Medication Safety Technology

The original planning group for improving medication practices identified a need for two new technologies that would reduce medication errors through improved communication, decision support, and documentation.
Electronic Medication Administration Record (eMAR) & Bar Coding
Electronic Provider Order Management (ePOM)

The planning group defined design specifications for each technology that included:
Ability to intercept errors
Integration with existing information systems
Ability to integrate with a variety of workflow patterns
Ease of use
Speed

Information Technology and Services at HCA worked with MEDITECH to develop software and implementation processes to meet these design specifications in the CPCS software. Input from pilot sites, user review groups, and patient committees was gathered at each step of the design process. Over 200 physicians have reviewed the electronic provider ordering software so far!

eMAR and Bar Coding
The Electronic Medication Administration Record (eMAR) and Bar Coding technology provides instant warnings to the nurse when one of the "five rights" of medication administration is violated.

Electronic Provider Order Management (ePOM)

• Medical Center of Plano in Plano, TX went live on Order Management (OM)and nearly 90% of orders were placed through the system on go-live day. Several physicians continue to use ePOM to enter orders as of August 10, 2005. The Dallas market is reviewing performance enhancements as ePOM rollout is planned to continue into October 2005.
• Frankfort Regional Medical Center in Frankfort, KY went live with nurses on Order Management (OM) on August 2, 2005 and all inpatient units are live. FRMC physician ordering began in late August 2005 and the hospital has 5 physicians live using the ePOM software.
• Rose Medical Center in Denver, CO started using Order Management (OM) July 25, 2005 in all inpatient units. Pediatric Group began using ePOM in September, 2005
• Clear Lake Regional Medical Center in Houston, TX has all nurses live on Order Management (OM) as of June 20, 2005. By August 15, 2005 all hospitalists began using ePOM and have reached over 15% of all physician orders coming through the system. Progress continues as the facility improves the speed of system performance.
• St. Lucie Medical Center in St. Lucie, FL went live with Emergency Department Management (EDM) for ED tracking and nursing documentation on January 27, 2004. Nurses began using Order Management (OM) on June 13, 2005, and physicians began using ePOM on August 8, 2005. ED physicians began placing over 90% of patient care orders through ePOM the first day of go live with over 500 orders being entered. From Auust 23rd to September 2st, there were a total of 18,791 ePOM orders entered, of which 16,971 (90.3%) were entered by physicians. SLMC plans to continue working with their ED physicians to customize the software to each physician's practice through additional favorite orders, medications, and order sets.
• The San Antonio Market in Texas began using Order Management (OM) on June 13, 2005 at Northeast Methodist Hospital and Metropolitan Methodist Hospital followed one month later with both facilities live in all inpatient nursing units. The 2 remaining sister hospitals are currently implementing OM and plan to be completed by year end 2005. The facilities are taking a market-wide approach for ePOM.
• North Austin Medical Center in Austin, TX started using Order Management (OM) in 3 pilot units on May 31, 2005 and implemented it one week later to the entire inpatient nursing staff. Additional staff will follow.
• Lewis-Gale Medical Center in Roanoke, VA in Roanoke, VA began using Order Management(OM)on May 31,2005 with the entire inpatient nursing staff. LGMC now has 6 physicians live with ePOM and are in the process of adding an addtional 14 physicians as they work aggressively to reach 50% of orders being entered by physicians.
• Eastern Idaho Regional Medical Center in Idaho Falls, Idaho began using Order Management(OM)on May 24, 2005 with the entire inpatient nursing staff. EIRMC now has 2 physicians live with ePOM and is in the process of adding more.
• Oklahoma University Medical Center in Oklahoma City, OK has been using Order Management (OM) in  the Endocrinology outpatient clinic since April, 2005. On August 15, 2005, ePOM went live in the inpatient Cardiac Care Unit. OUMC is the first HCA hospital to use the ePOM software with neonatal and pediatric patients. Almost 100% of Pediatric Surgery Services orders are entered through ePOM.
• Spalding Rehabilitation Hospital in Denver, CO began using ePOM on April 18, 2005 throughout the facility. Today, well over 50% of orders are entered by physicians or physicians assistants using ePOM.
• Chippenham/Johnston-Willis Medical Center in Richmond, Virginia went live on alpha phase I in 1Q 2003 and on alpha phase II in April, 2004. The software is currently deployed throughout the Chippenham campus with multiple physician, nurse, and unit clerk users.