MaineGeneral plans to use a combination of wireless handheld devices and desktop workstations, and will implement applications for prescribing, capturing charges, dictating, ordering labs and viewing results, providing patient education, and taking clinical notes. Each application will operate fully upon implementation and integrate with the previously added applications, ultimately building a complete mobile and modular electronic medical record, or mEMR.
Aurora's decision came following a successful initial deployment at eight Aurora clinics with the TouchWorks Rx+ e-prescribing module for sixty physicians. Aurora will now expand e-prescribing to over 300 physicians as well as roll out additional functionality, such as TouchWorks Charge. Aurora cited patient safety and speed of implementation as key reasons for selecting Allscripts. The system works in real time through a wireless network connected to central computers and printers within clinics allowing physicians to use these pocket-sized computers wherever they work.
Located in Augusta, Maine, MaineGeneral Health is the parent corporation of a network of acute care hospitals, physician practices, rehabilitation centres, long term nursing care, and assisted living and retirement communities. "With the implementation of the TouchWorks suite of applications, our clinicians will have robust decision support tools at their finger tips for the delivery of patient care", stated Kash Basavappa, Senior Vice President and Chief Information Officer at MaineGeneral Health.
"The modular implementation strategy will help our physicians to rapidly adopt this solution and we expect our physicians to embrace the TouchWorks applications in a very short period of time." With over 630 beds in service and 3400 full time equivalent employees, MaineGeneral is already implementing TouchWorks modules for prescribing, documentation management, and lab results management.
"The modular strategy is fast becoming the standard for successfully implementing an electronic medical record", commented Lee Shapiro, President of Allscripts Healthcare Solutions. "More and more, people are reaching the conclusion that a modular approach, like the TouchWorks mEMR, offers better promise for physician adoption and utilisation than an abrupt process overhaul."
Aurora chose TouchWorks software for its ability to improve patient safety, a primary concern for practice groups across the country. According to the 2000 Institute of Medicine report, To Err is Human, as many as 98.000 patients die per year due to medical errors. By automating their physicians with TouchWorks, Aurora will leverage leading edge technology to help their physicians prevent medication errors and deliver improved care to their patients.
The TouchWorks Rx+ application will help prevent medication errors by automatically checking for drug and food interactions, allergies, and compliance with the patient's insurance provider guidelines. TouchWorks automates the time consuming process of reviewing patient history and patient specific formulary as well as prepares the prescription in a legible format. TouchWorks saves the patient time at the pharmacy, co-payment dollars, and most importantly improves the level of medical care the patient receives.
"The system enhances patient safety with a three-pronged approach. It eliminates doctor handwriting, tests for drug to drug interactions, and tests for patient drug allergies or possible adverse reactions", explained John Schwab, M.D., an internist at Wilkinson Medical Clinic in Hartland, one of the sites involved in the initial deployment. Dr. Schwab was instrumental in evaluating the new programme. "In the past, if I had 45 different patients with 45 different insurance plans, then I had 45 different drug formularies to review. The new system does it automatically. It's a huge step forward."
Using TouchWorks Rx+, physicians see a message pop up on their handheld device that alerts them to contra-indications or possible problems with the prescription they are writing. This alert allows physicians to modify their prescription accordingly at the point of care, saving time for the patient at the pharmacy.
The e-prescribing software automates many tasks, allowing physicians to spend more time with their patients. Copies of the electronic prescription automatically become part of the patient's medical record and the system can also immediately send the prescription to a pharmacy of the patient's choosing. Additionally, the clarity of electronic prescriptions can reduce the large volume of telephone traffic to and from pharmacies that currently occurs in many clinics related to questions about individual prescriptions, which can unnecessarily delay a patient at the pharmacy.
"The care and safety of our patients is paramount", stated Eliot Huxley, M.D., president of Aurora Medical Group, which provides care at 75 clinics throughout eastern Wisconsin. "TouchWorks represents a significant part of our response to rising national concern over medication errors. The Institute for Safe Medication Practices has called for eliminating handwritten prescriptions by 2003. I have no doubt that our success could be a blueprint for the rest of the nation."
Patient safety has also been the focus of several health care watchdog organisations. The Leapfrog Group, a coalition of over 100 public and private employers, focuses on saving lives and reducing preventable medical mistakes through technology. Recently, Leapfrog has focused on computerised physician order entry (or CPOE) technology, and currently is preparing recommendations to extend these safety measures to doctors' offices.
The TouchWorks suite of applications will also help Aurora save money for their patients and health care overall. According to the 2000 Institute of Medicine report, To Err is Human, for every dollar patients spend on prescription medication, health care overall, including providers and payers, spends an additional dollar, on average, to pay for treatment related to medication errors. Aurora believes that in addition to the savings realised through increased efficiencies, there will be significant savings to consumers and payers associated with the prevention of medication errors.
TouchWorks will integrate with Aurora's current IDX practice management software. Aurora Healthcare has utilised IDX Systems Corporation's IDXtend business performance solutions, including Billing and Accounts Receivable and Enterprise-wide Scheduling, since 1997. Aurora encompasses Aurora Medical Group with more than 500 physicians practising in clinics and health centres, 13 hospitals, 90 community pharmacies, the state's most comprehensive home health and family service agencies, and several long-term care facilities and retirement communities. Aurora has care sites in more than 75 communities throughout eastern Wisconsin.
Allscripts Healthcare Solutions' TouchWorks software products enhance physician productivity using a wireless handheld device or desktop workstation to automate the most common physician activities including prescribing, capturing charges, dictating, ordering labs and viewing results, providing patient education, and taking clinical notes. The company also provides medication fulfilment services. Additionally, Allscripts offers patient compliance and health care product education services for physicians through its Physicians Interactive unit. Allscripts delivers services to over 20.000 physicians across the United States.
More news on TouchWorks is available in the VMW March 2002 article Modular TouchWorks solutions render hospital physicians mobile at their own pace.