Patient Safety Driving Point-of-Care I.T. Plans
October 2004
Lancaster General Hospital has a simple goal: to deliver safe, appropriate and consistent patient care. Reaching its goal and maintaining its patient care focus largely depends on point-of-care technology.
In early 2003, the Lancaster, Pa.-based hospital began rolling out medication administration and bar code technology that the 521-bed hospital's nursing staff hoped would reduce patients' risk of drug-related errors.
"From a business perspective, we're trying to put automation in place that enables those kinds of improvements," says Leo Gilmore, senior vice president and CIO, of the hospital's goal. "It requires more direct use of automation at the point of care by the people who are giving the care."
So far it's working: since implementing the technology medical errors are down 54%. Results like that aren't always so clear, nor are all hospitals looking for hard numbers when implementing point-of-care technologies, experts say.
But many hospitals are taking the same approach as Lancaster General: applying information technology at the point of patient care to improve patient safety and clinician efficiency, always with an eye on improving overall quality of care.
In addition to reducing medical errors, hospitals see greater care efficiency resulting from point-of-care technology, which can be as simple as enabling a nurse to look up patient test results in-room rather than from a computer or telephone at the nurse station.
Other benefits include improved patient satisfaction regarding safe administration of medication, more efficient handling of physician orders and improved revenue from better patient charge capture at the point of care.
Hospitals are turning to an array of point-of-care technologies to help them register the benefits, depending on their specific needs. The hardware roster includes hardwired or wireless PCs, laptops, tablets and hand-held computers; bedside monitoring devices; and bar code readers.
Applications include medication administration; computerized physician order entry; nursing documentation; and picture archiving and communication systems.
Many hospitals are piloting technologies in specific departments or in patient care units. And hospital emergency departments are frequent proving grounds for point-of-care technology because of clinician mobility and their inherent need for quick access to detailed information.
Some hospitals now are looking at point-of-care technology on an enterprise scale, after having approached it piecemeal. And while many hospitals are just developing their point-of-care strategies, others are moving forward and implementing them, says Donald Gravlin, vice president and chief technology officer in the health care practice at Capgemini, a New York-based consulting firm.
Extending scope
"Some of the very largest integrated delivery systems we work with have been in pilot mode for point-of-care technology for the better part of a decade," Gravlin says. "Now, with the push for electronic medical records and CPOE, they are migrating from departmental to enterprise point-of-care implementations."
Point-of-care strategy typically is embedded in a hospital's overall information technology strategy, industry observers say.
"Most point-of-care technology strategy is not discrete," says Frank Cavanaugh, a principal at Cardinal Consulting Inc. in Chicago. "Most point-of-care technology is embedded in the application side. Bar-coding is great, but it needs to be an element of medication administration or lab testing."
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