Enter Your Email Address to Receive a
Copy of MedicExhange Member Demograhpics

Chris Longhurst MD, medical director of clinical informatics at LPCH, speaks about the considerations for CPOE and clinical documentation activation strategies at HIMSS 2010 .

Lucile Packard Children’s Hospital (LPCH) in Palo Alto, Calif., in 2005 went from a Stage One hospital with only ancillaries online applications, to a Stage Four facility, complete with live nursing documentation and partial physician documentation based on the HIMSS analytics model for EMR adoption. Having recently undergone a computer provider order entry ( CPOE ) activation, Chris Longhurst MD, medical director of clinical informatics at LPCH, spoke about the considerations for CPOE and clinical documentation activation strategies at HIMSS 10 .

In December 2005, the Children’s Hospital of Pittsburg published a study suggesting that mortalities were significantly increased after an implementation of a commercially-sold CPOE system . “Having giving up part of my clinical career of  taking care of patients so that I could implement a system that I hoped was going to improve safety of the hospital, this study was very distressing,” said Longhurst.

After further review of this study, Longhurst noted that the aforementioned implementation was attempted over the course of six days. “We paused, and thought maybe we should take a step back and re-think our plans,” he said.

Using the lessons learned by the Children's Hospital of Pittsburg, Longhurst and his facility went forward with their implementation. Based on their survey data and discussions with colleagues, LPCH developed an acuity-based activation strategy, noted Longhurst.

As far as functionality activation is concerned, he said that both CPOE and nursing documentation were implemented together. “From a change management perspective, it got all our executive leadership on board,” said Longhurst, noting that the cons of this implementation strategy is that it resulted in  high stress levels due to the simultaneous implementations for both nurses and physicians undergoing change at the same time.

In terms of implementation outcomes, they did not receive any physician complaints to the CEO, and the issues that presented during the activation were minimal and the hospital was able to address them right away. “I think part of this speaks to our activation strategy,” he said.

“Meaningful use says you have to have 80-85 percent of your orders in [the system] by physicians and we have been at 97 percent since day one,” said Longhurst, noting that LCPH also has improved medication, laboratory and x-ray turnaround times.

Source: HIMSS

You can discuss about HIMSS conference and related topic in our Radiology & Healthcare IT Conferences Group.