excerpted from the November 13, 2006 issue
of:
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First
Eclipsys Pharmacy Site: an Early Report from Children’s Posted with permission of the publisher Pediatric hospitals don’t usually offer to be guinea pigs
for new information solutions, especially when they involve tricky functions
like medication dosing and dispensing. Likewise, vendors have found that the
unique software tweaks required for pediatric care make children’s
hospitals less-than-ideal candidates for an inaugural roll-out. Nevertheless, Children’s Hospital, a 142-bed regional
facility in “It’s very unusual for a pediatric hospital to
go live with out-of-the-gate software like this,” says Lisa Kwapniowski, PharmD, the
hospital’s pharmacy systems manager. “Usually you just hang back
for awhile and see how it works in other hospitals. For a peds
hospital to be the first, it had better be good.” Looking for a solution Children’s
began their pharmacy system search more than a year ago. The hospital runs
Eclipsys Sunrise Clinical Manager CPOE and wanted to extend it to a closed loop medication
system, but the company didn’t have a pharmacy solution at that time. During
the search, Eclipsys expressed interest in partnering with the hospital to
implement their soonto-be-released Sunrise
Pharmacy. According to Kwapniowski and Allana Cummings, Children’s Hospital’s CIO,
the hospital responded with requirements that included flexibility, plenty of safety
features, and a promise of active involvement by the vendor during and after
implementation. Most importantly, the system had to handle the unique demands
of a pediatric care facility. “Our
number one priority was to make sure we could handle pediatric patients
effectively with a new system,” Kwapniowski
says. “Before we really embarked on the search, I really wanted to make
sure the vendor knew there was no room to falter.” Eclipsys
understood the IT staff had a short timeframe in mind and acted accordingly,
Cummings says, proposing a 12-month implementation. “It was February
before our staff was actually training on the software,” she says.
“That’s a very collapsed schedule and it
was quite intensive, but it worked for us.” Safety
features Sunrise
Pharmacy came equipped with standard safety features such as allergy checks,
dose checking, and interaction warnings. It also displays CPOE alerts so that
pharmacists can double-check the information presented to the physician. Tall
man lettering, a drug labeling technique that reduces medication errors for
drugs with similar names, is a welcome new feature, says Cummings. The
system can handle children’s dosing, says Robin Stec,
the hospital’s clinical pharmacy coordinator. “For the most part,
it has been pretty seamless, and the best part is that we are able to
calculate very, very small dosages. I’m happy about that. A lot of
hospitals use automated dosing, but we usually can’t because the
patients are small children.” Although
Children’s hasn’t been using the new system long enough to
measure any decrease in adverse events, Kwapniowski
says Eclipsys has been responsive. “The fact that they allowed a
pediatric hospital to be the first hospital to go live speaks volumes about
how serious Eclipsys is about this product and how willing they are to meet
safety standards,” she says. Duplicate
data entry avoided One
of the most significant changes in workflow is that pharmacists no longer
have to enter information multiple times. Previously, physicians entered
orders into the Eclipsys CPOE system and they were then re-entered by
pharmacy into the pharmacy system, a process Stec says
wasted time and increased mistakes. The
software required some changes involving continuous infusions and PRN
medications. Both issues were corrected quickly. One unexpected but welcome
change has been an increase in captured hospital revenue. Sunrise Pharmacy
gets real-time pricing updates and automatically adjusts charges accordingly.
These adjustments caused a revenue spike in the first few weeks
that caused hospital staff to question their method of calculation. Down
the road First
on the agenda for Children’s is finishing the facility’s CPOE
implementation. Go-live in pilot areas is planned
for the first quarter of 2007. “The system is set up for CPOE,”
says Cummings. “It’s just not completed yet. Eclipsys helped us
configure CPOE into the pharmacy system and there won’t be any rework
needed for that.” The
hospital will roll out barcoding shortly. Kwapniowski expects few problems because the pharmacy
system and its configuration were built with barcoding
in mind. The
pharmacy team advocates integrated systems for medication ordering,
dispensing, and administering. “I can’t imagine how this process
would have worked if we had been forced to integrate a best-of-breed system
with our existing Eclipsys platform,” Cummings says. “I think an
integrated platform was the only way to deliver the closed loop
solution.” ---Maureen McKinney
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This article is excerpted from Inside Healthcare Computing, and is © Copyright Algonquin Professional Publishing, LLC, P.O. Box 668, Churchville, MD 21028 USA, (877) 690-1871, (410) 420-6741, Fax (410) 838-0504, http://www.insidehealth.com/. E-mail: custservice@insidehealth.com. |