McKessonHBOC's Horizon Clinicals solution expanded with Vanderbilt's clinical decision support and physician order entry tool

Atlanta 16 July 2001Vanderbilt University Medical Center in Nashville, Tennessee, has signed a strategic relationship with the Information Technology Business of McKessonHBOC Inc. to deliver a world-class solution for advanced clinical decision support and expert physician order entry. The solution, which has been in use at Vanderbilt for the past six years, will be known as Horizon Expert Orders. It goes beyond the current industry definition of physician order entry by providing interactive evidence-based guidelines, treatment advisors, and relevant clinical content before orders are placed.


"We listened to our physician customers, and they clearly told us that computerised order entry is only one step in addressing the information aspect of patient safety", stated Graham King, president of McKessonHBOC's Information Technology Business. "Vanderbilt has taken order entry to the next level by pioneering a solution which integrates medical informatics with daily physician practice to reduce variability in care processes and improve clinical outcomes. The result is the saving of dollars, resources, and most importantly, lives."

Horizon Expert Orders assists physicians in decision-making by presenting clinically relevant data about the patient's condition along with treatment protocols and evidence-based guidelines agreed upon by the organisation's physicians. Armed with this information, physicians and other clinicians can quickly enter orders with a few keystrokes or mouse clicks. According to William Stead, M.D., Vanderbilt's Assistant to the Chancellor for Informatics and Associate Vice Chancellor for Health Affairs, his organisation has seen a direct impact on decision-making and the quality of patient care. "Our physicians personally place 70 percent of the 10.000 orders that we generate every day, with the remaining 30 percent placed by other members of the care team. With Horizon Expert Orders, we have seen an average of over 500 warnings or advices per day, many of which result in an order change."

Horizon Expert Orders also has financial implications. At Vanderbilt, system-driven results include a $5 million annual reduction in pharmacy costs, with exclusion of the value of adverse drug event prevention. Vanderbilt equally reduced its X-ray costs by more than $1.1 million. McKessonHBOC will offer Horizon Expert Orders as a key component of its Horizon Clinicals solution, a suite of next-generation, integrated solutions for physicians and other clinicians. Horizon Clinicals is built upon an integrated clinical repository and common architecture, with advanced functionality to support clinicians in providing high-quality, cost-effective patient care across multiple care settings.

Just to help ensure the highest levels of clinician access and patient safety, patient information is available in personalised views anytime, anywhere via the Web using a physician portal, and mobile messaging solutions that page caregivers when care alerts are triggered. The other components of Horizon Clinicals include point-of-care clinical documentation, laboratory as well as pharmacy solutions, and integrated ambulatory and physician outreach. Horizon Clinicals equally features the only integrated solution for medication safety on the market, addressing all five steps of medication management, such as prescribing, transcribing, dispensing, administering and monitoring, as well as incorporating information technology, robotics, next to scanning technology.

As part of Vanderbilt's relationship with McKessonHBOC, the Medical Center is committed to provide medical content such as evidence-based medical protocols, and will support the development, implementation, support, and marketing efforts required for McKessonHBOC to successfully bring Horizon Expert Orders to the market. "From the beginning, our goal has been to use the power of medical informatics to develop a solution which will help physicians practise better medicine while reducing the cost of care", stated Dr. Stead. "We've proven the efficacy of Horizon Expert Orders in an academic environment. Now it is time to put that power in the hands of physicians in other hospital settings."

"It cannot happen soon enough", stated Dick Gibson, M.D., Ph.D., chief medical information officer for Providence Health System, a seven-hospital system in Oregon that has agreed to be a pilot site for Horizon Expert Orders. "Physicians are bombarded with information. They need a smart system bringing it all together in a way that is relevant to the patient situation at hand. Horizon Expert Orders does that for you. With Horizon Expert Orders, you are not getting just a set of protocols and guidelines, you are getting practice sets and treatment advisors clinically proven in your area of expertise. You're still making the decisions, but you're doing it with the backing of expert knowledge systems."

Vanderbilt University Medical Center is a major referral centre made up of Vanderbilt University Hospital, the Vanderbilt Clinic, Vanderbilt Children's Hospital, Vanderbilt School of Medicine, and Vanderbilt School of Nursing. Among the unique services offered by Vanderbilt to the community are the Burn Center, Level I Trauma Center, LifeFlight helicopter ambulance service, Level 4 Neonatal Intensive Care Unit, and the Middle Tennessee Poison Center. In all, Vanderbilt offers a total of 92 speciality clinics, including the Vanderbilt-Ingram Cancer Center, the state's only National Cancer Institute Comprehensive Cancer Center. Over the past decade, Vanderbilt has also emerged as one of the nation's foremost centres for biomedical informatics. Its focus on just-in-time decision support tools for physicians makes it a leader in that field.

Leslie Versweyveld

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