March 26, 2004

WizOrder goes live in adult ED

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James E. “Pete” Powell, M.D., was recently named medical director of VMG’s Williamson County division. Photo by Dana Johnson

WizOrder goes live in adult ED

On Tuesday at 7 a.m., WizOrder, the physician order entry and decision support system developed at VUMC, was switched on in the adult emergency department for the first time.

“Besides orders that are legible 100 percent of the time, overall benefits of the system include an expected decrease in medication errors,” said Ian D. Jones, M.D., assistant professor of medicine and medical director of the adult Emergency Department.

WizOrder automatically screens medication orders against the patient’s known drug allergies, potential drug-drug interactions, and weight-based dosing guidelines, and the system issues alerts when orders appear unsafe. The system also places more general information about tests and medications at the user’s fingertips.

WizOrder poses new quality assurance opportunities for the adult ED, Jones said. His team will periodically use data produced by the system to review ordering patterns against established ED protocols.

Nurses in the ED are now using computers to document immediately the completion of orders for tests and medications, and this information is fed right away into WizOrder. This enhancement was tested first in the pediatric ED beginning last December.

This new electronic documentation gives emergency physicians and their teams the ability to survey the status of multiple patients’ orders much more quickly; until Tuesday in the adult ED, all this vital documentation was dispersed among numerous pieces of paper. Vanderbilt Hospital is in the early stages of moving to paperless clinical work environment (the clinic is already paperless); electronic tracking of order completion is a welcome step along that path, Jones said.

WizOrder got underway at Vanderbilt in 1995, and part of the reason it’s coming last to the adult ED is the sheer pace of ordering activity in that area of the hospital. The government requires all ED orders to include justification in the form of attached codes that document specific patient problems.

Jones said WizOrder has been programmed to make attaching these codes more efficient. As another aid to efficiency and standardization of care, it has been programmed with newly streamlined order sets matching up with patient complaints commonly encountered in the adult ED. Jones said he expects use of WizOrder to spur development of more protocol-driven order sets in the adult ED.

Randy A. Miller, M.D., professor and chair of Biomedical Informatics, has been the project leader for WizOrder since its inception. In 2001, Vanderbilt licensed rights for commercial development and marketing of WizOrder to Atlanta-based McKessonHBOC, Inc.