What IMPACT Means to Physicians November 2014 Physician Champion: William Bradshaw, MD, FACS

 Changes for nurses and other departments will include: – All medications will be bar-coded, including IV Fluids. – Bedside monitors will automatically feed vital signs into the electronic chart for patients in the ICU, PACU, and certain beds in the Emergency Department.  Clinicians and staff will continue to perform the following daily functions: – Administer medications only after cross-checking the bar-coded label on the drug with the bar-coded wrist band on the patient’s arm. – Document directly into the computer as care is delivered (not on sticky notes or kardexes). – Give shift reports by looking at the information that was documented directly into the computer. A Glimpse of Our Future with IMPACT 2

 Changes for physicians – Physicians will look up patient information in the Cerner electronic chart from any wireless-enabled location (within the hospital or from their office, home, or remote location). – Orders will be entered electronically or immediate action by all departments in Cerner. With Cerner CPOE, physicians will enter their own orders to ensure that all the rules, alerts, contraindications, drug interactions, and other clinical decision support are acted upon at the time of order entry.  Changes for our hospital – Hospitals must attest to the U.S. Department of Health and Human Services that we are “meaningful users” of technology, based on information that we capture (including physician use of CPOE) in our Cerner electronic records. – Our compliance affects eligibility for ARRA incentives in the form of Medicare/Medicaid reimbursement. A Glimpse of Our Future with IMPACT 3

 Improved safety for your patients – Immediate notification of critical results – Decreased adverse drug events – Allergy checking – Clinical decision support at the time of order entry – Duplicate orders checking – Clinical alerts – Immediate communication of authorized physician order to all departments for follow up action (with CPOE) Benefits for Physicians 4

 Electronic Health Record – You will have electronic access to Cerner’s legible, complete, organized patient chart from a variety of locations  Computerized Provider Order Entry – You will streamline your ordering process by the use of Cerner’s evidence-based order sets, which were developed from order sets in use by doctors across Tenet (including yours) and compared against leading clinical practices – The time spent by physicians entering orders through Cerner’s CPOE will improve patient safety and save time in the long run by reducing manual communications to: – Clarify order legibility – Follow up on alerts or contraindications – Obtain signature for paper or phone orders Benefits for Physicians 5

 Enhanced communication and physician work flow – You will have improved access to patient records through Cerner Immediate access to electronic patient record from anywhere you have a PC and Internet connection Easy access to your patients using Rounds List No lost charts  Improved communication – With Cerner, handoffs between venues of care and care providers can happen seamlessly with information at your fingertips  Integration of bedside monitoring devices – Eliminates transcription errors – Will provide you with ease of access to monitoring data Benefits for Physicians 6

 Use of order sets for your convenience – Evidence links and treatment pathways embedded in order sets – The suggested order sets will be based on diagnosis and problems – You will have the ability to save your favorite orders  Your orders are communicated directly to other care providers for action – Decreases turn-around time – Eliminates transcription errors Benefits for Physicians 7