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Monday, 03 May 2010 23:44

Electronic doctoring saves lives


A first-of-its-kind study in the United States has shown that death rates in a hospital dropped significantly when a computerized physician order entry system was installed and efficiently used.


U.S. researchers at the Stanford University School of Medicine (in Stanford, California) and the Lucile Packard Children's Hospital (at Palo Alto, California) analyzed a new electronic medical system that was begun in 2007 at Lucile Packard Children's Hospital.

The medical researchers reviewed nearly 100,000 patient discharge records at Packard Children's between January 1, 2001, and April 30, 2009.

They compared these records with records from 42 similar not-for-profit pediatric hospitals.

They found that over these eighteen months the computerized physician order entry (CPOE) system implemented by Packard Children's Hospital resulted in 2 fewer deaths per 1,000 discharges (36 fewer deaths in 18 months) than in the other comparable hospitals.

The researchers stated that this statistic decreased the mortality rates at the hospital by 20%.

Dr. Christopher Longhurst, who is the lead researcher for the study, stated, "We've seen a 20 percent improvement in the time from order to administration for 'stat' [immediate] medications. This can have lifesaving consequences." [May 3, 2010 EurekAlert article 'Study shows for first time decrease in mortality associated with physician order entry system']

However, this percentage, the researchers admitted, may have also been affected by other projects in use at the hospital to make patient care safer and more efficient.

Page two continues.




Their study will be summarized in an article within the May 3, 2010 online edition of the journal Pediatrics.

The CPOE system allows the medical personnel at the hospital to prescribe medications, medical tests, and other related techniques through an electronically based procedure.

The system allows instructions to be seen instantaneously throughout the facility and at remote sites.

The EurekAlert article describes the ease at which the system works: 'All physicians need to do is boot up a computer, punch in a password and the heartbeat of a child in the neonatal intensive care unit will trace across the screen, or a brain scan can be viewed.'

Dr. Christopher Longhurst, the medical director at Packard Children's and an assistant clinical professor of pediatrics at Stanford University, states, "Prior to our report, no hospital or medical institution has shown that CPOE can be implemented and actually have an associated decline in mortality.' [EurekAlert]

Dr. Longhurst adds, 'But what we found is that CPOE implementation was statistically correlated with fewer patient deaths. As you can imagine, this is very meaningful." [EurekAlert]


And, "Our implementation of CPOE was executed superbly, but in addition, we were simultaneously making other advances in patient care. These included process and workflow changes, adjustments in ICU staffing, the rollout of Rapid Response Teams, the implementation of a nursing residency and more, all in the face of rising acuity in the hospital." [EurekAlert]

Page three concludes.


The EurekAlert article concludes with the following: 'Still, it's important to remember that CPOE, and electronic medical records in general, are simply technology tools that support or "hard-wire" best practices into the work environment.'



It takes technology and people working together to make systems function properly.

Paul Sharek, the medical director of quality management and the chief clinical patient safety officer at Packard Children's, comments, "Simply purchasing a fancy and expensive electronic medical records system in and of itself is not likely to make much of a positive impact on quality or patient safety.' [EurekAlert]

Dr. Sharek, also an author of the study, adds, 'What provides the real opportunities for improving care is using this technology to support best practice, such as displaying relevant blood test results at the time physicians are ordering medications, or allowing practice guidelines to be immediately available to physicians at the time of order entry." [EurekAlert]

And, Longhurst concludes: "We believe our experience is proof that CPOE is here to stay. However, to be successful, it takes an unwavering commitment to implementation. Our staff was very supportive, seeing it as a critical part of a hospital-wide commitment to continuous improvement in patient care. This approach gave us a better chance to determine if CPOE really has an impact in a hospital setting."



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