Concord Hospital begins implementation of computer entry system

Concord Hospital has begun implementation of an electronic order entry system that will allow medical staff to enter medication, imaging, laboratory and virtually all other orders directly into the computer, the first hospital in the state to install such a system, according to hospital officials.

“Over a decade ago, Concord Hospital adopted a comprehensive and long-term approach for the use of information technology to enhance quality and efficiency,” said Mike Green, president and CEO. “Physicians and hospital staff are presently using a variety of information technology applications including an electronic medical record system with a pharmacy system, a nursing documentation system and a provider portal that allows providers to access lab results and imaging exam results.”

Green said it was important to note that the order entry system is not just replacing paper. “It’s really a transformation in the flow of work for both nurses and physicians.”

Such secure computerized order entry systems, or CPOEs, are gaining use in hospitals across the country because they often provide a significant reduction in errors due to lost or illegible orders or serious drug interactions and contraindications.

Hospital officials also say the system, which is made by health-care IT giant McKesson and is also being used by Duke and Vanderbilt Universities, has decision support algorithms to aid physicians in making clinical decisions, such as medication contraindication and dosage warnings, and is able to track every order for outcome evaluation that can later be reviewed by clinicians.

The Institute of Medicine of the National Academies, an national health-care policy organization based in Washington, D.C., has long pointed out the country’s serious issue of preventable medication errors and has estimated in a new report issued this month that there may be at least 1.5 million preventable drug errors in the United States each year.

Green said there has been no push back from nursing or doctors partly because the implementation is still in its early stages but also because the “compelling reason” behind installing the system is for patient safety and positive clinical outcomes.

“If you look at the reports, we [Concord Hospital] do very well, but we believe we need to do better — and that takes a systems approach. Everybody is committed to improving care. We also have the IT, clinical and nursing leadership to help with the implementation,” he said.

For instance, the physicians themselves will be developing the order sets.

Green said he expects the $3 million system will be live in about year, with full use in 18 to 24 months.

“Every patient is unique and needs to receive care accordingly, but scientific studies unequivocally demonstrate that use of evidence-based practice and reduction of variation in care both improves care and reduces costs,” Green said. “However, the computer generated recommendations never take precedence over the clinical judgment of physicians, but rather provide information that can assist the thoughtful assessment of the needs of our patients.” — CINDY KIBBE

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