{"id":8455,"date":"2018-04-30T15:02:56","date_gmt":"2018-04-30T19:02:56","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-digit\/submission\/mass-general-hospital-digitizing-patient-care\/"},"modified":"2018-04-30T15:05:25","modified_gmt":"2018-04-30T19:05:25","slug":"massachusetts-general-hospital-digitizing-patient-care","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-digit\/submission\/massachusetts-general-hospital-digitizing-patient-care\/","title":{"rendered":"Massachusetts General Hospital: Digitizing Patient Care"},"content":{"rendered":"

Hospitals face some of the most daunting digital challenges: an unprecedented growth in unstructured data, the need to standardize IT platforms, and increases in sophisticated cyber threats. On top of that, hospitals are also facing pressure to deliver digital care.[1]<\/a> Massachusetts General Hospital (MGH) has consistently been ranked among the best hospitals in the US.[2]<\/a> However, although MGH has undergone digital transformations to integrate and enhance patient care, its digital acumen is lagging behind that of other top hospitals.<\/p>\n

Integrating care through digital transformation<\/em><\/strong><\/p>\n

In 2016, MGH, along with several other Partners HealthCare hospitals, transitioned off its home-governed EMR system and implemented Epic\u2019s EMR.[3]<\/a> The aim was to have one integrated system across all Partners facilities to allow for more coordinated patient care.[4]<\/a> Keith Jennings, MGH\u2019s CIO, described a vision of “one patient, one record, one bill and hopefully the best care to our patients across the whole continuum in a very efficient or most efficient way possible\u201d.[5]<\/a> By standardizing patient data across all Partners hospitals, patients visiting different hospitals would receive more integrated care.<\/p>\n

The transition was a huge undertaking. The system took 3 years to build and cost $1.2 billion, twice as much the initial price of $600 million. Jennings described it as a \u201cbusiness transformation\u201d rather than simply an IT implementation. MGH used a staggered implementation approach, whereby Jennings\u2019 team simultaneously kept the home-governed system running, executed data conversions, tested the new system in cycles, and trained employees on the new system.[6]<\/a><\/p>\n

The rollout was well-received by clinicians. For instance, prior to the system\u2019s integration, patients\u2019 vital signs were only recorded in plastic binders (hard to imagine that in 2016, MGH still hadn\u2019t digitalized vital signs!). With Epic\u2019s EMR, clinicians can now view vital signs with a single click. That said, clinicians have identified some challenges with the system: too many bells and whistles that detract from easily understanding patient information, hard-coded responses that inhibit clinicians from providing customization in atypical situations, and gaps in understanding of clinical practices (e.g., it is easier to order 12 days of intravenous fluid than 12 hours\u2019 worth).[7]<\/a> It is clear that for digital transformations to be successful in the healthcare space, simplicity, flexibility, and listening to the voices of frontline users should be prioritized.<\/p>\n

Enhancing care through digital transformation<\/em><\/strong><\/p>\n

MGH\u2019s Healthcare Transformation Lab (HTL) was launched in April 2014 \u201cto improve the experience and value of healthcare through collaborative innovation\u201d. By bringing together clinicians, engineers, designers, and entrepreneurs from MGH and institutions including MIT and HBS, MGH has implemented digital transformation solutions to enhance patient engagement and improve the clinician experience.[8]<\/a>,[9]<\/a><\/sup><\/p>\n

Patient engagement transformations aim to equip patients with the tools to be active participants in their own health. For example, the Visit Navigator and Digital Mapping seek to improve patients\u2019 experience navigating MGH\u2019s campus through responsive, web-based, interactive digital maps that show everything from buildings to ATM locations around the hospital.<\/p>\n

Clinician experience transformations aim to reduce clinicians\u2019 administrative burden so that they can spend more time interacting with patients and less time dealing with paperwork. For example, MGH implemented highly trained scribes to address clinicians\u2019 complaint that the use of EMR requires them to spend more time focused on the computer screen rather than on the patient. The Mass General Physicians Organization (MGPO) is now exploring ways to use virtual scribes so that more clinicians can benefit in a cost-efficient manner.[10]<\/a><\/p>\n

Other digital initiatives have benefited both patients and clinicians:<\/p>\n

Telemedicine<\/em><\/p>\n

TeleHealth enables clinicians to provide high-quality care to patients virtually (usually via video-conferencing), thus improving access and convenience. TeleHealth has been implemented across various departments at MGH:<\/p>\n