St. Michael’s Hospital, a 475-bed operation employing 5,250 staff in Toronto, has a reputation for providing compassionate care for all who enter its doors, including the disadvantaged as well those referred and flown in from across Ontario for highly complex care. In February, 2012, St. Michael’s went live with computerized physician order entry (CPOE) capability across all inpatient acute care services. “Leading studies note a decrease of 55 percent to 81 percent in the rate of serious medication errors following CPOE implementation,”1 states Anne Trafford, CIO, St. Michael’s Hospital. “We are significantly ahead of the industry best-practices standard for CPOE, which specifies that a minimum of 85 percent of orders should be placed directly by providers,” says Trafford.
Order sets key to practice transformation
The CPOE capability is key to St. Michael’s Gemini initiative, which harnesses Soarian® Clinicals workflow technology to help transform clinical practice. According to Dr. Mike Freeman, Director of Medical Informatics at St. Michael’s and Physician Lead for the Gemini program, a top benefit of CPOE capability stems from the use of pre-built order sets, developed by the clinicians who use them, to help apply evidence-based therapies for different diagnoses. Another CPOE benefit is the ability to flag physicians for potential adverse reactions to medications.
Closed-loop medication management process
The rollout of CPOE included Siemens Pharmacy for handling medication orders and Med Administration CheckTM, which uses barcodes to help to confirm that the right medication is administered to the right patient. “In today’s bedside environment, the patients are sicker and the care requirements are more complex, so the system provides alerts, queues, and guidance to help clinicians provide best care every time,” says Trafford.
Helps to put St. Michael’s among Canada’s best
St. Michael’s is in the top 0.2 percent of Canadian hospitals rated according to the Healthcare Information and Management Systems Society (HIMSS) Analytics Electronic Medical Records (EMR) Adoption Model,2 which scores hospitals on their implementation EMRs. St. Michael’s is one of only three hospitals in Canada to reach the prestigious Stage 6 designation. “Our plan will likely see us getting to Stage 7 within a few years. But where we really need to push the envelope now is on using all the patient data to help us understand how well we are doing with respect to health outcomes and to drive further improvements in clinical process.” To that end, St. Michael’s is implementing the Siemens Embedded Analytics component for data mining and business intelligence capabilities.
R. Stein, et. al. “Effect of computerized physician order entry (CPOE) on chemotherapy prescribing error.” Journal of Clinical Oncology, 2010 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 28, No 15_suppl (May 20 Supplement), 2010: 6034
According to HIMSS Analytics EMR Adoption Model, Q4/2011 Results at http://www.himssanalytics.org/stagesGraph.asp
The outcomes achieved by the Siemens customers described herein were achieved in the customer's unique setting. Since there is no “typical“ hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption), there can be no guarantee that others will achieve the same results.