Friday, January 6, 2017

engaging patients

Published in VC's Notes on January 06, 2017

Engaging Our Patients, Trauma Care, Blood Donation

Good morning!

I hope your new year has gotten off to a great start.  Today I'll cover several topics that have caught my attention lately.

ER PatientRecordThis coming Sunday we will have the go-live for the latest version of our electronic health record, Epic 2015.  It's hard to believe, but we are just a few months away from five years on Epic.  Those of you who are closer to patient care than I am know that Epic 2015 will contain many refinements and new features that will improve the user experience and yield more analytical insights into our clinical activities. 

Coupled with Sunday's transition, we will introduce a new feature in MyChart, our patient access portal, that will allow our patients to review their providers' chart notes.  In making this part of the medical record more accessible to patients, we are joining a national movement toward greater transparency called OpenNotes.

Beginning Sunday, as soon as a provider's notes are signed, the patient will receive a message in the secure MyChart portal that the notes are available for review.  A provider can opt out of the patient review on a case-by-case basis but the default will be that the notes are available and I expect this to become the norm.

I see this as a positive step toward getting patients more engaged in their care.  A number of studies have shown that access to the provider notes improves patients' understanding of their diagnosis and the treatment prescribed, enhancing compliance and patient safety.  On the other hand, provider concerns that patients will second guess their doctors' findings or won't be prepared to handle the “hard facts” of their condition have not been major issues in others' experience.

In adopting the OpenNotes practice, we will be joining 50 other health systems in 35 states, including Mayo Clinic and the Cleveland Clinic. Thanks to Dr. Louis Harkey, the Robert Smith Chair of Neurosurgery, for championing this effort in keeping with our commitment to provide care that is truly “patient-centered.”  For more information about OpenNotes visit this intranet site. (Login may be required.)

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If you've been following Mississippi news lately, you probably know the legislature is back in session.  Even though we interact with our state elected officials year-round, the activity level is dialed up several notches during the three to four months each year when the legislature is in session.  It's not uncommon for me to literally drop everything to attend an impromptu meeting downtown.

The stakes are always high.  Although our state appropriation makes up only about 12 percent of our revenue, and that money is used exclusively in support of our education programs, all of our state funding is vital to our mission of producing more health professionals for Mississippi. 

This year, while we are hoping to keep our state funding at its current level, we are also presenting our case for changes that will give us greater flexibility to collaborate with other health care providers.  The law that authorized UMMC and its teaching hospital to operate as a department of the University of Mississippi was passed in 1950, a time when the pace of change in the health care industry was glacial compared to today.  As the industry reorganizes into larger, more integrated networks to achieve economies of scale and improve quality, we need additional flexibility to participate in these collaborative activities, particularly with community hospitals that may be struggling to find their place in these new systems of care.  I'll go into greater depth on this subject in a future VC Notes.

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One topic that is already generating a lot of conversation downtown might be described as the unintended consequences that have impacted the state's trauma system from legislation passed last year.  As you may know, Mississippi has what is widely considered a national model for funding trauma care.  And UMMC, with the state's only Level 1 trauma center, is at the heart of it.  In 2015, we handled 4,400 trauma cases, half of them referred from lower-level trauma centers in the state.  One fourth of our state's trauma patients are treated at UMMC.

Before 2008, trauma care was chronically underfunded.  Progressive legislation passed that year directed fines and fees from high-risk activities that are naturally linked with trauma - speeding violations, for example - to a special fund that supports the statewide trauma system.

Since that time, the system has delivered improved outcomes.  In the first six years since the law was passed, even though motor vehicle accidents increased, deaths from motor vehicle crashes decreased by 24 percent.  At UMMC, between 2001 and 2015, the mortality rate for all trauma cases fell from 8 percent to 3.18 percent - below the national average of 4.5 percent.

In the waning days of last year's session, the legislature passed the Budget Transparency and Simplification Act, which essentially did away with many of the special funds that received monies from other agencies, diverting them instead to the state general fund.  While this was promoted as a cost-saving measure that enhances transparency, it has raised concerns about how the trauma system will be funded going forward.  We will be watching closely as this issue is managed in the weeks ahead, ready to offer whatever insight we can that will protect this important program.

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Our trauma center, by the way, is a major consumer of blood products collected by Mississippi Blood Services.  MBS is facing a severe shortage of blood in 4 out of 8 blood types.  That's why I encourage you to participate in a one-day blood drive here on the main campus next Tuesday, Jan. 10, 7 a.m. to 4:30 p.m.  The MBS Donor Coach will locate in its usual spot at the walkway between the School of Medicine and the Guyton research complex.

If next week isn't good for you, the Associated Student Body is sponsoring a one-day drive Wednesday, Feb. 8 from 10 a.m. to 4 p.m. in the gymnasium of the Nelson Student Union.

Please take a moment to mark your calendar now for one of these drives!

I'm dismayed that UMMC blood collections have fallen every year since 2010, from a high of 1,093 units to 367 last year.  While I appreciate those of you who are regular donors, I know we can do better than that.  So I've asked Dr. Claude Brunson, who's on the board of MBS, to organize an effort to bring greater awareness to the importance of regular blood donation to our campus.

If we want to lead our state to better health, we need to be leaders in blood donation as well.  I hope you will join me in rolling up your sleeves, on our way to A Healthier Mississippi.



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