"More than a decade ago, we began creating an IT infrastructure that would lead to the electronic medical record we have today", stated Sandy Haldeman, LVHHN Director of the Carecast upgrade project. "Using the IDX clinical system has allowed us to focus our efforts on patient safety initiatives recommended by the Institute of Medicine. Upgrading to Carecast is the next step for us."
Through its ongoing use of CPOE and wireless barcode medication charting, LVHHN has strengthened medication safety across the entire cycle of ordering, dispensing and administration. By combining CPOE and barcode charting, the organisation has documented a 44 percent reduction in medication error rates to date, and will continue to expand its use of technology to enhance patient safety. Today, attending physicians enter more than 65 percent of all inpatient orders electronically at LVHHN, and the organisation plans to complete its roll-out of CPOE in 2005.
"Creating a comprehensive safety net has been our highest priority, and with Carecast, we'll be able to keep pushing the envelope", stated Donald Levick, MD, Medical Staff President at LVHHN. "We are moving closer and closer to a completely paperless electronic medical record that spans care settings and enables clinicians to actively work as a care team."
The LVHHN nursing team has also been an intrinsic part of the organisation's commitment to error prevention across the medication cycle, reflecting the commitment to nursing excellence at LVHHN's three Magnet-certified hospitals. LVHHN nurses use wireless barcode medication charting to prevent errors during medication administration, the second most likely place for medication errors to occur, according to the Journal of the American Medical Association (JAMA) - 1998.
Wireless barcoding is widely recognized in the industry as vital to ensuring the "five rights" of medication administration: right drug, right dose, right patient, right route and right time. Nurses at LVHHN use the technology to close the loop on medication safety by scanning the drug and the patient's armband at the bedside, with patient and drug information automatically checked and confirmed by the IDX enterprise clinical system. LVHHN has documented that the technology enables the institution to successfully prevent 50 potential medication errors out of 10.000 doses administered. This means that on the average 30-bed medical unit, LVHHN prevents 50 medication errors per month.
"The integrated wireless barcoding system has become an inherent part of our nurses' work flow, providing a final safety check to support their advanced clinical skills", stated Jan Wilson, RN, MS, Nursing Informatics IS liaison. "The nursing staff is looking forward to even greater patient safety outcomes with advanced care plans and additional new functionality in Carecast."
LVHHN physicians, nurses and ancillary caregivers will use Carecast's interdisciplinary care plans to map out the activities that need to be completed for an individual patient over an entire hospital stay, track activities, and view results from clinicians' interactions with the patient.
Carecast is built on the HP NonStop platform, known for its ability to deliver 99,9 percent uptime and subsecond response time. The NonStop server's reliability has prevented any system-wide unscheduled downtime since LVHHN implemented IDX LastWord, Carecast's predecessor. LVHHN's experience reflects one of the key differentiators of IDX Carecast and LastWord on the NonStop platform, and a timely consideration for health care organisations embarking on electronic health records. In a recent report, Gartner Inc. emphasized that "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.") LastWord's uptime performance has reinforced the LVHHN's expansion of information technology that directly supports patient safety during care, Haldeman noted.
"As one of the leading community teaching hospitals to successfully deploy CPOE, LVHHN has shown tremendous commitment and innovation", stated Mike Raymer, Senior Vice President and General Manager of the IDX Carecast Operating Unit. "We look forward to supporting LVHHN's further roll-out of CPOE and greater expansion of electronic health records with Carecast."
A long-time customer of LastWord, LVHHN also uses the IDX Imagecast Radiology Information System and IDX Flowcast practice management system in its inpatient and ambulatory facilities. Through its Carecast implementation, LVHHN will also implement access to Imagecast's full-fidelity images directly within the electronic patient record.
Based in Allentown and Bethlehem, Pennsylvania, Lehigh Valley Hospital and Health Network is composed of Lehigh Valley Hospital - Cedar Crest & I-78, Lehigh Valley Hospital - 17th & Chew, Lehigh Valley Hospital - Muhlenberg and Lehigh Valley Health Services, which includes home health, hospice, rehabilitation, pharmacy and health management. Advanced regional resources at these non-profit hospitals include a Level I Trauma Center with added paediatric qualifications, as well as burn, kidney and pancreas transplant, perinatal/neonatal, cardiac, cancer care, and neurology and complex neurosurgery.
More news about IDX is available in this VMW issue's article IDX Digital Healthcare Community spotlights the next-generation EMR connecting providers and spanning care settings.