MU Health Care prepares to computerize prescriptions

Tuesday, November 9, 2010 | 7:14 p.m. CST; updated 7:21 a.m. CST, Wednesday, November 10, 2010

COLUMBIA — University Hospital is enlisting a team of 300 to handle the biggest change in its conversion to electronic record keeping.

On Nov. 30, doctors will begin using computers to manage all inpatient prescriptions. Instead of using traditional notepads, doctors will type medication, dosage and special instructions into a real-time database.

A message will automatically alert the pharmacy, nurses and other appropriate services down the line to complete the process.

The system also will cross-check a patient’s records for allergy information and send red flags to the prescribing physician if a medication could be dangerous.

This switch will help prevent medication errors by eliminating the need to translate a doctor's handwriting, said MU Health Care’s chief medical officer Les Hall.

“It completely removes the handwriting issue from the table,” he said. “The most important reason we’re doing this is to improve the quality and safety of patient care.”

According to a study by the Journal of the American Medical Association, about one-third of serious medication errors occur during these transcription and dispensing stages.

The hospital has been working with health software company Cerner for about 12 years on building an all-electronic system of medical records. Recently, the hospital introduced software that allows nurses to track the medications they administer.

Hospital officials have been “vigorously planning” for the go-live date for computerizing prescriptions since June 2009, and have put thousands of hours into preparation.

To ensure the program runs smoothly, 200 health care providers and unit clerks at the hospital have been designated “superusers” and will join 100 Cerner employees to help supervise the first 10 days.

The team will help iron out kinks other hospitals have experienced when adopting the new system, Hall said. The complexity of the process has been blamed for causing slow-downs during the initial stages.

“This is a huge project,” he said. “It generally represents the single largest IT project that any health system implements. It is certainly that way for us.”

Some employees are concerned that the initial stages will be a challenge.

Hospital lab technician Christopher Elliott said though the new system will likely save time and money in the long run, he was concerned about the first few days.

“Right now, we’re really good at interpreting what doctors mean when they order lab tests,” Elliott said. “In the beginning, there will be a lot of extra tests ordered. It’s going to get bad before it gets better.”

Hospitals across the country have been scrambling to get computerized records in place after federal legislation was passed in 2009 with financial incentives for those that comply with progressive standards.

They must meet certain benchmarks in their adoption of electronic medical records to qualify for federal Medicare reimbursements.

Hospitals also face financial penalties if they do not comply by the end of 2014.

“The end goal is meaningful use,” Cerner spokeswoman Kelli Christman said.

In the future, networks will be able to connect not only within the walls of the hospital but into the community and eventually nationally, regardless of the software. Such meaningful use is the eventual intent of these incentives.

But government reimbursement issues are not the driving factor behind adoption of the system, Hall said.

“My impression is that the cost of doing this will exceed the stimulus funding,” he said.

MU Health Care spends about $5 million to $6 million annually on electronic medical records, media coordinator Matt Splett said. For fiscal year 2010, it spent approximately $8 million, and computerized prescriptions are included in that total.

Splett said the impact of the incentives cannot yet be quantified.

“It’s too soon to tell,” he said. “But we are hopeful that they will cover some of the costs.”

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