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Western Pennsylvania Hospital News and Chicago Hospital News, November 2003

New Technology Improving Accuracy, Efficiency
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.

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Copyright © 2003 by John Fries, Pittsburgh, PA.
Please direct all correspondence to JohnFries@aol.com.