Electronic Medical Record
The first step in our plan to digitize the Medical Center, in 1994, was to create an electronic medical record (EMR) to streamline and eliminate paperwork in order to computerize everything and electronically place all patient health care information in a safe and secure digital environment. Now, everyone responsible for a patient’s care, physicians, floor nurses and Medical Center pharmacists, if given permission, can immediately access the patient’s personal health information.
Online Point of Care Wireless Patient Charting and Access to Information and Results
In 1998 the Medical Center introduced the ability to enter and access patient information at the point of care, the bedside. Cart mounted notebook computers, connected via a wireless network, provide clinicians with mobile, timely access resulting in improved response and decision making.
“Rosie” the Pharmacy Robot
Rosie the Robot, one of the first pharmacy robots in the United States, fills 2,500 doses daily from the pharmacy with 100% accuracy. Using barcode technology Rosie selects a patient’s drug, as ordered by the physician and entered by the pharmacist, and prepares the medication-with its own specialized barcode-for delivery. She even alerts the McKesson warehouse when stock is running low and electronically creates an order for a new supply of that medication. Rosie joined to Peninsula Regional's Pharmacy in 1999 and was retired in 2012.
Roise was replaced in 2012 by the MedCarousel system. While Roise could hold up to 500 medications, MedCarousel can do even more-in fact, it will hold more than 95% of all medications in the Pharmacy Department. It also advances the safety technology used by Rosie in scanning and ordering medications.
AcuDose Medication Storage Cabinets
Safely storing and securely protecting drugs on specific nursing and critical care floors is extremely important. In 2001 the Medical Center installed McKesson AcuDose cabinets. Codes are used to open the cabinets for storage and retrieval of drugs. This verifies when and by whom drugs are removed.
Bedside Patient and Medication Scanning
Less than 5% of all United States hospitals were scanning medication at bedside when Peninsula Regional implemented this safety check in 2002. This system removes, statistically, all margins for error in providing patients their medications. At bedside, the nurse uses a cart-mounted computer equipped with barcode scanners and technology. The nurse scans the patient’s armband, then scans the medication for verification. If the computer identifies any errors, it immediately warns the nurse before the medication is administered. Bedside I.V. “smart pumps” also guarantee that nurses program them correctly.
Horizon Medication Management Pharmacy
In the multi-phase process of introducing systems to address key components in the medication delivery cycle, Horizon Medication Manager (HMM) was installed in 2003 to provide Pharmacy clinicians with a departmental solution capable of processing orders received from a physician order entry solution. HMM functions as the gatekeeper in managing the dispensing of medications from the Medical Center’s pharmacy to reduce the possibility of errors occurring in the medication cycle.
Horizon Expert Order/ Physician Order Entry
As the final link in closing the medication safety loop, in 2005 Peninsula Regional installed a computerized physician order entry program. It allows doctors to obtain a predetermined list of approved medications for the condition they are dealing with, write their prescriptions electronically through a laptop with wireless technology and send them directly to the Medical Center’s Pharmacy. There they are checked by a pharmacist for accuracy, compared against the patient’s medical record to rule out any potential side effects or allergies and filled by Roise the Robot for delivery to the nursing floor. This procedure greatly reduces the problems that have resulted in the past with legibility concerns, interpretations of the physician’s order, incorrect prescription orders and timeliness of delivery.