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May 2009

IT at work for a paperless hospital

UPMC is a global leader in adapting information technology (IT) to improve clinical outcomes, enhance patient satisfaction, and reduce the cost of care. Recognizing the need to both improve access to patient medical information and reduce paper consumption, we are now leading the deployment of electronic medical records (EMRs). Digital records not only reduce the costs linked to printing and managing documents, but also improve the way data is collected, filed, distributed, and used.

UPMC’s international eRecord project is bringing electronic health record applications to ISMETT in Italy and to three Newcastle upon Tyne Hospitals in the United Kingdom.  Applications include patient order entry, patient administration, pharmacy management, accident and emergency services, and operating rooms.

Replacing paper medical records with an electronic format allows clinicians to:

  • improve access to medical record information
  • reduce administrative time to manage, copy, and file medical records
  • reduce time required for data entry
  • reduce incidence of human errors and eliminate potential handwriting misinterpretations
  • improve the quality of the information accessed by clinicians
  • improve data confidentiality

EMRs at ISMETT play an important role in the hospital’s information technology system. Computerized provider order entry (CPOE), was implemented in October 2008. It allows providers to insert medical orders directly into the electronic record; it also reduces errors and helps avoid adverse medication events. Today, physicians and staff use the many hospital workstations or laptops to check patient status, lab results, radiology reports, therapies, and the notes of other providers involved in patient care. Nurses insert progress notes using workstations from patient rooms, check prescriptions, and insert data on medications.

The introduction of such a system did not interfere with the hospital’s activity, and all employees reacted positively, recognizing its advantages. A few months after the introduction of EMRs in the hospital, physicians, nurses, and all personnel involved in patient care are confident in using this electronic tool.

This extraordinary result was achieved thanks to the strong support of the medical and nursing staff for this cultural change. Introducing EMRs was seen not just as a new IT project, but as a clinical project supported by IT. The project benefitted from the support of clinical staff from all areas, led by project manager Giovanni Vizzini, MD. The team spent months reviewing patient workflows and ISMETT policies. All information was reviewed, from patient admission to printing EMR copies for patients.

A similar accomplishment from a clinical standpoint went hand in hand with the improvement of ISMETT’s administrative management tools. Once again, ISMETT’s goal was to use information technology as a tool to improve processes and quality of care, and to evaluate internal monitoring procedures.

The major activities implemented by ISMETT last year include the new ERP (enterprise resource planning) system, based on an Oracle e-business software suite, and the upgrade of the Filenet document management system.

A variety of needs led ISMETT to introduce an ERP system that would improve corporate processes and the access tools to:

  • rationalize and streamline workflows
  • reduce the use and circulation of hard copies
  • manage processes online and attach electronic documents to transactions
  • provide rapid and easy access to information, thanks to the native network connection between documents and transactions
  • better monitor costs, effectiveness, and functionality using business intelligence tools to have an integrated and appropriate database

One year from the system’s go-live, the project has achieved extremely good results in all areas and has contributed to improving the effectiveness of corporate processes. At ISMETT, the level of interaction of business, corporate, and information technology processes has grown over time.

The introduction of new digital tools and the continuous support from IT to improve corporate processes has allowed ISMETT to become one of the first international models of a digital and paperless hospital.

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