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Case Study

                                    Memorial Health System
                                    Innovative Approach to CPOE
                                    Earns Robust Results
Memorial Hospital opened in         While the nearby Georgia coastal      advance clinical and financial
                                    region attracts a bustling tourist    excellence, they uncovered an area
1955 as a 300-bed facility          trade, Savannah-based Memorial        for improvement.
pioneering a new era in medical     Health University Medical Center
                                    (Memorial Health) attracts patients   Hospital staff studied processes
services. Considered the most       and clinicians with its reputation    tied to physician order entry and
                                    for excellence. Memorial Health       discovered that staff did not enter
modern hospital in the Southeast,   further strengthened its leadership   admission orders in the legacy
Memorial Health grew to             in patient safety and care by an      system until 3.35 hours after the
                                    innovative deployment of              physician wrote them. It took
become a two-state healthcare       McKesson’s computerized physician     74 minutes for daily orders to be
                                    order entry/decision support          entered. Deciphering physician
organization serving a 35-county    solution. The medical center          handwriting was also an issue with
area in southeast Georgia and       has significantly increased order     23% of orders deemed illegible.
                                    accuracy, decreased medication        Additionally, physicians spent an
South Carolina. The health          turnarounds by two hours, and         average of 7.2 minutes searching for
                                    achieved a 30% reduction in           a patient’s chart. Pharmacy often
system includes its flagship        pharmacy callbacks due to             did not have patient height, weight
Memorial Health University          illegibility.                         and allergy information, and other
                                                                          missing data created multiple
Medical Center, a 530-bed           Challenges                            opportunities for errors.

tertiary medical center; CareOne,   Memorial Health executives
                                    have long realized the value          With clinical outcomes and patient
a homecare division; Memorial       of information technology in          safety as top priorities, hospital
                                    improving clinical and operational    executives recognized that the next
Health University Physicians        performance. For example, the         stage of innovation had to include
                                    hospital moved ahead of many          one of healthcare’s most widely
primary and specialty care                                                discussed technologies: computerized
                                    providers with its deployment of
networks; a major medical           McKesson’s HorizonWP® Physician       provider order entry (CPOE).
                                    Portal six years ago, which gained
education program; business         widespread physician adoption         Chief Executive Officer Bob Colvin
                                    with its anytime, anywhere access     explains Memorial Health’s unique
and industry services; and                                                approach to garner maximum success.
                                    to vital patient information. The
NurseOne, a 24-hour call center.    portal was followed by other wins     “In terms of patient safety, CPOE is
                                    for physicians with document and      a major step we’ve taken in the last
                                    medical imaging technology. As        five years,” he says. “We saw the
                                    management began to define the        technology’s potential to greatly
                                    next set of strategic goals to        reduce transcription and medication
At a Glance                          errors, but also as a way to automate    As plans firmed up for the physician
                                     processes around best practices.         rollout, neonatologists learned
Organization                         Because nurses provide a great deal      their unit was scheduled last for
Memorial Health System,              of education and support for             deployment. “We had used a
Savannah, GA                         physicians, it made sense for us to      proprietary electronic medical
                                     deploy the technology to nurses          record system and understood how
– 530-bed Memorial Health            first and then physicians.”              electronic order entry eliminates
  University Medical Center                                                   illegible handwriting,” says Linda
– Primary and specialty care         Answers                                  Sacks, M.D., a neonatologist and
  physician networks                 Memorial Health’s patient safety         co-director of Nurseries. “We were
                                     strategy included the selection of       excited about the capabilities of
– Homecare services                                                           Horizon Expert Orders and asked
                                     McKesson’s Horizon Expert Orders™
– 24-hour nurse call center          computerized order entry/clinical        to go live first.”
– Inpatient visits: 28,000           decision support system with
                                     Horizon Meds Manager™ pharmacy           With neonatologists eager to use
– Outpatient visits: 217,000                                                  CPOE, Memorial Health chose the
                                     information system as the hub for
                                     the medication management                44-bed neonatal unit as the starting
Solution Spotlight                                                            point for the physician rollout.
                                     process. In addition to electronic
– HorizonWP Physician Portal         transcription capabilities, the system   Neonatology was also a wise choice
– Horizon Meds Manager               provides the necessary checks and        because the unit has a very low
                                     balances for medication orders.          patient transfer rate and the
– Horizon Expert Orders                                                       physicians generate a high volume
                                     Memorial then rolled out Horizon         of daily orders. While the unit
Critical Issues                                                               uses fewer than 100 different
                                     Expert Orders to 935 nurses and
– Missing clinical data              unit secretaries for nonmedication       medications, the system supports
                                     ordering. This nontraditional            the precise weight-based dosing
– Medication safety
                                     approach created a built-in support      required for infants.
– IT use and satisfaction
                                     system to drive physician adoption,
– Inefficient processes              explains Lynne Williams, RN,             Results
                                     manager of clinical systems.             As part of its incremental approach,
Results (based on live units)        “IT system adoption is enhanced          Memorial has implemented Horizon
– Improved availability of height,   with multiple layers of support,”        Expert Orders in neonatology, the
  weight and allergy information     says Williams. “By having nurses         emergency department, pediatric
  to 100%                            trained and using the system, they       hematology and oncology, pediatric
                                     would be the power users and give        intensive care, and general pediatrics
– Increased legibility and
                                     physicians any needed support.”          and has gained strong physician
  accuracy of medication orders
                                                                              adoption.
– Reduced turnaround time
  for medications by an average
  of two hours
– Reduced order call backs
  associated with legibility
  by 30%
According to Dr. Sacks, use of            Medication Safety and
Horizon Expert Orders has improved        Turnarounds – The integrated
both the accuracy and speed of            systems have helped reduce time
carrying out physicians’ orders,          delays previously associated with
which in turn improves quality.           order entry. Memorial Health has
“Physicians were entering 100%            increased order accuracy, decreased
of their orders within days of going      turnarounds for medications by
live,” says Dr. Sacks. “We reduced        an average of two hours, and
turnaround time for orders, and           reduced pharmacy callbacks
the number of calls required to           due to illegibility by 30%.
clarify verbal or written orders is
rapidly approaching zero.”                Dr. Sacks notes, “Neonatal drug
                                          dosing is extremely complex.             “We are changing the culture
Other results for Memorial Health         Horizon Expert Orders allows me
include:                                  to instantly pick the correct            by providing physicians with
                                          evidenced-based dose for any
Height, Weight and Allergy                given clinical patient need.”            technology that supports
Information – On the units where                                                   the way they practice, thus
physicians use Horizon Expert Orders,     Memorial Health has earned strong
the pharmacy now receives height,         results with CPOE, improving             delivering solutions that
weight and allergy information            patient safety and access to
100% of the time, eliminating the         mission-critical information and         physicians find valuable.”
opportunity for medication errors due     best practices. “We are improving
to incomplete patient information.        adoption by providing physicians
                                          with technology that adds value to       Patty Massey
Clinician Efficiency and Satisfaction –   their processes, thus enhancing care,”
Physicians can monitor active orders      says Patty Massey, vice president and    Vice President and
and make necessary changes to             chief information officer.               Chief Information Officer
keep orders current and accurate.
Clinicians praise the system’s quick,     Dr. Sacks agrees: “We are extremely      Memorial Health
efficient order entry process and         enthusiastic about Horizon Expert
real-time organized view of orders        Orders. The technology is physician-
and patient care activities.              friendly, intuitive and can be quickly
                                          customized to the individual hospital
                                          or unit based on how we practice
                                          medicine daily.”
McKesson Provider Technologies
5995 Windward Parkway
Alpharetta, GA 30005
                                 Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All rights reserved. HorizonWP is a
http://www.mckesson.com          registered trademark of McKesson Information Solutions LLC. Horizon Expert Orders and Horizon Meds Manager
1.800.981.8601                   are trademarks of McKesson Information Solutions LLC. All other product or company names mentioned may be
                                 trademarks, service marks or registered trademarks of their respective companies.                 PRT257-10/06

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Memorial Health System Innovative Approach to CPOE Earns Robust Results

  • 1. Case Study Memorial Health System Innovative Approach to CPOE Earns Robust Results Memorial Hospital opened in While the nearby Georgia coastal advance clinical and financial region attracts a bustling tourist excellence, they uncovered an area 1955 as a 300-bed facility trade, Savannah-based Memorial for improvement. pioneering a new era in medical Health University Medical Center (Memorial Health) attracts patients Hospital staff studied processes services. Considered the most and clinicians with its reputation tied to physician order entry and for excellence. Memorial Health discovered that staff did not enter modern hospital in the Southeast, further strengthened its leadership admission orders in the legacy Memorial Health grew to in patient safety and care by an system until 3.35 hours after the innovative deployment of physician wrote them. It took become a two-state healthcare McKesson’s computerized physician 74 minutes for daily orders to be order entry/decision support entered. Deciphering physician organization serving a 35-county solution. The medical center handwriting was also an issue with area in southeast Georgia and has significantly increased order 23% of orders deemed illegible. accuracy, decreased medication Additionally, physicians spent an South Carolina. The health turnarounds by two hours, and average of 7.2 minutes searching for achieved a 30% reduction in a patient’s chart. Pharmacy often system includes its flagship pharmacy callbacks due to did not have patient height, weight Memorial Health University illegibility. and allergy information, and other missing data created multiple Medical Center, a 530-bed Challenges opportunities for errors. tertiary medical center; CareOne, Memorial Health executives have long realized the value With clinical outcomes and patient a homecare division; Memorial of information technology in safety as top priorities, hospital improving clinical and operational executives recognized that the next Health University Physicians performance. For example, the stage of innovation had to include hospital moved ahead of many one of healthcare’s most widely primary and specialty care discussed technologies: computerized providers with its deployment of networks; a major medical McKesson’s HorizonWP® Physician provider order entry (CPOE). Portal six years ago, which gained education program; business widespread physician adoption Chief Executive Officer Bob Colvin with its anytime, anywhere access explains Memorial Health’s unique and industry services; and approach to garner maximum success. to vital patient information. The NurseOne, a 24-hour call center. portal was followed by other wins “In terms of patient safety, CPOE is for physicians with document and a major step we’ve taken in the last medical imaging technology. As five years,” he says. “We saw the management began to define the technology’s potential to greatly next set of strategic goals to reduce transcription and medication
  • 2. At a Glance errors, but also as a way to automate As plans firmed up for the physician processes around best practices. rollout, neonatologists learned Organization Because nurses provide a great deal their unit was scheduled last for Memorial Health System, of education and support for deployment. “We had used a Savannah, GA physicians, it made sense for us to proprietary electronic medical deploy the technology to nurses record system and understood how – 530-bed Memorial Health first and then physicians.” electronic order entry eliminates University Medical Center illegible handwriting,” says Linda – Primary and specialty care Answers Sacks, M.D., a neonatologist and physician networks Memorial Health’s patient safety co-director of Nurseries. “We were strategy included the selection of excited about the capabilities of – Homecare services Horizon Expert Orders and asked McKesson’s Horizon Expert Orders™ – 24-hour nurse call center computerized order entry/clinical to go live first.” – Inpatient visits: 28,000 decision support system with Horizon Meds Manager™ pharmacy With neonatologists eager to use – Outpatient visits: 217,000 CPOE, Memorial Health chose the information system as the hub for the medication management 44-bed neonatal unit as the starting Solution Spotlight point for the physician rollout. process. In addition to electronic – HorizonWP Physician Portal transcription capabilities, the system Neonatology was also a wise choice – Horizon Meds Manager provides the necessary checks and because the unit has a very low balances for medication orders. patient transfer rate and the – Horizon Expert Orders physicians generate a high volume Memorial then rolled out Horizon of daily orders. While the unit Critical Issues uses fewer than 100 different Expert Orders to 935 nurses and – Missing clinical data unit secretaries for nonmedication medications, the system supports ordering. This nontraditional the precise weight-based dosing – Medication safety approach created a built-in support required for infants. – IT use and satisfaction system to drive physician adoption, – Inefficient processes explains Lynne Williams, RN, Results manager of clinical systems. As part of its incremental approach, Results (based on live units) “IT system adoption is enhanced Memorial has implemented Horizon – Improved availability of height, with multiple layers of support,” Expert Orders in neonatology, the weight and allergy information says Williams. “By having nurses emergency department, pediatric to 100% trained and using the system, they hematology and oncology, pediatric would be the power users and give intensive care, and general pediatrics – Increased legibility and physicians any needed support.” and has gained strong physician accuracy of medication orders adoption. – Reduced turnaround time for medications by an average of two hours – Reduced order call backs associated with legibility by 30%
  • 3. According to Dr. Sacks, use of Medication Safety and Horizon Expert Orders has improved Turnarounds – The integrated both the accuracy and speed of systems have helped reduce time carrying out physicians’ orders, delays previously associated with which in turn improves quality. order entry. Memorial Health has “Physicians were entering 100% increased order accuracy, decreased of their orders within days of going turnarounds for medications by live,” says Dr. Sacks. “We reduced an average of two hours, and turnaround time for orders, and reduced pharmacy callbacks the number of calls required to due to illegibility by 30%. clarify verbal or written orders is rapidly approaching zero.” Dr. Sacks notes, “Neonatal drug dosing is extremely complex. “We are changing the culture Other results for Memorial Health Horizon Expert Orders allows me include: to instantly pick the correct by providing physicians with evidenced-based dose for any Height, Weight and Allergy given clinical patient need.” technology that supports Information – On the units where the way they practice, thus physicians use Horizon Expert Orders, Memorial Health has earned strong the pharmacy now receives height, results with CPOE, improving delivering solutions that weight and allergy information patient safety and access to 100% of the time, eliminating the mission-critical information and physicians find valuable.” opportunity for medication errors due best practices. “We are improving to incomplete patient information. adoption by providing physicians with technology that adds value to Patty Massey Clinician Efficiency and Satisfaction – their processes, thus enhancing care,” Physicians can monitor active orders says Patty Massey, vice president and Vice President and and make necessary changes to chief information officer. Chief Information Officer keep orders current and accurate. Clinicians praise the system’s quick, Dr. Sacks agrees: “We are extremely Memorial Health efficient order entry process and enthusiastic about Horizon Expert real-time organized view of orders Orders. The technology is physician- and patient care activities. friendly, intuitive and can be quickly customized to the individual hospital or unit based on how we practice medicine daily.”
  • 4. McKesson Provider Technologies 5995 Windward Parkway Alpharetta, GA 30005 Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All rights reserved. HorizonWP is a http://www.mckesson.com registered trademark of McKesson Information Solutions LLC. Horizon Expert Orders and Horizon Meds Manager 1.800.981.8601 are trademarks of McKesson Information Solutions LLC. All other product or company names mentioned may be trademarks, service marks or registered trademarks of their respective companies. PRT257-10/06