October 13, 2011

New support for clinics’ information technology efforts

New support for clinics’ information technology efforts

As part of a new patient safety initiative, over the next 12 months health care providers in most Vanderbilt University Medical Center outpatient areas are going to begin using computers a bit more.

They’ll use an electronic prescription writer developed at VUMC, called RxStar, to write outpatient prescriptions, a great majority of which will be sent to patients’ pharmacies electronically.

Providers will also begin issuing electronically gathered clinical summaries — including known patient problems, allergies, medications and any new test results — that will be printed out and handed to each patient at the conclusion of each clinic visit.

Radiology, Pathology and most of Anesthesiology are the only outpatient groups not included in the push to adopt these tools by October 2012.

Paul Sternberg, M.D., assistant vice chancellor for Adult Health Affairs and associate dean for Clinical Affairs, is among those overseeing this initiative.

He notes that RxStar has been in use for years by many providers.

“The benefits for our patients from this technology are increasingly apparent to everyone, but in our outpatient areas we’ve often been hesitant to require that providers use these tools. It’s now time to enlist everyone’s participation,” Sternberg said.

“And to make this as easy and efficient as we can, we’ve allocated significant new resources for user training and assistance, system performance and user interface design.”

David Uskavitch, M.D., director of the Division of General Neurology and assistant chief medical information officer for VMG, agrees.

“These tools have a role in patient safety, with e-prescribing in particular being proven to reduce medication errors. I find both RxStar and the clinical summary tool easy to use; they haven’t slowed my productivity one bit,” he said.

Over the next 12 months, clinical teams will also begin routine electronic documentation of patient smoking status and patient race and ethnicity.

All these measures relate specifically to new federal incentives for clinical IT use by providers and hospitals; less specifically, they relate as well to future federal disincentives for not using clinical IT.

The new IT standards were piloted in Adult Primary Care and they’ve since been adopted in Digestive Disease and Neurosurgery.

Sherry Raber, R.N., MMHC, is manager of the Digestive Disease Center. She hopes future versions of the clinical summary will incorporate patient instructions, information on follow-up appointments and possibly even consumer health information.

“This project is focused entirely on our patients,” Raber said. “Given the often traumatic personal circumstances in which patients come to our clinic, they’re naturally prone to forget what the provider has discussed with them.

“The clinical summary can be a big help, since they’re leaving with something tangible to refer to after the visit.”

The Meaningful Use Group, or MUG, was set up to help clinical teams with this work. (The term “meaningful use” is borrowed from the legislation that launched the federal incentive program.)

MUG staff include nurses and others familiar with clinic operations.
Since launching in July, they’ve acquired 11 members; they hope to fill an additional 11 positions by November.

Vanderbilt Medical Group Administrative Director Danny Bonn leads the MUG. He expects five-week engagements in most clinics, and says the MUG will work in tandem with the VMG Systems and Service Education Department.

“With each new clinic, we’ll observe the operation, do a formal analysis of any gaps in terms of the new standards, then work directly with staff and faculty members to help them fold these tools and processes into their workflow,” Bonn said.