Mather Hospital is moving ahead with plans to customize and install an electronic information system that will detail all the care given to a patient from his or her first contact with a clinician through discharge and allow all caregivers – physicians, nurses, therapists and others – to access that patient’s record.
Sunrise Clinical Manager (SCM) is an electronic health records system (EHR) provided by the Allscripts/Eclypsis company, designed to automate and streamline the process of recording a patient’s personal and health information. Studies indicate that over time, an EHR can save time and resources by reducing the amount of time needed to place orders, improving accessibility of the chart from multiple locations and safeguarding against inadvertent duplication of medication or other orders. Historical information can be stored in the system that will not only help to provide care during the current admission, but remains retreivable for subsequent admissions. The federal government is encouraging hospitals and physicians’ practices to move from paper to electronic systems by offering incentives through stimulus funding (the American Recovery and Reinvestment Act).
Physician input was elicited soon after the Recovery Act was signed in February of 2009, with the convening of a Physician Advisory Council who served as an early selection committee sitting on focus groups to help vet the different vendors, and giving feedback during interactive “Dueling Demos,” an in-house, side-by-side demonstration of the two final vendors, Siemens and Eclipsys.
Currently the Physician Advisory Council, with physician representatives from various medical and surgical specialties has meets frequently during the “Future State Design,” a building phase for SCM. The group, led by Chief Medical Information Officer, Joseph Ng, has helped drive design of parts of the chart that are critical to the treatment of patients. Their discussions have directed the construction of physician order sets and medicine reconciliation orders that reflect a streamlined, patient-centered workflow that will be user-friendly, yet robust enough to handle the complexities of processes like transfers to and from the OR or ICU, and sudden changes in patient status.
“EHR systems do more than just replace paper forms and charts: they are the tools that provide timely and accurate information which are utilized by the staff to deliver evidence-based care,” noted Nursing Vice President Marie Mulligan, RN.
Features offered by the Sunrise Clinical Manager include tracking all medications given to a patient and alerting caregivers to possible drug interactions and incorrect doses; using patient information to help guide a clinician in selecting the correct orders and medications; alerting a physician or nurse to drug or food allergies and relevant lab results; and electronically recording a patient’s vital signs through direct hook-ups to various monitors.
The new system, which is a $22 million investment and will be phased in over the next seven years, is actually two systems that will work together – the Clinical Manager system and a pharmacy system that will also use bar codes to track all medications given to patients.
“Together, the two systems will provide a single, unified view of a patient’s information from emergency room to bedside and into the hospital pharmacy,” said Chief Medical Officer Joan Faro, MD. “Furthermore, this information may be accessed remotely from an office or home by the patient’s attending physicians and specialists – thereby allowing them to immediately address any care needs.”
The systems will accomplish this using a number of applications, including:
- Computerized Physician/Provider Order Entry – Physicians directly place orders for their patient in the electronic record. Medications, nursing orders, physical therapy, special diets and lab work are all ordered online so that information is available to everyone caring for a patient. Patients benefit from increased safety and more time with caregivers. Alerts or reminders can be displayed to the provider at the time an order is being placed in the system. Critical order sets – a grouping of tests and procedures based on a patient’s diagnosis that can be ordered in one step – will help to make the order process more efficient.
- Intelligent Clinical Decision Support – This intuitive feature helps guide clinicians to select the proper orders and medications based on the patent’s ever-changing condition. It will alert them to a patient’s allergies, drug interactions and other medical conditions based on a patient’s medical history and the information entered since his or her arrival at the hospital. Again, the system increases the level of safety for patients.
- Clinical Analytics – The electronic system will capture information needed for continuously monitoring and tracking quality and utilization. Information can then be analyzed to help in clinical quality improvement.
- Integrated Device Monitoring – Allows the system to automatically record a patient’s vital signs through direct hook-ups with monitors. This replaces the need for a nurse to manually enter the information into a chart and allows for continuous computer monitoring of a patient’s condition.
- Bar-coded Medication Administration – Through the use of bar codes on all medications and on the badges of those ordering, administering and receiving the meds, the system ensures that the right patient gets the right medication at the right dose via the right route (IV, oral) at the right times.
- Critical Care – An application specifically designed for patients in Critical Care Units allows caregivers to closely monitor the condition of those patients and alerts staff to any significant changes.
“Mather is making a significant investment into advancing patient care by implementing this system, which will aid faster treatment and further our patient safety practices,” noted Chief Information Officer Tom Heiman. “It is essential to making Mather the best community hospital in New York State.”
