IDX Carecast delivers high-availability technology to support critical health information needs

Seattle 15 February 2005There is a new urgency in the discussion of how to achieve a lifetime electronic medical record for every patient in the United States. President Bush's call for widespread adoption of electronic medical records within 10 years would require highly reliable, fail-safe technology that will meet the health care industry's stringent requirements for system performance and availability. With its combination of scalability, unsurpassed reliability and a guarantee of 99,9 percent uptime, IDX Carecast is uniquely positioned to meet the demands of the 21st century health care organisation. Carecast runs on the HP NonStop platform, distinguished by its enterprise-ready, continuously available, linearly scalable servers.


According to a recent report by Gartner Inc., a provider of research and analysis on the global information technology industry, "As care delivery organisations increase computer-based patient record use for clinical care, they will become increasingly intolerant of downtime." (Hieb, Barry, M.D.; Scott, D., 9 November 2004. Clinical Automation to Drive High Availability Requirements.)

The experiences of many IDX customers, often spanning a decade or more of system use, speak to the extraordinary reliability of Carecast and its predecessor, IDX LastWord, combined with the HP NonStop platform.

The Nebraska Medical Center, Omaha, Nebraska, serves more than a quarter of the Omaha-area market through its hospital, 22 clinics and 350-physician faculty practice. The organisation's Carecast electronic medical record encompasses both ambulatory and inpatient care, and is used by 5000 health care professionals. The organisation is also distinguished as an early adopter of portable electronic medical record technology, which gives patients a password-protected, portable version of key information from their integrated inpatient and outpatient health record.

"The IDX technology platform has never caused us a moment of unplanned downtime in 10 years. Our positive experience with system reliability strongly influenced our decision to upgrade from LastWord to Carecast two years ago, and has continued to this day", stated Jim Veline, Executive Director of Information Technology, the Nebraska Medical Center. "With IDX, we have the mission-critical performance that supports our clinicians and advances our progress towards a paperless record. In addition, we've consistently maintained sub-second response times, ensuring that our system supports the fast pace of patient care."

Montefiore Medical Center, New York, New York, a 1062-bed, three hospital academic health system, is one of the leading organisations using CPOE in the United States, with virtually 100 percent of inpatient orders entered electronically and 2500 physicians participating. Using the LastWord enterprise system on NonStop servers, Montefiore estimates it has reduced potential prescribing errors by 70 percent, and reduced by 60 percent the elapsed time from a physician issuing a medication order to the patient receiving the medication. In addition, CPOE has resulted in annual productivity savings at Montefiore that are estimated at $2,5 million a year.

"When Montefiore first began our CPOE project, we knew that system reliability would be essential, and that's one reason we chose IDX and NonStop servers", stated Dorrie Napoleone, Montefiore Medical Center Director of Clinical Applications. "In the eight years since our go-live, our NonStop servers have delivered 99,9 percent uptime as guaranteed in our contract with IDX. This reliable performance has helped us to significantly prevent unscheduled downtimes and has supported our successful use of CPOE with IDX software."

In addition, Montefiore will be using NonStop servers to create a full back-up repository of all data, to ensure that the system remains up during scheduled downtimes, and to support appropriate measures for disaster recovery of patient data. The organisation has also established a separate business arm, Emerging Health Information Technology (EHIT), to offer consulting and hosting services to other hospitals embarking on CPOE and electronic medical records. EHIT has deployed NonStop servers to support LastWord's use at the 560-bed Bronx Lebanon Hospital Center, which is currently close to 80 percent live on CPOE.

Lehigh Valley Hospital and Health Network (LVHHN), Allentown, Pennsylvania, uses the LastWord clinical information system across its three community teaching hospitals to support computerized physician order entry, combined with wireless barcode medication charting to safeguard against errors during medication administration. LVHHN is also one of the 100 Most Wired Hospitals in the United States, as designated by the Hospitals & Health Networks' Most Wired Survey and Benchmarking Study, 2004.

LVHHN estimates its combined use of CPOE and barcode charting has reduced medication errors by 44 percent. System reliability has been vital to clinician acceptance of CPOE at LVHHN. The organisation recently announced an upgrade to Carecast to support its further development of a completely paperless electronic medical record across its hospitals, including use of interdisciplinary care plans.

"Our IDX system simply doesn't go down unless we bring it down for regular maintenance and this has been our experience for more than a decade", stated Sandy Haldeman, LVHHN Director of the Carecast Upgrade project. "Our clinicians depend on the reliability of IDX and NonStop to keep the electronic medical record, computerized physician order entry, wireless medication barcode charting, and other clinical functionality up and running. These systems are essential for direct patient care."

Consistent system uptime also offers financial benefits to health care organisations, as shown by industry research. Mark Anderson, of the Anderson Consulting Group Inc., has estimated that every minute of downtime requires 4,5 minutes to complete the same tasks manually plus update the computer system once it is back up and running. Mark Anderson calculated the difference between 98 percent uptime and 99,9 percent uptime would cost a 514-bed hospital $2,7 million per year. (System Uptime Study for the Healthcare Industry, September 2001, Anderson Consulting Group Inc.)

Similarly, the Standish Group reviewed the total cost of ownership of 16 different computer systems. That report found that the HP NonStop had the lowest total cost of ownership when all factors, including downtime, were taken into account. (Dollars and CENTS: TCO in the Trenches 2002, The Standish Group International Inc.)

"The Gartner report predicts that electronic health record software vendors will need to offer a high-availability option by 2008 in order to stay competitive", noted Mike Raymer, Senior Vice President and General Manager, IDX Carecast Operating Unit. "IDX has been delivering extraordinary system uptime for years, well ahead of the competition."

Beyond the health care industry, the NonStop platform is known as a leading platform for a variety of mission critical industries that demand continuous availability, including telecommunications, financial markets, securities, eCommerce and the Internet. NonStop servers support 106 of the world's 120 stock exchanges, 95 percent of the world's security transactions, the majority of all ATM and credit card transactions, 75 percent of the world's 100 largest electronic funds transfer networks, and most of the largest telecommunications companies.

Carecast is IDX's next generation of electronic clinical information solutions, delivering unsurpassed response time and reliability to support fast-paced clinical environments. The system automates work flow throughout the health care enterprise and enables rapid access to patient records across the care continuum, from admission to discharge, including pharmacy and ambulatory care. Carecast is a fully integrated clinical, financial and administrative system, combining core clinical processes for orders, results, pharmacy and clinical documentation with administrative and financial processes for scheduling, registration, admitting, charging and billing. The result is a comprehensive lifetime patient record that enhances the quality of care and promotes operational efficiencies. Developed by and for providers - in collaboration with some of the nation's leading hospitals, clinicians and health care executives - Carecast builds on 25 years of innovation with the IDX LastWord enterprise clinical system.

Founded in 1969, IDX Systems Corporation provides information technology solutions to maximize value in the delivery of health care, improve the quality of patient service, enhance medical outcomes, and reduce the costs of care. IDX supports these objectives with a broad range of complementary and functionally rich products installed at 3300 customer sites. Customers include 138.000 physicians who utilize practice management systems to improve patient care and other work flow processes. IDX software solutions are installed at 380 integrated delivery networks (IDNs) representing more than 500 hospitals; 175 large group practices with more than 200 physicians; and 665 mid-size group practices with less than 200 physicians.

IDX also provides its enterprise clinical software as a subcontractor to BT and Fujitsu Services, Local Service Providers for the United Kingdom National Health Service's National Programme for Information Technology, an initiative to establish electronic patient records for 50 million patients. The IDX Web strategy includes browser technology, e-commerce and Web-based tools - built using Internet architecture - that facilitates access for patients, physicians and care providers to vital health information and data managed by the IDX clinical, administrative, financial, and managed care products. IDX has approximately 2100 full-time employees.

You can find more IDX news in the following articles of this VMW issue:

Leslie Versweyveld

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