January 9, 2004

Paperless process successful in clinic

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Dr. Elizabeth Heitman

Paperless process successful in clinic

The project to rid the clinics of paper-based processes in favor of electronic processes continues to lead to more efficient ways of working and is paying new dividends in improved patient safety, said Laura W. Montgomery, director of clinic redesign.

Montgomery highlighted three clinic projects at or near implementation: (1) transplant programs are about to automate their outpatient care guidelines; (2) secretaries across surgical departments are about to discard their varied paper forms for operating room requests in favor of an online form; and (3) staff are beginning to use an online form to schedule patient visits to the Preoperative Evaluation Center.

“It isn’t simply that we’re substituting electronic processes for paper-based ones. What’s notable is that work is becoming more streamlined and standardized,” Montgomery said. “We’re able to standardize these processes without sacrificing the different needs of our various specialty groups.”

The new tools are features of StarChart, the electronic medical record application created by project leader Dario A. Giuse, Ph.D., associate professor of Biomedical Informatics, in collaboration with Vanderbilt Medical Group faculty and staff. Health Systems Analyst Programmer Jun Kunavut wrote the code for these new StarChart features.

A StarChart form for confirmation of transplant donor and recipient blood typing is now in use. Electronic documentation means handwriting legibility is no longer a concern, and there is no longer a risk of case cancellation due to forms being lost en route to the blood bank and the OR. “With this tool teams quickly moved away from the inherent patient safety risks of a hand-written, paper-based process,” Montgomery said.

StarChart automated transplant outpatient care guidelines are nearing implementation, Montgomery said. Throughout the course of care, from pretransplant evaluation through follow-up, the tool automatically gathers test results from the lab system and inserts them into the plan and record of care.

Surgeons and their teams will use this tool to pull together and present the information used to propose transplant candidates. As doctors work with patients in the clinic, they’ll be able to turn to StarChart for help in following best practice.

Widespread use of the StarChart form for requesting operating rooms is also nearing implementation. Montgomery said the tool will help expedite case scheduling and insurance precertification and will prevent administrative loose ends that can sometimes result in case cancellations.

She said each surgical service can customize the form around their particular OR equipment needs. Teams will also soon begin using StarChart to schedule patient visits to the Preoperative Evaluation Center.

Doctors and clinic teams are saving time by using a new feature that allows faxing of patient records to referring physicians from within StarChart.