Mission: Critical - InformationWeek
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Mission: Critical

Imagine 30% fewer deaths in intensive-care units and half the medication errors in hospitals. IT is poised to deliver improved patient care.

The Sutter hospitals also are among several hundred in the country deploying computerized, bar-coded drug systems that let nurses scan drugs at patients' bedsides, receiving alerts if they're giving the wrong medication.

At Erlanger Medical Center, a 22-building complex in Chattanooga, Tenn., wireless technologies help nurses eliminate hours of paperwork and miles of running around, freeing them to provide more hands-on care.

Electronic intensive-care units let one doctor and one nurse monitor dozens of cases remotely at the same time.
At Memorial Health University Medical Center in Savannah, Ga., a Web portal and computer order-entry system give doctors access to real-time patient information, lab results, X-rays, and other materials, so physicians can make better decisions, either remotely or at the patient's bedside.

Add to this a broad, though slow, movement toward digital medical records and electronic information-sharing among doctors, nurses, and hospitals, and the potential exists to give health-care workers more accurate and timely information that will let them deliver better care. "In five or 10 years, patients will be amazed when they enter a hospital and don't see bar-coded drug systems, electronic medical records, and technologies like that," Sutter CIO John Hummel predicts. "Those that don't have the technology will be at a great competitive disadvantage--on the business side and especially in patient safety."

In addition to saving lives, there's a growing money motive for health-care providers to buy IT systems that improve patient care. Malpractice insurance premiums are skyrocketing, so technologies that reduce the chance for medical errors are attractive. There's also a shortage of people with many health-care skills, including intensive-care physicians and registered nurses.

Plus, hospitals are just beginning to be judged--and paid--based on quality. Influential organizations such as the Leapfrog Group, a nonprofit company founded by businesses and other big health-care buyers to improve quality, rate hospitals on whether they employ certain practices to reduce errors and improve care, including computerized drug systems. For example, Leapfrog advocates that a hospital always have a doctor specializing in urgent care in the intensive-care unit. But many hospitals can't afford that or can't find the people, since there's a national shortage. Leapfrog has blessed the eICU units at Sutter and Sentara. "What's lacking in the on-site presence of an intensivist in the unit is made up with the smart software," Leapfrog executive director Suzanne Delbanco says. "It's fine-tuning of information that's not even available at the actual bedside."


Sutter Health could provide remote intensive-care services to non-Sutter hospitals in rural areas that have difficulty recruiting physicians, CIO Hummel says.
Insurance companies also hold hospitals more accountable. Some insurance networks provide payment incentives to health-care providers that rate higher on quality standards. Cigna HealthCare gives members detailed online reports on mortality and complication rates for more than 50 diagnoses and surgeries.

But money is also the reason many companies haven't yet invested in promising technologies. Erlanger Medical Center, for example, expects to lose at least $9 million this year. It's a leap of faith that the $1.5 million it's spending on wireless connectivity will improve the nursing staff's productivity and performance enough to justify the expense.

Some barriers are beginning to fall. In March, the U.S. Food and Drug Administration proposed a rule to require bar codes on all individual doses of over-the-counter or prescription drugs, vaccines, blood products, or intravenous medications dispensed in hospitals or other care settings. The rule, which is expected to be finalized this year, would require a bar code that includes the drug's National Drug Code number, a unique identification of the drug, its strength, and its dosage form.

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