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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.”