New Technology Improving Accuracy, Efficiency
and
Patient Care in Hospitals
Written by John Fries
Patient
care is experiencing a quantum leap in a number of hospitals and health
systems, thanks to new technology that enables physicians, nurses
and others in the hospital environment to electronically interact
with each other, place medication and other orders, and log patient
information with greater efficiency and accuracy than ever before.
Gone--or significantly reduced--are the paper charts of the past.
In their place are computers and PDAs. This is due in large part to
the efforts of the Cerner Corporation, a Kansas City-based company
that develops advanced technology solutions for hospitals.
Hospitals adopting this and other technology are setting the bar for
how health care will be provided, and information recorded and communicated,
for years to come.
At Children's Hospital of Pittsburgh, Children'sNet--a computerized
provider order entry (CPOE) system for tests, care and medications--went
live a year ago and has been enthusiastically embraced by physicians
and other clinicians. The CPOE system, which a diverse cross-section
of medical and hospital staff worked jointly with Cerner to develop,
eliminates handwritten and verbal orders by allowing doctors to place
orders directly into the computer system.
This means there's no possibility of such past problems as illegible
writing, transcription errors or unsigned orders. The system also
reduces delays in treatment and provides the physician with relevant
information when an order is being placed.
"We're committed to continuously improving patient safety, quality
of care and health outcomes," said Eugene S. Wiener, M.D., the hospital's
medical director and surgeon-in-chief. "We also wanted to be paperless.
This system enables us to work in a highly efficient manner. Doctors
can order medications while at the patient's bedside. Those orders
are immediately transferred to the pharmacy. Also, X-ray and test
results can be viewed immediately."
Wiener said that Children's has about 400 computer stations in place
throughout the hospital, including a number of portable carts that
allow physicians and nurses access to patient records and enter orders.
Computer stations are also set up in physician practice offices, hospital
clinics, conference rooms and even near the hospital cafeteria.
According to Wiener, future plans include upgrading the current system
to provide increased functionality, and implementing an online documentation
system to complement--and integrate with--the order entry system.
In Chicago, the Cook County Bureau of Health Services also went live
last year with similar technology it developed with Cerner.
As part of the initial phase of the bureau's process improvement initiative,
two of its three hospitals--John H. Stroger Hospital, a tertiary care
facility on the near West Side, and Oak Forest Hospital, a rehab and
long term care center in the southern suburbs--now have 2,000 active
computer workstations between them that offer physicians, nurses and
others a wide range of capabilities.
In addition to order entry and greater communications efficiency,
the system stores a massive volume of patient records.
"We've scanned and uploaded many patient records going back 27 years,
and can retrieve data on any patient--inside or outside the hospital--quickly
and easily," said Mike Sommers, the Bureau's chief information officer.
He noted some other advanced capabilities in use as well.
"We have an atypical radiology department, in that we don't use film.
We shoot digital X-rays and images and send them to Cerner, which
places them on a terabyte class server. Once there, physicians can
just click a button to access them. We've also implemented a scanning
system for paper that covers 20 different categories of forms. Users
can click on a date and get a perfectly scanned image in seconds."
In addition, Sommers said that about 50 physicians will soon be able
to access patient information on their PDAs, and that by next spring,
he anticipates that number will grow to 500.
Cook County's future plans include implementing the technology, or
relevant parts of it, at the Bureau's third hospital, Provident Hospital
of Cook County, and the Bureau's 30 community-based clinics, totaling
more than 3,000 computer desktops.
Both Wiener at Children's Hospital of Pittsburgh and Sommers at the
Cook County Bureau of Health Services said they evaluated a variety
of potential partners and systems before choosing Cerner.
"Rather
than looking for cutting edge technology--which Cerner provides--our
priority was to find a company with an excellent track record offering
solid, proven technology that would provide a great return on investment,"
said Sommers.
In light of stringent HIPAA patient privacy regulations, both hospitals
confirmed that security is of the utmost concern, and that only authorized
users have access to confidential information.
