Physicians at University Health Network enter medication orders on-line to enhance patient safety and CPOE adoption

Raleigh 19 August 2004General internal medicine physicians at University Health Network's (UHN) Toronto General Hospital are now placing 95 percent of medication orders on-line, an essential last step forward in the full activation of computerized physician order entry (CPOE). Long-time users of Misys CPR computer-based patient record solution, the physicians are now incorporating its CPOE clinical decision support tools to support UHN's Patient Safety Initiative of combining the latest technologies with medical practice to enhance quality of patient care delivery and patient safety.

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Misys CPR is a core component of Misys Optimum, a family of best-in-class solutions and Web technologies designed specifically to connect community-based caregivers to acute-care organisations and achieve meaningful electronic data sharing.

"Medication order entry is the area of greatest resistance in deploying full CPOE, and we expect this milestone implementation to expedite physician adoption of order entry", stated Matthew Anderson, vice president and chief information officer, University Health Network, one of Canada's largest teaching hospitals. "Clinicians understand that the safest process today guaranteeing the right patient, right drug, right dose, right time and right route is implementing a closed-loop on-line medication management process. With the implementation of the electronic medication administration record in early fall, UHN is relying on Misys CPR's integrated medication management solution to realize its strategic EPR vision."

Physicians, nurses and other clinicians at UHN have been using Misys CPR to enter orders for radiology exams and laboratory tests since 1988. Since June 7, select physicians at Toronto General Hospital have been placing medication orders on-line. UHN plans to expand medication order entry to all physicians employed at Toronto General Hospital, Toronto Western Hospital and Princess Margaret Hospital.

One work flow streamlining benefit resulting from medication order entry is the elimination of a time-consuming duplicate activity: UHN pharmacists re-entering medication orders into the pharmacy departmental system. Because Misys CPR also interfaces to UHN's departmental pharmacy solution through bi-directional interface technology. "We have one point of order entry and that is through our physicians, minimizing transcription errors thereby creating the safest medication administration process", stated Dafna Carr, project director, patient care management systems, University Health Network.

To maximize the value of Misys CPR, UHN deployed the Misys Clinical Desktop Java-based graphical user interface (GUI). "Our physicians quickly endorsed the new GUI desktop's intuitive look and feel and streamlined order screen navigation design that enables quick access from one patient's record to the next and offers customized order screens with departmental or diagnosis specific order sets", stated Dafna Carr. "Misys' ability to develop a clinician friendly GUI desktop is a crucial success factor in increasing physician buy-in."

"University Health Network is one of the few large-size health care organisations worldwide excelling in implementing an electronic medication management process that encourages above-standard practice and safe care for their patients", stated Matthew Morgan, M.D., vice president of clinical informatics, Misys Healthcare Systems. "Misys CPR's Integrated by Design approach supports UHN's objective of improved patient safety and optimized medication management as part of its patient-centred care vision."

University Health Network is a major landmark in Canada's health care system, and a teaching hospital of the University of Toronto. The organisation brings together the talent and resources that make it an international expert in health care. The health institution has a total of 823 licensed beds that accommodate approximately 29.028 inpatients annually. Building on the strengths and reputation of each of its three remarkable hospitals, Toronto General Hospital, Toronto Western Hospital and Princess Margaret Hospital serve more than 73.300 emergency department and 875.600 ambulatory visits annually.

Misys Healthcare Systems develops and supports reliable, easy-to-use software and services of exceptional quality that enable physicians and caregivers to more easily manage the complexities of health care. Its Misys Optimum solutions, a family of best-in-class products and Web-based technologies, enable patient information sharing across all medical care settings, thus connecting community-based physicians to the acute care enterprise and enabling increased efficiencies, better decision making and improved hospital-physician relations.

With 25 years of experience in the industry, Misys currently serves more than 92.000 physicians in 18.000 practice locations, 1250 hospitals, 600 home care providers and hundreds of commercial laboratories, clinics, managed services and other related organisations. More Misys information is available in this VMW issue's article Lower Bucks Hospital deploys Misys RIS-PACS as an integrated work flow optimization solution


Leslie Versweyveld

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