Patient Safety & Clinical Quality: Information Technology at THR Internal Medicine Update Presbyterian Hospital of Dallas October 29, 2003.

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Presentation transcript:

Patient Safety & Clinical Quality: Information Technology at THR Internal Medicine Update Presbyterian Hospital of Dallas October 29, 2003

10/29/2003Internal Medicine Update2 Overview Case study (Cleary 2003) Quality (IOM 2001) Safety (Bates 2003) Projects NOVA (IOM 2003) Key Success Factors (Berwick 2003)

10/29/2003Internal Medicine Update3 Case Study Cleary (2003;138:33-39) A Patient’s Perspective on Quality

10/29/2003Internal Medicine Update4 Case Study Cleary (2003;138:33-39) Admission experience Postoperative experience Teamwork failures Pain management Discharge services

10/29/2003Internal Medicine Update5 Crossing the Quality Chasm IOM (2001) “Information technology has enormous potential to improve the quality of health care”

10/29/2003Internal Medicine Update6 Crossing the Quality Chasm IOM (2001) Safety Effectiveness Patient-centered Timeliness Efficiency Equity

10/29/2003Internal Medicine Update7 Efficiency and Timeliness Case study: PACS and voice recognition technology Ted Wen MD, Radiology Presbyterian Hospital of Plano

10/29/2003Internal Medicine Update8 IT and Patient Safety Bates and Gawande (2003; 348: ) Prevention of errors and adverse events Facilitating a more rapid response to adverse events Tracking and providing feedback about adverse events

10/29/2003Internal Medicine Update9 IT and Patient Safety Bates and Gawande (2003; 348: )) Improve communication Access to knowledge Require key information Assist with monitoring Provide decision support

10/29/2003Internal Medicine Update10 Communication Case study: electronic messaging Ed Goodman MD, Infectious Disease Presbyterian Hospital of Dallas

10/29/2003Internal Medicine Update11 Communication

10/29/2003Internal Medicine Update12 Access to Knowledge Case study: medical references and clinical data Robert Lilli MD, Family Practice Harris Methodist Fort Worth Hospital

10/29/2003Internal Medicine Update13 Access to Knowledge

10/29/2003Internal Medicine Update14 Assist with monitoring ICU monitoring Fetal monitoring

10/29/2003Internal Medicine Update15 Decision Support

10/29/2003Internal Medicine Update16 Decision Support Case study: Weight based dosing for intravenous unfractionated heparin Rashke et al (1993;119: )

10/29/2003Internal Medicine Update19 Impact of Decision Support Compliance with weight-based dosing for Heparin pre-CPOE: 15% post-CPOE: 85%

10/29/2003Internal Medicine Update20 Projects NOVA Infrastructure Mainframe Network Common desktop Interface engine Applications Surgical management and scheduling Laboratory information system Physician portal (CareGate)

10/29/2003Internal Medicine Update21 Projects NOVA Applications Clinical documentation Orders management Medication management

10/29/2003Internal Medicine Update22 Selection Methodology NOVA Advisory Board IOM Report: Key Capabilities of an Electronic Health Record System (2003) THR functional requirements Vendor evaluations

10/29/2003Internal Medicine Update23 Information Services National recognition

10/29/2003Internal Medicine Update24 Challenges Cultural Administrative Technical

10/29/2003Internal Medicine Update25 Change Leadership Berwick (2003; 289: ) Find sound innovations Find and support innovators Invest in early adopters Make early adopter activity observable

10/29/2003Internal Medicine Update26 Change Leadership Berwick (2003) Trust and enable reinvention Create slack for change Lead by example

10/29/2003Internal Medicine Update27 Discussion Roles of allied health professionals Achieving consistency of clinical practice (e.g., formulary, order sets) Using decision support to influence clinical practice Medical staff by-laws

10/29/2003Internal Medicine Update30 Bibliography Cleary PD: Ann Intern Med. 2003;138:33-39 Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21 st Century. Washington, DC: National Academy Press; 2001:1 Bates DW and Gawande AA: N Engl J Med 2003; 348: Institute of Medicine. Key Capabilities of an Electronic Health Record System. Washington, DC: National Academy Press; 2003:1 Berwick DM: JAMA 2003; 289:

10/29/2003Internal Medicine Update31 Presenter Contact Information Ferdinand Velasco, MD Chief Medical Information Officer Texas Health Resources 601 Ryan Plaza Dr., Suite 301 Arlington, TX (817)