HackensackUMC 'FHIR'-ed up mobile to speed patient care

Profile picture for user Steve Fanning By Steve Fanning February 20, 2017
Hackensack University Medical Center saw more patients and improved care with a FHIR-powered mobile app, writes Infor Healthcare's Steve Fanning

HackensackUMC patient care (c) Richard Titus Photographics 2014
The promise of real interoperability has been described as a ‘lifesaver’ by many healthcare organizations, and they’re usually talking about saving time, resources, and overall hassles.  But at Hackensack University Medical Center (HackensackUMC), when they say interoperability is a lifesaver, they mean it quite literally.

HackensackUMC was one of the first major US healthcare providers to pledge participation in the White House Precision Medicine Initiative, a federal call to eliminate the traditional, one-size-fits-all approach to healthcare. Core to the initiative is targeting individual differences, including genetics, lifestyle and environment, in making crucial treatment decisions.

And that requires information – lots of it. HackensackUMC is the largest provider of inpatient and outpatient services in New Jersey and one of the nation’s leading teaching, research and care organizations, with more than 10,000 employees and 775 beds. To enable such an ambitious culture shift, Hackensack UMC’s CIO Shafiq Rab, MD, took a close look at the organization’s medical record system. More specifically, he wanted that system to interact with all clinical and nonclinical systems to give care teams the most accurate, real-time and individualized patient information, how and when they needed it.

Laying the FHIR foundation

HackensackUMC’s very capable IT staff and leadership lives by the philosophy that technology is their second priority after saving lives. They partnered with Infor Healthcare to help guide them to full interoperability across systems, choosing the vendor's Cloverleaf Integration Suite, which is enabled with HL7’s Fast Healthcare Interoperability Resources (FHIR) standard. This led to HackensackUMC working with the Cloverleaf team to build a mobile app for patients to use when completing questionnaires.

For the first step, HackensackUMC created a simple-to-use, mobile system for patients to schedule appointments and provide information via a single health questionnaire. By replacing the previous paper-based questionnaire, the aim was to decrease waiting room time, increase patient satisfaction, and allow for more face time between patients and providers.

Hackensack worked with the Infor Cloverleaf team to build a web service interface layer that allowed the mobile application to interact with the Epic electronic heath record (EHR) system. This allowed them to streamline the questionnaire itself – tailoring it to the patient and enabling them to simply confirm the information and deliver its data back to Epic, leveraging FHIR and proprietary integration.

Baby step with a huge impact

It sounds simple, but the impact was huge. Hackensack had nearly 450,000 outpatient visits in 2015. With the combination of the mobile application and web services foundation laid down with Cloverleaf, the hospital estimates it saved in excess of 65,000 hours in manual data entry of paper based questionnaires. The innovation also resulted in a reduction on average of three minutes per patient spent in waiting rooms, and an increase in provider productivity – it made it possible to see one additional patient each hour.

Brian Benson, manager of enterprise systems, along with Modi Boutrs, team leader for enterprise development at Hackensack UMC said about their vision:

We took the pledge from the White House to help gear towards precision medicine and interoperability. We’ve taken a stand to enable our environment and our EHR to help us meet the HL7 FHIR standard.

Our main goal was to empower the patient so they can take care of their personal health data. We believe that the HL7 FHIR will allow us to reach this goal faster than any other technology.

Hackensack has made major strides toward achieving this vision of delivering precision medicine, and plans to continue to innovate to fulfill its commitment to the White House.

Now, interoperability is showing up in better patient engagement, satisfaction and care. In this downloadable video, Dr Rab talks about how the FHIR initiative enables improvements in how patients interact with HackensackUMC.

More innovation with FHIR

In related efforts, HackensackUMC is leveraging this web service interface layer to enable patients to use a mobile scheduling application. Patients can schedule appointments at any time day or night with this application, allowing patients to avoid the need to research doctors, call the doctor’s office during office hours, and to ensure that insurance is accepted. This simple but powerful tool lets patients make appointments in one minute, five to 10 times faster than in the previous phone-based system.

What this means is that patients who may be nervous about seeing a doctor now fill out paperwork only once – on a device they choose – which eliminates frustration and keeps them engaged in discussions about their care. FHIR is also being utilized to help further enable improved patient care by giving physicians and other care givers one place to quickly and easily view all patient information.

Rather than spending time searching for patient data, doctors now can spend more time discussing care options with the patient during appointments. Regardless of how information is used, interoperability – done right – is leading the way to saving more lives.

Infor is exhibiting in booth 2147 at this week’s HIMSS17 show in Orlando, Florida. Read more about how Infor can work with you on your healthcare technology challenges to reduce costs, improve care, and lower risk.