Transcript paperless hospitals

KAREN ZIKOSKY
LAURIE NARDOZZI
OBJECTIVES
Describe paperless hospitals
Describe and evaluate the hardware and
software utilized in Paperless Hospitals
Describe and evaluate the information
systems used in Paperless Hospitals
OBJECTIVES
Assess the role and function of the
nurse of paperless hospitals
List the advantage/disadvantages of
paperless hospitals
Examine legal/ethical issues
INTRODUCTION
Paperless hospitals are the wave of the
future. The key concept is to minimize
the amount of paper and convert all
forms of documentation to digital form. It
will be the integration of all disciplines to
one system. Patient images and
information are readily available from
parts of the hospital and thru a secured
network.
INTRODUCTION
Paperitis is becoming an epidemic
(Omtool 2007)
5% of hospitals are computerized
Electronic prescriptions to be mandated
by 2010 (Schlesinger 2003)
INTRODUCTION
Incentive programs for successful
electronic prescribers (AHA 2008)
Medicare payments increase for
paperless physicians (MSNBC 2008)
Computer based records may include:
EHR (Electronic Health Record)
Prescriptions
Test order & result retrieval
Physician orders & progress notes
Messaging & reporting
Documentation & VS
Billing & Scheduling
HARDWARE USED IN
PAPERLESS HOSPITALS
Webcams
Monitors
Mouse
Wireless networks
Bluetooth
WEBCAMS
Video cameras
Images can be accessed through
WWW, instant messaging or video
conferencing.
Images upload to a web server,
continuously or timed intervals.
Wikipedia (2008)
WEBCAMS
Monitors traffic, weather, volcanic
activity
Tracks weather
Educators use for virtual classes
Interpretation service (Gately 2008)
WEBCAMS
Rooms at Sloan Kettering ICU are
equipped with web cameras that allow
staff to monitor patients from locations
outside the ICU, and physicians now
enter orders on a computer system that
produces an electronic medication
administration record that calculates
dosages and sends reminders to the
nurse when medications are due, or are
late.
(Dunbar, 2008)
Sloan Kettering ICU
SOFTWARE IN PAPERLESS
HOSPITALS
Microsoft Office, Excel
Spreadsheets
Visualization & Imaging software
Anti-virus software
Billing software
Scheduling software
SOFTWARE
Adobe reader
Health & wellness
Discharge planning
Bed management
Patient tracking
Medicare coding
STATCOM SOFTWARE
Facilitates workflow and escalates task completion
Provides staff with real-time logistical information
Focus remains on patient care
Acquires data from:
hospital information systems
phones and wireless devices
touch-screen input panels
voice over IP badges
barcodes
RFID scanners
(StatCom 2008)
STATCOM
Emergency Department
Bed Management
Patient-Stay Management
Discharge Planning
Hospital Support Services
Business Activity Monitoring
Perioperative Services
(StatCom 2008)
USABILITY EVALUATION
Training minimal
Implementation months not years
User friendly displays
Cost effective
Information easily entered through touch pads
(Staggers 2003)
USABILITY EVALUATION
Proven to increase patient & staff satisfaction
Automatic time-stamp for patient safety &
security
Real-time communication
No written documentation on HIPPA
(Staggers 2003)
3M HEALTH
INFORMATION SYSTEMS
Used by all healthcare professionals
Functions:
Health information management
Documentation Creation
Documentation management & imaging
Case management
Revenue cycle management
Performance improvement
Health information exchange
(3M 2008)
3M
Workstation configuration
Healthlevel 7 data standard
ICD-10
LOINC and SNOMED CT
3M
From the research that has been done, this system
would be recommended because it has been around
since 1983. 3M has over 55,000 products ranging from
post-it notes, bandages, stethoscopes, to computer
technology. Their products and ideas are simple to use,
enhance and improve lives.
(3M 2008)
ADVANTAGES OF
PAPERLESS HOSPITALS
Reduces medical errors
Prevents deaths by mistakes
Alerts nurses to allergies
Eliminates hard to read handwriting
Eliminates transcription errors
24 hour access
MEDICATION ERRORS
ADMINISTRATION,
26%
ORDERING, 49%
DISPENSING, 14%
TRANSCRIPTION,
11%
ADVANTAGES OF
PAPERLESS HOSPITALS
Avoids duplicate ordering
Time efficient
Accurate billing
Automatic inventory replacement
Patient satisfaction improvement
Prior treatment instantly available
DISADVANTAGES OF
PAPERLESS HOSPITALS
Initial cost $500,000-$1,500,000
Ongoing costs
Continuous need for upgrades
Reduced hospital revenue
Difficult transition
DISADVANTAGES OF
PAPERLESS HOSPITALS
System failures
Resistance to change
Violation of HIPPA
Still generates paper
(McCracken 2008)
ETHICAL/LEGAL ISSUES
Access only to employees with need
Time and signature stamped
Biometric devices
Voice recognition
Retinal patterns
Fingerprints
Computer hackers
Legal rights
INFORMATICS COMPETENCIES OF
THE PROFESSIONAL NURSE
E-learning based competencies
CEU’s
On job training
MAGNET Recognition
FUNCTIONS AND RESPONSIBILITES
OF THE PROFESSIONAL NURSE
Restrict to relevant information
Keep passwords safe and to self
Patient confidentiality
FUNCTIONS OF THE INFORMATICS NURSE
IN THE PAPERLESS HOSPITAL
SELECTS AND EVALUATES SOFTWARE
TROUBLESHOOTS
SELECTS NURSING TERMINOLOGY
TRAINS
YEARLY COMPETENCIES
SUMMARY
The paperless system improves patient
care and saves billions of dollars, yet
less than 20% of hospitals have gone
paperless. The ultimate goal is a
nationwide network. Benefits could
reduce medical errors, redundant tests,
and shorten length of stays. Advanced
computerized records can signal
dangerous drug combinations and
potentially save a life.
SUMMARY
Files will be stored electronically, reducing
the storage space needed. Paperless
hospitals goals are for all health care
workers to have access to all patient
records from anywhere in the hospital.
Physicians also may have access to
records away from the hospital setting.
President Bush has set a goal for all
hospitals to be paperless by 2014.
REFERENCES
OmtoolLTD. (2007). YouTube. The cure for paperitis-Creating
the paperless hospital. Retrieved September 05, 2008, from
youtube video Web site:
www.youtbe.com/watch?v=5fje4pehkt8
Schlesinger, A. (2003). Paperless hospitals' popularity grows.
Retrieved September 05,2008, from CBS News Web site:
http://www.cbsnews.com/stories/2003/01/13/tech/main53626
7.shtml
Conway, M. (2004). MSNBC. Retrieved September
06,2008, from Health officials back paperless
prescriptions Web site:
http://www.msnbc.msn.com/id/25787848/
REFERENCES
King, J. (2005). AHA News. Retrieved September 05, 2008, from The Paperless
Hospital -- Really! Web site:
http://www.computerworld.com/industrytopics/healthcare/story/0,10801,102387,
00.html
McGonigle, D, & Mastrian, K. (2008). Nursing Informatics and the Foundation of
Knowledge. Sudbury, MA: Jones and Bartlett Publishers.
Gately,(2008) iHealthBeat. Retrieved September 16, 2008, from Arizona hospitals
use webcams to overcome language barriers Website:
http://www.ihealthbeat.org/articles/2008/9/15/Arizona-Hospitals-Use-WebcamsTo-Overcome-Language-Barriers.aspx?topicID=89
REFERENCES
SNOMED. (2008). In
Wikipedia Free Encyclopedia
[Web]. Retrieved October 2, 2008, from
www.wikipedia.com
3M.(2008). Retrieved October 4, 2008, from The spirit of
innovation. Web site: http://solutions.3m.com/en_US
McCracken, T. (2008). Retrieved September 19, 2008,
from Cartoons by T.McCracken. Web site:
http://www.pioneer.net/~mchumor/
REFERENCES
StatCom. (2008).Retrieved September 10, 2008, from Patient flow logistics
& tracking software Web site:
http://www.statcom.com/healthcare-technology/hospital-software.aspx
ANCC., (2008). MAGNET program overview. Retrieved October 09, 2008,
from American Nurses Credentialing Center Web site:
http://www.nursecredentialing.org/Magnet/ProgramOverview.aspx
Associated Press. (2005, September 14). Promises, challenges of digital
medical records. Retrieved October 10, 2008, from MSNBC Web site:
http://www.msnbc.msn.com/id/9336861
Staggers, N. ( 2003). Human factors: Imperative concepts for critical care.
AACN Clinical Issues14 (3), 310-319.