citizens and stewards of protected information.

Texas Children’s events

Information Security will have a series of onsite events to increase awareness and share information. Please see locations, dates and times below:

  • Tuesday, October 8: 10 a.m. to 2 p.m., Main Campus (The Auxiliary Bridge)
  • Tuesday, October 15: 10 a.m. to 2 p.m., The Woodlands Campus (Donor Wall)
  • Tuesday, October 22: 10 a.m. to 2 p.m., West Campus (first-floor main entrance)
  • Thursday, October 24: 10 a.m. to 2 p.m., Texas Children’s Health Plan (WLS_ninth-floor conference room_NE924)
  • Friday, October 25: TBD, Cyber Security Escape Room [Feigin Tower_FC 6 IS (C.0650.46)]

 

September 23, 2019

Texas Children’s has received the 2019 “Most Wired” designation for outstanding healthcare-based technology from the College of Healthcare Information Management Executives (CHIME).

The annual Most Wired survey recognizes hospitals and health systems nationwide for information technology (IT) initiatives in the areas of infrastructure, business and administrative management, clinical quality and safety, and clinical integration. For the first time, CHIME introduced separate surveys for domestic, ambulatory and international healthcare. Texas Children’s earned Most Wired in the domestic and ambulatory surveys. We did not participate in the international survey.

“Earning Most Wired designation reflects the partnership of the Information Services team and our many clinical and operational partners at Texas Children’s,” said Myra Davis, senior vice president of Information Services. “One of our strategic goals is to leverage technology and digital platforms to revolutionize the way we provide care to our patients and manage our business enterprises.”

Texas Children’s has earned Most Wired recognition in 2013, 2014, 2016, 2017, 2018 and now in 2019. This year’s survey incorporated an improved certification system that allows participating organizations to better benchmark their level of adoption and outcomes achieved. This year, participants were certified at a level between one and 10 that represents their respective achievements, allowing organizations to clearly benchmark against a defined worldwide industry standard.

Texas Children’s achieved Most Wired Certified Level 8. Organizations certified as levels seven and eight met the criteria for being designated as Most Wired. These organizations have deployed technologies and strategies to help them analyze their data and are starting to achieve meaningful clinical and efficiency outcomes. Some of these organizations, such as Texas Children’s, are experimenting with more advanced technologies, like telehealth, that expand access to care.

Some of Texas Children’s notable IS achievements include:

Successful Epic system upgrade – IS successfully upgraded Texas Children’s Epic electronic health record. The upgrade is important because it touches users and patients throughout the organization. It provides a robust platform to support patient engagement and care team enablement to influence positive patient outcomes through quality, safety and operational efficiencies. Some highlights include:

  • Renal – EpicCare Dialysis (Nephrology) integrates outpatient dialysis treatment and therapy plan data; extracting clinical information and demographic data and submits directly to CrownWeb/CMS, provides new specialty plans of care activity for required monthly, annual and unstable reviews, and creates a ‘snappy’ new dialysis snapshot report available by default to clinicians.
  • MyChart – Texas Children’s newly redesigned patient portal has expanded functionality to include subspecialty self-scheduling, quick and easy account (instant) activation, guest bill pay, pre-appointment check-in, waitlist for sooner appointments, and the ability for patients to share the information in their MyChart accounts with other medical providers via Share Everywhere.
  • Beacon – Epic’s module to manage oncology care allows providers to create a patient’s treatment plan that carries over to every oncology appointment. Treatment plans are created from standardized protocols, which are templates that promote standardized documentation and treatment for similar diagnoses.

More Epic benefits to come – In addition to improvements and new features, the recent Epic upgrade set the stage to launch additional application features:

  • Beaker – Epic’s new pathology information module manages lab orders and results, specimen collection, workflows, testing and reporting.
  • Cupid – Epic’s new cardiovascular information module provides order entry, scheduling, procedure documentation and structured reporting for diagnostic cardiology procedures.
  • Alaris Smart Pump – A communication interface between patient IV pumps and Epic that allows staff to focus on patient care rather than manual data entry. The system also promotes patient safety by decreasing the risk of IV medication errors.
  • Tapestry Program – Implementation of Epic Tapestry, CRM and Healthy Planet modules to replace several disparate systems at Texas Children’s Health Plan in order to improve Health Plan operational efficiency and improve care of its members.

Disney Team of Heroes – IS worked with the Walt Disney Co. to ensure the installation of equipment related to the Disney Team of Heroes Program. Texas Children’s is the first hospital to work with Disney on this comprehensive new initiative that will enhance the patient and family experience at children’s hospitals across the globe through a unique combination of reimagined spaces, personalized moments and engaging content, all featuring Disney’s beloved characters and themes.

Improved access to care – IS improved the patient experience by enhancing access to care by:

  • Patient scheduling – IS partnered with clinicians, schedulers and the Epic & Revenue Cycle team to generate a questionnaire template to guide scheduling staff when making appointments. The result is a consistent process that improves the patient experience and promotes access to care.
  • Wait times – IS updated the Texas Children’s Urgent Care website to display location wait times, which allows patients to make an informed decision and potentially save time, improving patient satisfaction.

Spanish language version of MyChart – The Epic Patient Engagement team introduced a Spanish language version of the MyChart patient portal for Texas Children’s multilingual patients, families and staff.

July 15, 2019

Texas Children’s Hospital is seeking an innovative solution to at-home hospital care for patients who are discharged from the health care setting but are still healing. Instead of providing patients with a binder of instructions, Texas Children’s Cancer & Hematology Center is working with a group of college and graduate students to create an interactive video game that encourages positive health habits in the home. The effort is part of the Healthcare Games Showdown™, which is going on throughout July and is being hosted by the world-renowned Texas Medical Center Innovation Institute.

“Leveraging game design to encourage healthy behaviors in the home is a great way to engage children and promote positive health outcomes,” said Business Development & Innovation Manager for Women’s Services Haley Jackson. “We are excited to learn from this innovative project!”

Jackson, Quinn Franklin, Assistant Director of the Psychosocial Division of the Cancer and Hematology Centers; and Dr. Monica Gramatges, Co-Director of the Center’s Survivorship Program, are advising the TCH student team with the support of Senior Vice President Myra Davis, Chief Quality Officer Dr. Eric Williams, Vice President Jackie Ward and Texas Children’s Cancer and Hematology Centers Director, Dr. Susan Blaney.

The group is working with a team of four digital media and computer science students – Jacqueline Nguyen of the University of Texas Dallas, Carlos Puerta of the University of Houston, David Musick of the University of Houston and Jonathan Nelson of Huntington University – to develop a prototype for an augmented reality game that focuses on the importance of hand washing and oral hygiene.

The concept for the game revolves around an animated world that can be unlocked by patients, families and/or caregivers when they complete a handwashing or oral hygiene activity. Players will be sent alerts on their smart phone device when it’s time for an action to be completed. Each time the player completes a task, their animated universe becomes more complex and elaborate.

“Health care video gaming allows us to foster playfulness and learning through a medium that our patients are naturally drawn to,” Franklin said.

During the development period, patients will be viewing the game and providing feedback as it is created. Marty McMahon, our Texas Children’s Gaming Activity Coordinator funded through a collaboration with Child’s Play, is also supporting this effort as a technical mentor for the students.

A live-stream following the progress of all three teams participating in the Healthcare Gaming Showdown is being hosted weekly by comedian and voice-over actor, Scott Gibbs, together with Ink Rose and Kevin Wu. Click here to learn more about the games and how to tune in to the live-stream.

“At Texas Children’s Hospital, our mission is to create a healthier future for children,” Davis said. “Using augmented reality and video games is an excellent means with which to continue our mission.”

March 26, 2019

Myra Davis, senior vice president of Information Services at Texas Children’s Hospital, received the 2019 Chief Information Officer (CIO) of the Year ORBIE Awards from the Houston CIO Leadership Association.

The CIO of the Year ORBIE Awards is the premier technology executive recognition program in the United States that is based upon a nominee’s leadership and management effectiveness, technology innovation, size and scope of responsibilities and engagement in industry and community endeavors.

“I am very grateful to receive this honor,” Davis said. “Information Technology, particularly in health care, has the opportunity to enhance, in many ways, how we deliver care to our patients and families. I love what my team and I are able to do and the boundless opportunities IT presents at Texas Children’s.”

Since joining Texas Children’s 15 years ago, Davis has helped Texas Children’s consistently stand out amongst our peers, and it is her visionary leadership and passion for the hospital’s mission that keep Texas Children’s on the leading edge of technology, and perpetually surfing the innovation curve.

While her leadership philosophy centers on cultivating strong partnerships that drive the successful delivery of improved quality, safety and patient outcomes at Texas Children’s, Davis enthusiastically credits her team of more than 400 employees for helping to lead the organization through some major technological transformations, including spearheading the recent integration of Texas Children’s Health Plan systems into the hospital’s electronic medical record.

Davis and her team have been instrumental in other systemwide initiatives including implementing new MyChart enhancements that have significantly improved patient experience and access to care; building the technology infrastructure to support daily operations at our new Texas Children’s Lester and Sue Legacy Tower; upgrading the patient transport system used to document incoming and outgoing transfers; and implementing a stringent cyber security protocol throughout Texas Children’s that employs a layered defense to prevent unauthorized access to organizational assets and patient information.

“Our IS department is truly the village that makes everything happen on a daily basis,” Davis said. “I am grateful to work with such a dedicated and talented team, and look forward to what we can accomplish together to better serve our patients and their families, and our employees and staff at Texas Children’s.”

Beyond her leadership responsibilities at Texas Children’s, Myra also devotes much of her free time serving the community. She has developed a collaboration between local universities (Rice, UT Austin and University of Houston) and Texas Children’s, where students are able see how technology is used in health care and explore the possibility of wanting to work in healthcare technology post-graduation.

In addition to the CIO of the Year ORBIE Award, Davis has been the recipient of the 2017 Houston Business Journal CIO of the Year in addition to Association for Women in Computing Award for Leadership in Technology that recognizes women who are making a difference in their professions, companies and communities through hard work and innovative leadership.

December 3, 2018

Texas Children’s has received the 2018 “Most Wired” designation for outstanding health care-based technology from Hospitals & Health Network Magazine – the flagship publication of the American Hospital Association.

The annual Most Wired survey polls hospitals and health systems nationwide regarding information technology (IT) initiatives in the areas of infrastructure, business and administrative management, clinical quality and safety, and clinical integration.

The 2018 survey of 647 participants represents 2,190 hospitals – almost 40 percent of all hospitals in the United States. Texas Children’s has earned Most Wired recognition in 2013, 2014, 2016, 2017 and 2018.

“Earning our fifth Most Wired designation reflects the hard work of the Information Services team and our many clinical and operational partners at Texas Children’s,” said Myra Davis, senior vice president of Information Services. “The survey results provide industry-standard benchmarks to measure IT adoption and meaningful use for operational, financial and clinical performance in health care delivery systems.”

Texas Children’s noted several IS achievements, including enhancements to patient safety, patient care and the patient experience. Notable accomplishments include:

Digitally tracking surgical instruments – Information Services helped to implement a digital tracking system for Texas Children’s operating rooms and Sterile Processing Department. Tracking surgical instruments digitally supports patient safety by preventing surgical delays, matching the patient with the correct instrument, prioritizing instruments for high risk cases and identifying obsolete instruments/sets. In addition, it supports continuity of communication (system-wide instrument pool), manages cost of lost instruments, tracks usage for additional sets for replacement or maintenance, enhances employee productivity and meets CMS/CDC/OSHA guidelines.

Improving access to care – Information Services improved the patient experience by removing a couple of issues that occasionally hindered access to care.

  • Patient scheduling process – IS partnered with clinicians, schedulers and the Epic & Revenue Cycle team to generate a questionnaire template to guide scheduling staff when making appointments. The result is a consistent process that improves the patient experience and promotes access to care.
  • How long will I wait? – IS updated the Texas Children’s Urgent Care (TCUC) website to display location wait times. Displaying wait times allows TCUC patients to make an informed decision and potentially save time, improving patient satisfaction. The patient retains some control over the waiting experience, giving them greater flexibility with their time.

Patient transport system intake and dispatch – Information Services upgraded the patient transport system used to document incoming and outgoing transfers. The upgrade optimized the use of tablets in the field, allowing EMS staff to collect data for reporting while providing patient care. In-house, the upgrade enabled Epic integration, supported Windows 10 deployment and brought Texas Children’s into compliance with industry reporting standards.

Multi-Factor Authentication (MFA) – Information Services implemented a stringent security protocol throughout Texas Children’s that employs a layered defense to help prevent unauthorized access to organizational assets and patient information. Combining two or more independent credentials, MFA can help protect sensitive personal and health information. Data breaches can result in significant fines with regulators, impact our brand reputation and damage our patients’ trust.

“This designation shows the commitment of Texas Children’s leadership in partnership with Information Services to embrace our transformation as a digitally enabled organization,” said Texas Children’s Chief Medical Information Officer Dr. Carla Giannoni. “Medical care, like other industries, are in evolution in this age of information. The opportunities are endless. Especially exciting to me is that we are now positioned to capitalize on the potential for an integrated communications platform and to develop a data strategy that uses data analytics and machine learning to provide clinical decision support at the bedside.”