Brenda Freymiller, RN, assistant vice president, wound and hyperbaric shared services, at Intermountain Health
Photo: Brenda Freymiller, RN
Nursing leaders at Intermountain Health are constantly seeking opportunities to improve patient safety and clinical excellence. They realized that if they had faster and more reliable ways to identify clinical safety events, they could empower frontline teams to glean near-real-time insight into evolving clinical needs.
However, nurse leaders were hampered by legacy reporting systems that were delayed and heavily reliant on IT and analytics teams. As a result, key events like return visits to the OR or post-surgery complications often went uncaptured and peer review processes lacked meaningful, timely cases for review.
THE CHALLENGE
One of the biggest challenges was simply getting access to accurate, timely data. Validating the data and ensuring it was fit for nurses' purposes took considerable effort. Staff often had to rely on analysts who were juggling multiple projects.
"Depending on their workload, our request could get deprioritized, delayed or paused altogether," said Brenda Freymiller, RN, assistant vice president, wound and hyperbaric shared services, at Intermountain Health. "It was frustrating to have an idea or an urgent need and not be able to pursue it because the data wasn't readily available or the help to access it wasn't timely due to competing priorities.
"Being at the mercy of someone else's schedule made it difficult to make progress," she continued. "For example, we might get a sliver of time from an analyst, then lose momentum when they were pulled into another project."
This back-and-forth slowed everything down.
PROPOSAL
That's why gaining the ability to directly explore and analyze data herself was such a breakthrough for Freymiller. It meant she could finally pursue questions as they came up and iterate quickly without waiting in line for support. Freymiller and Intermountain turned to a self-service synthetic data and data analytics platform from vendor MDClone.
"I had initially heard about the self-service platform through a physician colleague who mentioned its potential for enabling easier access to data," she recalled. "Intermountain had already been exploring its use in some research contexts, so when the opportunity was presented to me, I was eager to try it.
"Given my prior struggles with getting timely data, the idea of being able to explore it myself was compelling," she continued. "I'm naturally inclined toward data – my team jokes I should have been an analyst instead of a nurse – so this felt like a promising solution to the problem."
The limb preservation program in particular required data to answer key questions: How was staff going to measure success? Were the health system's outcomes in line with national benchmarks? More important, how did those national data points compare with what the health system was seeing locally, in its patient population and region?
"Having access to our own data helped support the case for launching the program and set realistic strategies based on actual need," Freymiller explained. "Similarly, when vendors pitched systems promising dramatic improvements, I could use the platform to see whether the same issues even existed in our setting. This ability to locally validate assumptions and tailor proposals based on our own data was invaluable."
MEETING THE CHALLENGE
Freymiller jumped into the platform with a hands-on mindset, using open office hours and support sessions to build her skills. Initially, she used it to examine amputation data – looking at when and where amputations were occurring and what factors might have led up to them.
"I analyzed demographic details like age, race and location, as well as whether the patient had received best-practice interventions like wound care, hyperbaric therapy or vascular referrals," she explained. "It was about understanding what was happening before the patient ended up in surgery and identifying areas where we might intervene earlier.
"The data is sourced from our Cerner electronic health record system and supplemented by some claims data," she continued. "While the limitation is that we can't always see procedures performed outside our organization, the internal data has still proven powerful. I also benefited from resources like tutorial videos and expert guidance during office hours."
There she learned how to fine-tune queries, broaden or narrow date ranges, and avoid tunnel vision. Many departments across Intermountain – pharmacy, women's health, oncology and others – also were engaging with the platform, which reinforced its versatility.
RESULTS
One of the most tangible results has been the ability to identify where amputations are occurring and who is performing them. With this data, Intermountain built a contact list of providers and used it to extend invitations to join the Limb Preservation Task Force.
"The idea is to bring together stakeholders to improve collaboration, ensure patients are receiving best-practice care, and ideally intervene before a limb is lost," Freymiller reported. "We've already seen strong interest. About half of the 50 people we reached out to responded positively, which is encouraging for future teamwork.
"Another success metric has been the ability to track patients who come through our limb preservation program via our 'limb line' hotline," she added. "The team running the hotline maintains a spreadsheet of each case, and I can import that data into the platform to analyze outcomes."
Are these patients avoiding amputation? How quickly are staff getting them into care? Are staff doing the right things at the right time?
"It has allowed us to monitor effectiveness and identify areas for improvement," she noted. "We've even made the hotline more accessible by placing the number on our website and distributing flyers to urgent care centers, ERs and primary care offices."
ADVICE FOR OTHERS
Freymiller's advice to peers potentially using similar synthetic data and data analytics technology is to "absolutely go for it."
"The ability to answer questions in real time without waiting on someone else is incredibly empowering," she stated. "When someone on my team asks, 'Do we know how this is trending?' I can now dive right in, explore the data and get an answer quickly.
"Once you have a few templates or queries set up, it becomes easier to replicate and adapt them to new problems," she continued. "You're not reinventing the wheel each time, just tweaking it to suit the situation. It becomes a fast, efficient way to continuously learn and optimize."
A real-world example Freymiller offers is in vascular referrals.
"With the data at my fingertips, I could ask: Why are only five out of 20 patients being referred to vascular care? Is that appropriate, or are we missing key interventions?" she explained.
"Similarly, analyzing hemoglobin A1C levels led to surprising insights," she concluded. "Many patients undergoing amputations didn't have extremely poor A1C levels, suggesting we need to widen our focus beyond just glycemic control. This kind of insight enables a broader, more inclusive approach to care and helps us optimize processes not just for the most obvious cases, but for the entire patient population."
Follow Bill's health IT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
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