EVIDENCE BASED INSIGHT
Organizing Information Systems in Support of Global Diversity
The milestone of 100,000 active patients is an important achievement, but it is not the end of the journey. On the contrary, it is a stimulus for the continuous improvement of EuCliD to enable a better user experience and an opportunity to leverage this unique international clinical system for new innovations in areas like artificial intelligence, anemia management, and patient risk stratifi cation, in order to support healthcare professionals and patients.
A NEW PLATFORM FOR CONNECTED HEALTH:
THE NORTH AMERICAN EXPERIENCE
In 2019, Fresenius Medical Care North America (FMCNA) launched a new IT platform to serve providers, clinicians, patients, and families. This platform, called “theHub,” has been adapted to meet the unique regulatory, documentation, and billing requirements of US nephrology and dialysis practice.
The first phase of theHub targets three constituencies and includes:
- CareTeamHub: connected care application for home therapy clinicians
- ProviderHub: mobile-enabled rounding tool for dialysis provider partners
- PatientHub: integrated patient portal
Together, these applications provide a unifi ed system for care coordination, based on Fresenius Medical Care’s global approach to data management.
Following a very successful pilot in the spring of 2019, CareTeamHub rolled out system-wide in the summer, linking home therapies staff with patients to provide remote monitoring and bidirectional communication.
With CareTeamHub, home therapy nurses can review data automatically retrieved from peritoneal dialysis cyclers and home hemodialysis machines as well as weights, blood pressures, and other data gathered electronically from patients at home. In addition, the care team also receives alerts for patients with any unexpected variations, alarms, or home dialysis issues.
CareTeamHub gives nurses a comprehensive dashboard for each patient and allows them to respond proactively to issues that may occur during or after treatment (rather than waiting for end-of the- month meetings with patients).
In September 2019, ProviderHub launched system-wide access to FMCNA provider partners (nephrologists and nurse practitioners) as a platform-agnostic rounding and documentation tool. Although ProviderHub can be accessed by providers through any desktop browser, the greatest adoption has been on mobile platforms—specifi cally on iOS and Android devices. Providers can use native apps on iPads, iPhones, Android phones, and other devices to access information about dialysis treatments as well as labs, medications, notes, orders, patient photos, and more. They can write basic and comprehensive notes and sign orders, all on the go. And, of course, ProviderHub off ers real-time connectivity with FMCNA back-end electronic health records.
PatientHub, Fresenius Kidney Care’s (FKC) patient portal, has long provided a mechanism for patients to review, track, and enter their own health data. But it has recently been enhanced to allow bidirectional communication with FKC nursing staff (through CareTeamHub) and seamless tracking of patient-supplied data (like weights and blood pressures taken at home).
Outcomes of theHub
The implementation of theHub was incredibly fast and successful. For example, in just two months, nearly 1,000 new users joined ProviderHub in North America, generating more than 36,000 notes in the month of October 2019 alone. FMCNA also found that compliance with its internal order-signing procedures was dramatically improved. Defi ciencies in order-signing are approximately three times more common among providers who do not use ProviderHub compared to those who do. In addition, FMCNA observed a 56 percent drop in order-signing defi ciencies for ProviderHub users before and after implementation of ProviderHub compared to just a 17 percent drop in defi ciencies for non-ProviderHub users. This change suggests the implementation of ProviderHub is directly improving the workfl ow for providers.
Regarding CareTeamHub, the rollout was accompanied by a surge of positive comments from FKC home therapy nursing staff who are now able to track the progress of home patients on a daily basis. For example, fl owsheet data from patients and home cyclers now fl ow directly to nursing staff so that exceptions and issues can be detected daily (rather than at end-of-the-month offi ce visits).
Kidney disease knows no national boundaries. A global approach to health data and population management is critical for success. But equally important are systems with fl exibility and adaptability that reflect the real-world needs and requirements of diverse populations and regions as well as local legal requirements. Fresenius Medical Care has taken that insight to heart with the successful deployment of global data governance, data warehousing, analytics, research, and patient engagement in conjunction with regional adaptations to refl ect enormous patient diversity. These local adaptations, like EuCliD and theHub, are having measurable and exciting positive eff ects on the care provided to patients around the world.
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