By Dr. Brita Hansen

Value-based care is revealing a “quiet crisis” in health care today: the lack of capability enabling clinical teams to control, improve and standardize clinical processes in near real time.

Without timely process control and standardization systems and tools, clinical teams are challenged in the delivery of consistent, high-quality and reliability care. As a result, outcomes and financial performance suffer.



Health systems allocate significant resources to standardization initiatives. But they are doing so by committing expensive staff resources to “one-off,” time-consuming processes of aggregating data housed in the electronic health record. Clinical leaders have no real mechanism for instant insights into the impact of individual process interventions on clinical practice patterns, leaving them in the dark as to which areas within the workflow require additional, or alternate, intervention.

Without those granular insights, it is also unlikely that any improvements resulting from the initial initiative will be scalable or sustainable, hindering efforts to replicate any successful actions.

EHRs’ role in standardization
EHR systems are a strategic asset for their ability to influence and, in some cases, drive standardized, high-value care. Yet EHR workflows and content often fail to align with clinical workflows, thereby hindering the potential to achieve and maintain standardized care. For example, when health care systems undertake process improvement initiatives, it is common to identify multiple conflicting, outdated or dormant order sets, which contribute to unnecessary care variations.

To overcome the challenges created by these care variations, providers must adopt a holistic approach that includes analyzing all workflow components with the potential to influence clinical processes, while eliminating areas within the EHR where discrepancies can occur. Preventing these issues requires the ability to easily access and see clinical processes and data. It also requires accounting for the individuals, technology and tools that support these processes and influence outcomes.

Integrating enterprise clinical process control and improvement solutions
Increasingly, health systems are leveraging enterprise clinical process control and improvement software to assist in the analysis, evaluation and management of clinical processes to fix what is broken and ensure appropriate standardization. By aggregating data related to EHR components, such as order sets, that support clinical processes, organizations are better able to evaluate all care delivery practices and determine where breakdowns leading to unnecessary variation occur.

Enterprise clinical process control and improvement software allow those teams and/or individuals specifically tasked with identifying and implementing workflow enhancement and process improvement to do so on their own, without the need to get in line for IT support or a report from the informatics team. This reduces the resources required to fix and/or improve a clinical process, and enables it to happen in a timelier manner.

To drive enhanced outcomes, enterprise clinical process control and improvement platforms must be able to measure, evaluate and manage the entire life cycle of standardized care delivery in near real time. Continuous monitoring and control by clinicians as they deliver care ensures that the right content supporting current best-practice standards is built into the EHR. Clinical teams with the capability at their fingertips to systematically apply technology that helps them control and improve their processes ensures the right information is sent to the right person, in the right format, through the right channel, at the right time in workflow.

In this manner, dynamic clinical process improvement solutions can save time and resources by ensuring EHR workflows and order sets are regularly updated when changes are made to medical evidence and best practices.

Continuous improvements
Enterprise clinical process control and improvement solutions are powerful tools for maintaining standardized care.

One good example is how this type of technology helped reduce the sepsis rate at one Florida hospital. The facility initially standardized all clinical content around the early detection of sepsis, then continuously measured clinician adherence to standardized workflows and the correlation between care delivery and outcomes. This enabled real-time data collection and analysis, which led to the determination that an enhanced sepsis order set was needed to guide clinicians in the accurate ordering of IV fluids. Once the new order set was in place and workflows standardized, the hospital realized a 50 percent increase in sepsis bundle compliance in just one week.

By integrating clinical process control and improvement systems that provide real-time insight into critical data, health systems will realize benefits including enhanced care and reduced costs while achieving, and exceeding, quality benchmarks and improving care outcomes.

About the author: Dr. Brita Hansen is chief medical officer of LogicStream Health, a leader in clinical process improvement solutions. She is also a practicing hospitalist and an assistant professor of medicine at the University of Minnesota School of Medicine.