Project Unwires The Medical Arts

June 6, 2003
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GRAND RAPIDS — A new information system at two West Michigan hospitals will handle everything from patient records to ordering medical procedures and medications.

And the system is about more than the technology designed to reduce and ultimately eliminate errors and improve patient safety.

For the nursing staff, clinicians and physicians, the system is part of some major changes in store concerning the way they've always cared for patients.

"We will be changing the way we work today," said Greg Forzley, M.D., the medical director for Advantage Health, the physician-hospital organization of Saint Mary's Mercy Medical Center.

"We are changing our workflow and the way we do things," he said.

Forzley heads Saint Mary's participation in Project Genesis, a $192 million initiative by parent corporation Trinity Health to reduce the potential for hospital medical errors and improve patient safety and the quality of care.

Saint Mary's Mercy Medical Center and Muskegon's Mercy General Health Partners are among the first of Farmington Hills-based Trinity Health's 42 hospitals to implement computerized physician order entry, or CPOE, under Project Genesis.

The system, representing a significant step up to the next generation of technology many hospitals now use for patient records and other administrative tasks, enables caregivers to electronically order medications and medical procedures and better access and maintain medical records electronically.

Forzley said CPOE will enable physicians to access a patient's medical chart, with real-time information from any location. Thus, if a nurse has an urgent question about how to minister to a patient, the question needn't wait until the physician responds to a pager or arrives at the foot of the patient's bed to examine his or her chart.

The information will be available 24/7 via a wired or wireless PC, laptop computer or personal-digital assistant, regardless of whether the doctor is home, at the office or making rounds.

Forzley also said software will cross-reference prescription orders for adverse reactions with the medications a patient is already using. It also will help to eliminate potential mistakes stemming from physicians' notoriously illegible handwriting or some other misstep in the process.

Operationally, the system is viewed as helping to generate efficiencies for hospitals and costs savings by reducing the amount of time a physician or nurse takes to locate a patient's medical chart and fill out documentation.

The intent is to mitigate the potential for errors as best as humanly possible, although there's always a potential for mistakes to occur if a person errs in entering data.

Forzley believes the advances the system brings will help doctors, nurses and clinicians to do their work faster, more efficiently and effectively, and result in a safer environment for patients.

"It's better medicine," he said. "We can save patients' lives and we can avoid near misses."

Despite all the technology involved, he said the key to such a system is the people who use it — and designing a system in the most user-friendly way possible for the physicians and nurses who are long accustomed to the routine of filling out paperwork as they go about their jobs.

One of the biggest challenges for CPOE is getting some health care professionals to buy into and use the system.

"It's a big cultural change," said Leslie Coerper, manager of clinical informatics at Saint Mary's Mercy Medical Center.

"The most important part is changing the way our nurses and our medical staff do their work. They're used to having that piece of paper," Coerper said.

"It has to fill the need clinically and it has to be easy to use. You have to marry that user-friendly with the clinical needs."

The push for CPOE systems in hospitals stems from a 1999 report published by the Institute of Medicine that estimated that as many as 98,000 people die annually in the U.S. from medical errors that occur in hospitals.

The report, even as its conclusion spurred considerable debate, gave rise to a major push in the health care industry to improve patient safety and quality.

One of the biggest came from The Business Roundtable — an association of Fortune 500 chief executive officers — which formed the Leapfrog Group, a coalition of more than 135 public and private organizations that provide health care benefits.

The Leapfrog Group has made the implementation of CPOE one of its three major quality measures for hospitals.

As part of the planning for Project Genesis, hospital administrators at Saint Mary's and Mercy General have set up what they've labeled an "innovation station" at each hospital that features a hospital room equipped with a myriad of PCs, laptops and PDA devices that staff can experiment with to determine which hardware works best for them on the job.

Trinity Health is investing $10 million at Saint Mary's to install and implement a CPOE system by May 2004.

Mercy General Health Partners anticipates a new system going into operation by March 2004.

The Mercy General system will cost Trinity $7 million over three years.

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