eMAR

.....only clinician involvement can orchestrates the process by which clinicians are “integrated” in the process of delivery of quality-centered care. An obstructionist clinician team can derail an otherwise successful HIT adoption project and/or your EHR application implementation.

Winchester Medical Center, a 411-bed community hospital in Winchester, Va., part of the six-hospital Valley Health system in Virginia, West Virginia, and Maryland, has been taking an innovative approach to inpatient education. The hospital has been using patient engagement software from the Bethesda, Md.-based GetWellNetwork since 2003. Currently, the hospital has 360 beds live with the service and has implemented some key applications including a falls pathway, pain management pathway, and service recovery pathway. Beginning in 2008 the results from the patient engagement software fed back into the hospital’s electronic medical record (EMR) from the San Francisco, Calif.-based McKesson, and a GetWellNetwork tab was added in the EMR so clinicians could verify that patients watched certain education videos and record patient pain assessments.

A report recently released by the Framingham, Mass.-based advisory services and market research firm IDC Health Insights has projected spending on both ambulatory and inpatient EMR software to nearly double between 2009 and 2015, driven forward strongly and primarily by the stimulus monies to be made available through the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health Act (ARRA-HITECH).

The folks at Children's Hospital of Pittsburgh don't just parrot the party line about using actionable data to optimize patient care; they live the creed. Not only do executives - including Vice President and CIO Jacqueline Dailey - regularly participate in executive patient-safety rounds across the hospital's units, but years after implementing core EMR and CPOE systems, they're using data from Children's itself, as well as from the national clinical literature, to modify care processes and establish clinical guidelines.

Electronic medical records, meaningful use, interoperability — these common terms have been at the forefront of our discourse since the passage of the ARRA recovery act. Many of us, however, have been working on initiatives and struggling with these concepts for years. In our case at Newton-Wellesley, business drivers from our integrated delivery system and associated partnerships have already given us a test run on some of the challenges created by the stimulus incentives. What follows are our examples of underlying disruptive forces and tips we learned for mitigating them.