Patient Safety Measures Set Saint John's on Top
Saint John's has joined an elite group of hospitals nationwide in the development and implementation of a Computerized Physician Order Entry (CPOE) system, an information technology solution that improves the efficiency, effectiveness, and safety of patient care. In the United States, there are only a few hospitals that have made the progress Saint John's has in designing processes, building order pathways and successfully using CPOE.

The CPOE system aids physicians and ancillary staff on several levels. CPOE at Saint John's eliminates the potential for errors that could be caused by misinterpretation of handwriting or re-entry of information, and it speeds the process for ordering tests, treatments and therapies. The system alerts physicians of drug interactions and suggests alternate drugs that may be used, checks dosage, and patient allergies. Remote access from off-site locations is available to physicians using a secure connection to the hospital network. Physicians have instantaneous access by computer to information on a patient as far back as four years, including all lab and radiology tests.

Siemens Medical Solutions, of Malvern, PA and Erlangen, Germany, one of the largest suppliers of medical technologies in the world, serves as Saint John's information technology partner on the project.

"The electronic health record and the related successful implementation of CPOE systems has been the goal of medical professionals for years," said Thomas Miller, president, Siemens Medical Solutions, IT division. "And while much evidence exists that electronic information systems can sharply reduce errors, improve clinical workflow and save lives, most of our nation's hospitals and doctors remain woefully behind the technology curve. Saint John's, however, represents a shining example of what is possible through a successful technology deployment -- increased physician satisfaction and adoption rates, leading to better outcomes in terms of cost and quality of care."

Saint John's deployment of the CPOE system began in the summer of 2003 a result of more than a year's work by a collaboration of physicians and an implementation team consisting of hospital staff and Siemens personnel. The pilot group of physicians consisted of Jeffrey Blake, M.D., Sunil Juthani, M.D., David Mares M.D, Jeffrey Mathison, M.D, Donald Reed, M.D., and Kahlil Wakim, M.D. Since the implementation, already 25% of physician orders are being placed through the CPOE system. Physicians are continually added to the process at the rate of 10 every 8 weeks, and should be at 80% of total orders entered by the end of 2004.

"Saint John's Health Systems' success with CPOE is a direct result of partnerships," said Roger Strange, Chief Information Officer at Saint John's. "Our partnership with our physicians provided leadership in system design and clinical excellence. Our partnership with Siemens provided cost effective technologies and responsive support."

Siemens has been very impressed with Saint John's progress and plans to make Saint John's a "National Showcase site" for this state-of-the-art system. As such, Siemens will be bringing clients from throughout the country to Saint John's for system demonstrations.

"We find that our customers learn best from the success of other customers," adds Miller, "which is why our National Showcase program is a vital part of the true collaborative partnerships we share with our customers. It's important for all healthcare organizations to see how a given technology is being used successfully in a real healthcare environment, as opposed to being simulated in a demonstration environment."

Because of the CPOE system, Saint John's is in the 99th percentile of performance nationwide in this important Leapfrog patient safety and quality initiative. The Leapfrog Group, founded in 2000, is a growing consortium of over 130 Fortune 500 companies and other large private and public healthcare purchasers that are establishing standards for patient safety and quality. They will be rewarding hospitals for advances in meeting these standards and educating employees, retirees, and families about the importance of hospitals' efforts in this area. Leapfrog purchasers provide health benefits to more than 34 million Americans in all 50 states and spend billions on healthcare annually.

The Leapfrog Group has identified initial patient safety practices (Leaps), one being the Computer Physician Order Entry system, as the focus for hospital recognition and reward. The goal is to establish practices that will help eliminate medical errors. Leapfrog requires that 75% of all medication orders be computerized by the end of 2004.

Patient Safety is a priority at Saint John's. Computerized Physicians Order Entry is one of many examples of initiatives we have undertaken to ensure that patient care at Saint John's is safe, effective and high quality. Improving patient safety measures is an ongoing process at Saint John's that includes the implementation of an automated drug dosage system on the patient floors and the development of a patient barcode system, Siemens Med Administration Check, to reduce patient care errors.

"CPOE provides an environment to initiate breakthrough performance in patient safety, timely care delivery and quality, one place for physicians, nursing, and ancillary departments to access clinical information and a common consistent information tool for communications," said Strange.

"CPOE is such a remarkable system because it was developed by Saint John's Information Resources and doctors working side by side for over a year! It has completely revolutionized the way I care for hospitalized patients," said Dr. Mathison. "It gives me the ability to access patient data and act on them from virtually anywhere at any time."