Print This Article | 
Share this Page |
Methodist Medical Center Keeps CPOE Momentum Alive by Demonstrating Tangible ResultsBy Rick Anderson, MD Chief Medial Officer and Senior Vice President of Medical Affairs Methodist Medical Center Peoria, Ill.  Cultivating CPOE Interest It's always easier to make things happen if you "strike while the iron is hot." That's why we're keeping the iron over a roaring fire as we seek to get the most out of our computerized physician order entry (CPOE) system here at Methodist Medical Center. To begin, we warmed our physicians up to the idea of electronic orders well before we ever asked them to use a CPOE system. As a matter of fact, our CEO and other leaders were praising CPOE for three or four years before we brought a system in-house. Getting our clinicians keyed into the concept of electronic ordering was just the start. When we finally started our implementation, we didn't want to dampen the excitement by asking our "super user" physicians to give up 15 hours of their time to be trained. To ensure they continued to look upon CPOE favorably, we reimbursed them for their training time. To get quick adoption, we rolled out the system to departments most likely to readily adopt CPOE. We started with the intensive care unit, and then moved on to our hospitalists. We then began deployment in other patient care units. A Hard-Line Approach At the center of our plan was zero tolerance for maintaining a dual (paper and electronic) world. Instead, we made sure that everyone was "on the same screen," requiring physicians to use the CPOE system in order to treat their patients. To ensure this approach would work, we provided our doctors with "elbow-to-elbow" support on the hospital floors. The CPOE implementation team, along with physician champions, stood side by side with the doctors to ensure any questions or objections were addressed on the spot. We moved from initial CPOE implementation in the ICU in April 2008 to hospital-wide adoption in January 2009 — just eight months later. Currently, about 70% of all orders are entered through CPOE. To maintain physician engagement, we focused on developing proof points from the start. Our first focus was reducing telemetry costs while maintaining quality of care and patient safety. To help us use telemetry more effectively, we created tools within the CPOE system that prompt physicians to review existing telemetry orders each time they log into the system. As a result, physicians are much more likely to discontinue telemetry when it's no longer needed. In a paper world, physicians are never prompted to review the order — and sometimes they don't realize that the patient is still on telemetry at discharge. Without the electronic prompts, physicians may not discontinue telemetry in a timely manner, causing unnecessary costs for patients and the hospital. Rallying Around Results Our focus on telemetry resource utilization has enabled some impressive results.  In January 2009, 274 patients had telemetry orders totaling 1,083 days. A year later, 118patients had telemetry orders totaling 346 days. The average number of telemetry days dropped from 3.95 to just 2.93 for the same time period. Reduction of telemetry usage resulted in cost avoidance of $144,000 — $52,000 for anadditional monitoring station and $92,000 for technician salaries. Without compromising quality, we have controlled resource utilization. We have not had one adverse event related to the reduction of telemetry usage. The end result: We have maintained enthusiasm for the CPOE system at Methodist. With engaged physicians, we plan to implement additional initiatives to leverage our CPOE system so that we are continually improving care while reducing costs. Rick Anderson, MD, is senior vice president of Medical Affairs and chief medical officer at Methodist Medical Center of Illinois, a 360-bed community hospital with 3,000 employees. Prior to becoming the CMO, Dr. Anderson served as the organization's chief quality officer and medical director of Hospital Medical Affairs. He has served as the ED medical director of three different hospitals and continues part-time practice in Emergency Medicine at Eureka Community Hospital, a small Critical Access Hospital.   |
|
|
|||||||||||||||||||||||||||||||||||||||
       |
||
  
|
||
