Well, it’s been a couple of months since my last post and I’ve spent an enormous amount of time working through issues and changes proposed by our strike team. Things on our project are getting better and better, but we still have plenty of challenges. As well, with summer out of the way and all of us back to work and school, I’ve set aside time on my calendar to write an entry every Friday starting September 23 so more information will be available. I do plan to talk about a number of different things over the next couple of months because there is a lot going on in the industry.
As mentioned, the last few months have been pretty hectic. Duncan Regional Hospital (DRH) is currently holding steady with 83% of our inpatient orders all done electronically by a physician. Again, that is ALL ORDERS, not just medications or what is required by Meaningful Use. We still have a number of issues to work out dealing mostly with medication ordering. To date, the pharmacy TallMan lettering scheme is still causing us issues because the physicians don’t like how that looks. Look alike, sound alike drugs, use this type of lettering in our pharmacy system as a flag of which drug is which for our pharmacy staff. But that doesn’t work well with how the physician thinks or sees information. So we’re revamping a number of dictionaries going from the all caps entries to standard upper-lower case descriptions and mnemonics and looking for other alternatives to the TallMan layout.
In October, we’ll bring the Meditech Bedside Medication Verification (BMV) system live enterprise-wide. The solution is replacing a product in this space we implemented several years ago, and it is showing signs of alleviating some of the smaller issues around what nurses and physicians see on medications and gives us one place to look for that information via the electronic medication administration record (eMAR). This was one of the major areas of concern with physicians because it is harder to read everything on the patient’s chart electronically. There just isn’t enough screen size to get everything on there, unlike opening a paper record where you can see and flow through things very rapidly.
Type fonts, screen size, ability to read through the electronic chart, and speed are very real priorities for your physicians during this type of implementation. Remember, it is the CIO’s job to get out there and honestly educate them that the computer will slow them down. The goal is not to make them faster on the computer, the goal with this project has to be safer, higher-quality care, and yes…that means it will slow the continuum of care down a bit. That isn’t a bad thing! All of us are moving to new payment structures that require us to have better quality outcomes. It is very difficult to get consistent high-quality care when your caregivers are rushing to see 70-80 patients a day – promote that to your medical staff now. Safety, quality, safety, quality…that’s what we should all be saying in unison as these very complex, very time and resource consuming systems are going into place.
Again, I’m very excited to be back on the blog front, and I’m very excited about what this next year will hold for all of us. I hope you continue to read my blog and follow along with me as we navigate the murky uncharted waters of healthcare information technology from the American rural-community hospital front. See you next week!