We recently worked with a hospital in Newport Beach, California, U.S.A. to maximize Allscripts Sunrise capabilities for better outcomes. We formed an Outcomes Board with leaders from both entities representing clinical, financial and operational disciplines. The Outcomes Board sets goals, identifies anticipated returns on investment and develops metrics for performance improvements. We’ve had some exciting results, improving early intervention for patients with Clostridium difficile (C. diff) and reducing risk of infection by converting patients from intravenous (IV) to oral (PO) medications. Faster interventions for patients with C. diff Physicians note that of all the common hospital-acquired infections in California, all of them are improving except for C.diff. Orange County has one of the highest rates of C. diff infections in the state. The Outcomes Board targeted C.diff cases, with a goal of identifying patients sooner to help provide faster intervention, […]

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Kid-sized doses in an adult-sized world

  • Salman Naqvi, MD, MPH
  • 07/21/2015

When prescribing medications, physicians base it on the weight of the patient. Pediatricians are constantly scaling doses to fit their patients, increasing the risk of errors. To ensure patient safety, Phoenix Children’s Hospital (Phoenix, Arizona, U.S.A.) wanted to find an enhanced solution to Dose Range Checking (DRC) to help its clinicians during order entry. Phoenix Children’s Hospital Chief Medical Information Officer, Dr. Vinay Vaidya, M.D., shared more information in a recent Client Outcomes Collaboration Program webinar. The positive results were also published in an article in the Journal of Patient Safety. Phoenix Children’s had three goals for this project. First, given the importance of pediatric patient safety, it wanted to move quickly. Second, it wanted to take a phased approach, addressing high-risk, high-frequency medications first. And third, it was striving for zero prescribing errors. Unfortunately, there weren’t any commercially available, […]

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Using pharmacogenetics for safer drug orders

  • Rick Mansour, M.D.
  • 06/10/2014

The SunriseTM platform is unique because we designed it to be a central nervous system of health care organizations. It constantly gathers, aggregates, evaluates and acts on information for optimal clinical decision support. Our clients are using these capabilities to integrate evidence-based information at the point of care. For example, a team at the U.S. National Institutes of Health Clinical Center (NIH CC) recently developed a program for Sunrise using pharmacogenetics, which evaluates genetic information to predict a patient’s response to medication. The goal was to provide newly available information at the point of care to help clinicians reduce the risk of adverse drug events. The Journal of American Medical Information Association (JAMIA)* featured this patient safety project in a recent article. Starting with safety checks for three drugs The NIH CC team wanted a tool to help clinicians as […]

You can’t have a separate electronic health record (EHR) for every specialty in medicine. On the other hand, if you have a general EHR, it won’t have the “brains” to support specific workflows. Fortunately, we can customize SunriseTM EHRs with Medical Logic Modules (MLMs). 3 of my favorite MLMs MLMs are packages of computer code that are the building blocks of electronic clinical decision support. Their potential to improve patient safety is unlimited. Here are three of my favorites: 1)      Insulin dose adjustment When caring for diabetics in a critical situation, clinicians must have fine control of blood sugar levels. A nurse under pressure has to rapidly gather information, calculate dosage and document the chart. One of our clients developed an MLM algorithm using 100 data points to assist in these situations. Now the nurse simply enters the current blood […]

Does anyone enjoy “paperwork,” even when it’s electronic? I don’t, and neither did the physicians at Springhill Medical Center (Mobile, AL). Last year during a routine review of health information management (HIM) tasks, doctors asked for a simpler way to complete discharge summaries. This documentation recaps events during a patient’s hospital stay and helps coordinate care. Unfortunately, physicians avoided finalizing discharge summaries because it was a time-consuming process. Incomplete charts caused delays in coding and billing. Springhill clinical and IT teams decided to work together to find a better way.   In this video, Springhill Medical Center physicians and IT team members describe how they automated discharge summaries. The key to faster summaries is automation Springhill Medical Center looked to Allscripts Sunrise Acute CareTM to help improve the discharge summary process. The team started by reviewing hundreds of dictated reports […]

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Improving Public Health with EHRs

  • Toby C. Samo, MD, FACP
  • 10/31/2012

Often when we talk about the benefits of Electronic Health Records (EHRs), the focus is on bettering individual patient outcomes. Increasingly, however, stakeholders have been paying increasing attention to the potential benefits EHRs can offer when dealing with public health issues. That’s why Allscripts is taking two important steps to help our clients manage the recent rash of fungal meningitis infections related to tainted steroid injectables. The Center for Disease Control posted a list of facilities known to have received the tainted medications. First, Allscripts is comparing this list against our database of clients.  We will be contacting these clients to provide any assistance they might need to identify the individual patients that received intra-spinal steroid injections since May to determine if they are at risk of infection. This proactive step can offer critical benefit to the affected patients, as fungal […]

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ACE12 Final Day

  • Todd Stein
  • 08/17/2012

The final day of ACE12 dawned a gorgeous day in Chicago – sunny and not too hot. But the crowd has definitely thinned.  We spoke with several Allscripts clients who were eager to head home to their families and look for ways to apply what they’ve learned. Those who stuck around for Friday’s half day of sessions found some of the best had been saved for last.   The Story of “Open” Among them, David Vawdrey, Ph.D. of Columbia University presented one of the most exciting stories in healthcare IT today.  Vawdrey, Assistant Professor of Bioinformatics, is part of a small team of IT geniuses tasked with enhancing the Sunrise and Enterprise EHR deployments for Columbia’s 1,000+ faculty physicians and NewYork-Presbyterian Hospital (his colleague, Dr. Peter Stetson, presented at ACE12 yesterday).  NewYork-Presbyterian Hospital includes Columbia Presbyterian Medical Center, Weill Cornell Medical Center, and […]

Most Electronic Health Record users are forced to wait for the next upgrade to extend their system’s functionality.  At University Hospitals in Cleveland, we’re fortunate to use Sunrise Clinical Manager (SCM), an EHR that gives us a lot more flexibility.  With SCM we’re able to make the changes we want ourselves, by leveraging Medical Logic Modules (MLM) — a kind of artificial intelligence that queries the underlying EHR database and, depending on the if-then logic that you create, triggers advanced clinical decision support. Like the apps that make your smart phone smarter, these packets of artificial intelligence have improved patient care and even made our caregivers happy (no easy task for an IT team). Our team has launched many MLM-powered innovations across the eight UH hospitals that use SCM. But I want to talk about just one: a patient handoff […]