Paperless Hospital

Amy Stayer

Objectives

Describe Paperless Hospital

Describe hardware/software

Assess nursing implications

Examine related legal/ethical issues

Advantages/Disadvantages from nursing perspective

Paperless Hospitals Key Concepts

Minimize the amount of paper

Convert all forms of documentation to digital form

The integration of all disciplines to one system

Patient images & information are readily available

Secured network

Introduction

5% of hospitals are computerizedElectronic prescriptions to be mandated by 2010Cutting the paper loadElectronic health records within 10 years as mandated by President Bush in 2004

(McGonigle and Mastrian, 2009)

Computer based records may include:

EHR {Electronic Health Record}

Prescriptions

Test order & result retrieval

Physician orders & progress notes

Messaging & reporting

Documentation & vital sign recording

Billing & coding

Lab

Radiology

Nursing

Physicians

Medical Records

Coding

Billing

Order Entry

Paperless Model Being Used at the Altoona Regional Health System

Picis ED Pulse CheckPart of the CareSuite® family of high-acuity solutionsThe most comprehensive & well integrated ED information system {EDIS} in the industry.Combines triage, patient tracking, physician and nursing documentation.Combines risk management, charge management, prescription writing and other unique features.

(Picis, nd)

Hardware used in the ARHS Emergency Department

Flat Screen Monitors {10}

Mouse

Two printers {located in the nurses station}

Keyboards

Software used in the ARHS Emergency Department

Company name: Picis

EDIS-Emergency Department information system

Product name: ED PulseCheck

ED PulseCheck is Web browser-based software

Designed by clinicians

(Picis, nd)

ED PulseCheck combines the following:

Patient tracking

Complete online ED record

Real-time documentation for physicians and nursing staff

Precise prescription writing

Comprehensive charge capture

Interoperability with hospital information systems

(Picis, nd)

Benefits of Picis ED PulseCheck

Quick and easy charting {check boxes & drop down menus}Proven 3 to 6 month payback with charge managementImproved patient satisfaction {faster door to doctor times}Increased revenue & reduced costsPromotes patient safetyIncreased efficiency

(Picis, nd)

Physician Order Entry

Nursing Documentation

Reported success with Picis ED PulseCheck at ARHS

Initial return in investment in 6 months

$175,000 savings in coding and dictation costs a year

Doubled captured of charges monthly from $800,000 to $1.6 million

Helps reduce denials for reimbursement

Allows the ED to bill faster

( Picis, nd)

Usability

Minimal Training

Updates periodically

Ease of use

User friendly displays and tracking board

Staff and patient satisfaction

Increased efficiency

Advantages of Paperless Hospitals

24 hour access

Reduces medical errors

Prevents deaths by mistakes

Alerts nurses and doctors to allergies

Eliminates hard to read handwriting

Eliminates transcriptions errors

Advantages of Paperless Hospitals

Instant visit history accessibility

Time efficient {decreased turn around time for test results}

Assists with accurate billing

Improves patient satisfaction

Avoids duplicate ordering

Can be used in inventory replacement

Disadvantages of Paperless Hospitals

Costly to initiate with ongoing costs

Continuous need for upgrades

System failures

Difficult transition as well as resistance to change

Still generates paper

HIPPA violations

Siemens Information System

Synonymous with technological innovation and global business.They have a wide array of products and services.Their products help their customers in industry, energy and healthcare.They strive to help businesses meet their challenges and stay competitive.

(Siemens, n.d.)

Siemens Healthcare

Siemens medical solutions

Siemens medical solutions health services

Siemens diagnostics

Siemens hearing instruments

(Siemens, n.d.)

Siemens at Altoona Regional Health System

Invision Patient Care Solutions:Online capture of assessmentsInvision patient care solutions help to streamline clinical workflow and enhance overall productivity.Enable improved interdisciplinary and interdepartmental communications.Support consistent communication of patient information.

(Siemens, n.d.)

Siemens

Invision Financials:A cost effective billing and receivables management solution.Access to patient accounting information through a web enabled browser.Helps streamline your patient accounting processes.Invision financials is complemented by and integrated with other Siemens Patient Financial Service Solution.

(Siemens, n.d.)

Siemens

Invision Clinicals:Supports the flow of patient information and resources throughout the healthcare continuum. Invision facilitates the support of an Electronic Health Record.Standardizes collection and structure of clinical information.

(Siemens, n.d.)

Ethical/Legal Issues

Computer hackers

Potential for HIPPA violations-onscreen patient tracking board

Access only to employees & departments with need

System sign on- fingerprint or password sign on

Functions & Responsibilities of the Professional Nurse

Minimize onscreen patient tracking board to protect patient privacy

HIPPA rights and responsibilities- maintain patient confidentiality

Keep passwords safe and to self

Log off when walking away from computer

Competency Requirements of the Professional Nurse

On the job training

Attend updates and training seminars

CEU’s

Summary

A paperless system improves patient and employee satisfaction while reducing errors and preventing deaths. The Picis system used at the ARHS emergency department has proven to save money and monthly captured charges have doubled.

Summary

The PICIS system at the ARHS is user friendly and requires only minimal training. It has an easy to read patient tracking board and the staff has 24 hour access.

References

McGonigle, D. & Mastrian, K. (2009). Nursing informatics and the foundation of knowledge. Boston: Jones & Bartlett Publishers.

Picis (n.d.) ED Pulse Check. Retrieved November 4, 2008, from http://www.picis.com/products/emergency-department/ED-pulsecheck/default.cfm

References

Picis (n.d.) Success Stories. Retrieved November 4, 2008, from http://www.picis.com/success/-stories/default.cfm

Picis (n.d.) Take the crisis out of emergency management. Retrieved November 4, 2008, from http://www.picis.com/solutions/hospital-executives/ED/default.cfm

References

Siemens (n.d.) Invision clinicals. Retrieved December 11, 2008, from http://www.medical.siemens.com/webapp/wcs/stores/servlet/ProductDisplay?storeId=100