Overlook Hospital Makes Most Wired List

Atlantic Health was recently named one of the nation's "Most Wired" health care organizations by Hospitals & Health Networks, the journal of the American Hospital Association.

While this designation includes the state of the art technology in place at Overlook Hospital, such as the 320-slice CT scanner, it also encompasses innovations in electronic patient health records and medication administration.

"At the end of the day you want the kind of technology to help you take care of your patients and make your day easier," said Linda Reed,  RN, Vice President, Information Systems and Chief Information Officer at Atlantic Health.

The company began investigating and implementing forms of electronic billing 20 years ago but it wasn't until eight years ago that these innovations reached the clinical level.

"We started looking at patient safety aspects," Reed said. "If you take a look at one of the most dangerous things to do in a hospital it is giving patients medications."

So, working backward from the pharmacy to the doctor's orders, Atlantic Health implemented a barcode medication administration system to ensure patients get the right medicine at the right time and in the right dose.

Nursing manager in the oncology department Celeste Castle showed Patch firsthand how this automated medication administration works.

First a physican submits an order for medication electronically and it is then reviewed by the on site pharmacist who verifies that the order is correct and does not conflict with anything else the patient is on.

Once an order has been verified, a nurse may go to a machine in the pharmacy and select the patient they are trying to administer medicine to from a list on a computer screen. Then, the drawer the medicine is in will unlock so the nurse can get the medication.

Once back at her mobile unit, Nurse Karolen Varner showed Patch what happens next. Varner must scan the barcode on each medication she just withdrew from the pharmacy. The computer on her mobile nursing station will indicate whether this medication is the correct one prescribed by the patient's phsyican, if it is in the right dose and if it is being administered at the correct time.

For the patient Varner was about to visit, certain medications needed alternative doses, for example half a pill and two pumps of nasal spray.

Each patient has a locked drawer on Varner's nursing station as well to store items related to the patient.

Once Varner goes into the patient's room to actually administer the medication, one more line of safety checks is in place. The nurse scans the barcode on the patients hospital identification wristband. The nursing station will confirm she is about to administer medication to the correct patient. Before she can scan the barcode on the medication to administer, Varner must manually enter the changes in doses to reflect that she followed the doctor's orders and also write a comment explaining why she was delivering the patient's medicine later than ordered, in this case because she waited until Patch arrived to witness the administration.

"Patient safety is always at the top of our minds with everything we do," Reed said.

Other innovations include a remote portal that allows doctors to access patient records – and subsequently write orders – from anywhere.

Overlook also has integrated electronic health records with many general practitioners and other doctors so a patient's health record can be complete.

While the technology has temporarily pulled nurses away from patient's bedside as nurses adjust to new processes, Reed thinks once the devices catch up to the capailities of the software in use, this problem will be rectified.

One other concern some patients have about the automation of many of the functions at a hospital is the security of their personal information.

But Reed said the hospitals many networks are very secure.

"We've put a lot of money into our security software," she said.

Overlook also uses television monitors in each unit that show the layout of the entire floor, color-coding hospital rooms so nurses and doctors can tell at a glance if a room is occupied, needs to be cleaned, if a patient is off the floor at a test, or if a patient is nearing the end of their life.

Another television monitor is being used in the waiting room in surgery to allow family members to monitor the statuf of their relative in surgery. The monitor scrolls through a list of patients, identified only by a secure ID number, and lists if they are pre-operation, in surgery or post-op.

"What we've done over the last 6 or 7 years is we've taken a look at how do we make our staff more effective and improve patient safety and patient care," Reed said. "We've also tried to improve the patient experience."