MHE Executive View
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MEDICAL PROFESSIONALS are taking to heart the old saying that necessity is the mother of invention. Now more than ever, they're
putting their knowledge and experience to work in developing IT innovation.
Such a scenario has unfolded at Summa Health Systems, in Akron, Ohio. The Summa system serves more than 500,000 patients a
year in comprehensive emergency, acute, critical, outpatient and long-term and home-care settings.
Summa has implemented a new IT initiative: a hand-held computerized physician order entry (CPOE) system, put in place in 2006
after three years' development. Charles Ross, MD, Summa's chief medical information officer, led the effort to create a CPOE
system tailored to healthcare network's needs.
"Four years ago, the Summa board of directors and the medical staff formally agreed that quality and patient safety were top
priority," Dr. Ross tells MANAGED HEALTHCARE EXECUTIVE. "My job was to find a system that met our needs, and perhaps more
important, would overcome the biggest obstacle: getting buy-in from physicians and nurses because they would have to change
the way they were doing things. The system we chose and helped design required more change on the part of caregivers." Working with an IT vendor, Dr. Ross and his team developed a customized, hand-held CPOE device designed for: providing treatment-decision
data; minimizing drug-, lab- and radiology-order loss or duplication; and coping with the age-old problem of physicians' notoriously
hard-to-read handwriting—a leading contributor to medical errors.
"By automating orders, we knew we'd improve patient safety and care quality," says Dr. Ross. "We found that order sets in
a paper-based care-management system are used less than 15% of the time but more than 90% of the time in an automated system.
This drastically affects outcomes."
HANDS-ON PHYSICIANS
One of the strategies Dr. Ross and his IT team employed to smooth the path to physician buy-in was to give them a leading
role in order-set development. He and his team brought in medical professionals from all specialties—some of them tuned-in
to technology, some of them computer-wary skeptics—to review old order sets and develop new ones.
"The order sets are customized and multiple-choice, and they are key to overcoming doctors' concerns that the CPOE system
would lead to 'cookie-cutter' medicine," Dr. Ross says.
In late 2005, more than 2,000 Summa physicians and nurses received training, which was provided by the group of computer-savvy
physicians. Training was done one department at a time over several months, and today, there's 100% physician system usage.
So far the new system, PLATO (Physician Leader and Timely Accurate Ordering), is delivering the kind of improvements Summa
wanted, says Dr. Ross. "We're in the process of tracking outcomes, but we're already seeing major improvements in both patient
safety and quality of care," he says. "Turnaround times for drug, lab and radiology orders have been significantly lessened,
and we know PLATO has helped reduce length-of-stay by two-tenths to three-tenths of a day. That doesn't sound like a lot,
but the cost-savings to the hospital are unbelievable."
Summa invested $26 million in the PLATO CPOE system; Dr. Ross says he expects to see return on that investment within a year
or two.
"When a hospital organization makes a change like this," he adds, "it's not the application and it's not the technology
that make it work—it's the input from the medical side and the extent of practitioner buy-in that make it work."
