Information systems improve hospital emergency departments

Attending a 2002 Las Vegas trade show, Kavit was impressed with the simplicity and intuitive interface of ED PulseCheck from vendor Picis, and he convinced hospital administrators to invest in the software. Over the next two years, Riverside gradually rolled out the Picis system in its 42-bed, 45,000-square-foot emergency department. It features customizable templates for clinical charting and a revenue management component to ensure accurate and compliant charge capture during clinical documentation.

Riverside has worked on interfaces to improve data sharing between the ED and lab, radiology and other information systems, including the Siemens Soarian clinical information system. It claims to have achieved a 40-minute decrease in average patient turnaround time and a significant reduction in incomplete patient charts.

Moving toward totally electronic charting has decreased labor costs, says Renee Roundtree, VP for trauma and emergency services, who adds, "We used to have information go back and forth from paper to electronic and back to paper five times. We have eliminated most of that inefficiency."

Lost and incomplete charts used to cost a great deal of time, effort and money to find and complete. "We eliminated four to five clerical positions just pulling charts," she says. "And there is a satisfaction issue for physicians. They are no longer hunting for charts or being called at home and asked to come in to fill in an incomplete chart." Because the system is Web-based, if physicians do need to fill in something, they can do it from home.

Kavit adds that the Picis system allows ED physicians to deal with patient complaints much more rapidly. "Previously to look up a record about a complaint on paper might have taken two days. Now I can look at the record in three minutes and get back to them right away," he says.

Progress at Einstein

By deploying a best-of-breed product, Dr. Albert Villarin Jr. says his hospital ED is making important patient safety and efficiency gains.

Villarin, chief medical informatics officer for the Albert Einstein Healthcare Network in Philadelphia, says he began looking at automation in 2003 when Albert Einstein Medical Center’s level 1 trauma center was planning a $10 million expansion.

"We realized that in the larger department, we would need a heads-up display to see where everyone is," he says.

Using the Amelior EDTracker platform from Patient Care Technology Systems, staff members now have Web portal access to patient health information that used to be in paper charts. The system also monitors the location of patients and staff members through the use of ultrasonic badges clipped to their collars.

Villarin says the system allows staff members to match patients to available providers and address bottlenecks that may delay treatment.

"We have cut throughput time by 40 percent," he stresses. For instance, the department used to waste time waiting on calls from hospital admissions.

"With the EDTracker interface, that is all automated and we don’t have to spend that time on the phone," Villarin says. "We found that patients spent 30 percent of the time in the ED waiting for something to happen. We focused on decreasing those wait times."

Because the tracking software maintains a time-stamped record of patient flow data, the ED can generate reports on patient flow and bottlenecks that provide feedback for ongoing quality improvement.

"Now we are applying what we learned in ED to the rest of the hospital system," Villarin says. "In the operating room, they see what we can do with tracking. The word is out. We in emergency are the leaders of this movement."