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TRMC-Sunnyvale successfully implements technology to ensure doctors' orders
From Staff report
The phrase, "Just what the doctor ordered," has entered the technology age at Texas Regional Medical Center at Sunnyvale. All 256 of the hospital's physicians on staff now use computers to enter their medical orders, thus lessening chances for errors.
Through a process known as computerized physician order entry (CPOE), TRMC-Sunnyvale's doctors send their instructions to nurses or to the pharmacy, radiology or laboratory departments electronically. That way, no one has to decipher physicians' notoriously bad handwriting or interpret possibly confusing transcriptions to fulfill the orders.
"CPOE decreases delays and helps ensure patients' safety," said Kristi Box, TRMC-Sunnyvale's director of clinical informatics. "Studies have shown 96-97 percent of all errors are made during the times when people in the various departments transcribe physicians' orders.
"Each physician sends an order and it's transmitted directly to the appropriate department or departments," Box said. "For example, when a medication order is placed by the physician, it's electronically transmitted to the pharmacy and verified before it's released to the electronic medication-charting system. Then, using the charting system, the physician's original order is compared to both the barcode of the drug to be given and to the barcode of the patient's identification bracelet to ensure everything is correct."
TRMC-Sunnyvale, which uses Siemens MedSeries 4 software, is one of the first hospitals in Dallas-Fort Worth to implement CPOE fully and adheres to Stage 1 of the Meaningful Use requirements necessary to receive federal funding for health information technology. Meaningful Use was developed by National Quality Forum to determine national priorities to help health care performance and improvement efforts.
Funds come from Health Information Technology for Economic and Clinical Health Act, which allocates $19.2 billion toward health information technology to improve health care delivery in the United States. It's part of the giant American Recovery and Reinvestment Act of 2009.
Stage I Meaningful Use requires 30 percent of all patients have at least one medication order placed through CPOE.
TRMC-Sunnyvale's implementation process spanned two years and all the hospital's physicians received personalized training. One hundred percent of TRMC-Sunnyvale's physicians on staff were using it by Aug. 1; now, 85-93 percent of the physicians' orders are sent through the electronic system each month, Box said.
"We were able to implement everything a few weeks ahead of schedule, and everything is working better than we expected," said Box, who has been monitoring the process for the last few months.
The hospital also is well on its way toward Stage II compliance, which requires more CPOE, Box said.
Dr. Rizwan Bukhari, a vascular surgeon on staff at TRMC-Sunnyvale and whose practice is Surgical Associates of Dallas, was one of the first physicians to test the system and uses CPOE at some of the other area's hospitals where he also maintains medical privileges. He said the technology is user-friendly and he likes its immediacy.
"It's better for us to embrace the technology now," Bukhari said. "Every doctor will be using it soon."
Officials from 28 hospitals nationwide have consulted with Box and attended special classes in the last few months to learn how TRMC-Sunnyvale implemented CPOE. Box also is co-chair for the Med Series 4 Patient Care Focus Group, as well as an active member of the Siemens Meaningful Use Task Force; both are aimed at helping hospitals implement CPOE and other patient-safety measures.
Through a process known as computerized physician order entry (CPOE), TRMC-Sunnyvale's doctors send their instructions to nurses or to the pharmacy, radiology or laboratory departments electronically. That way, no one has to decipher physicians' notoriously bad handwriting or interpret possibly confusing transcriptions to fulfill the orders.
"CPOE decreases delays and helps ensure patients' safety," said Kristi Box, TRMC-Sunnyvale's director of clinical informatics. "Studies have shown 96-97 percent of all errors are made during the times when people in the various departments transcribe physicians' orders.
"Each physician sends an order and it's transmitted directly to the appropriate department or departments," Box said. "For example, when a medication order is placed by the physician, it's electronically transmitted to the pharmacy and verified before it's released to the electronic medication-charting system. Then, using the charting system, the physician's original order is compared to both the barcode of the drug to be given and to the barcode of the patient's identification bracelet to ensure everything is correct."
TRMC-Sunnyvale, which uses Siemens MedSeries 4 software, is one of the first hospitals in Dallas-Fort Worth to implement CPOE fully and adheres to Stage 1 of the Meaningful Use requirements necessary to receive federal funding for health information technology. Meaningful Use was developed by National Quality Forum to determine national priorities to help health care performance and improvement efforts.
Funds come from Health Information Technology for Economic and Clinical Health Act, which allocates $19.2 billion toward health information technology to improve health care delivery in the United States. It's part of the giant American Recovery and Reinvestment Act of 2009.
Stage I Meaningful Use requires 30 percent of all patients have at least one medication order placed through CPOE.
TRMC-Sunnyvale's implementation process spanned two years and all the hospital's physicians received personalized training. One hundred percent of TRMC-Sunnyvale's physicians on staff were using it by Aug. 1; now, 85-93 percent of the physicians' orders are sent through the electronic system each month, Box said.
"We were able to implement everything a few weeks ahead of schedule, and everything is working better than we expected," said Box, who has been monitoring the process for the last few months.
The hospital also is well on its way toward Stage II compliance, which requires more CPOE, Box said.
Dr. Rizwan Bukhari, a vascular surgeon on staff at TRMC-Sunnyvale and whose practice is Surgical Associates of Dallas, was one of the first physicians to test the system and uses CPOE at some of the other area's hospitals where he also maintains medical privileges. He said the technology is user-friendly and he likes its immediacy.
"It's better for us to embrace the technology now," Bukhari said. "Every doctor will be using it soon."
Officials from 28 hospitals nationwide have consulted with Box and attended special classes in the last few months to learn how TRMC-Sunnyvale implemented CPOE. Box also is co-chair for the Med Series 4 Patient Care Focus Group, as well as an active member of the Siemens Meaningful Use Task Force; both are aimed at helping hospitals implement CPOE and other patient-safety measures.
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