March 25, 2008 - Improved outcomes in patients with community-acquired pneumonia (CAP) led to top honors for AnMed Health in a recent competition hosted by McKesson to quantify the value of computerized provider order entry (CPOE) and clinical decision support (CDS) in community hospital settings.
AnMed Health, a 500-bed health system in Anderson, SC, was one of multiple inpatient community organizations to participate in the metric-based CPOE and CDS competition.
Two other organizations - Concord Hospital, Concord, NH, and Providence Health and Services - Oregon Region, Portland, OR tied for second place for using evidence-based guidelines to reduce variability in healthcare quality.
"Healthcare is complex, and physicians who make difficult decisions every day deserve to have the best tools available to them to effectively manage today's higher-acuity patient," said Duncan James, president, health systems, McKesson Provider Technologies. "Over the past 12 months, we've seen a sevenfold increase in the adoption of Horizon Expert Orders, McKesson's CPOE and CDS solution, by physicians in the community hospital setting. It's very rewarding to see such tremendous performance as customers improve upon traditional methods of managing and delivering care."
AnMed Health won the competition for results achieved by using Horizon Expert Orders to automatically present physicians with evidence-based guidelines when treating CAP patients. Within seven months, the health system logged a 42 percent improvement in the number of CAP patients receiving antibiotics within four hours, the medical best practice for CAP. In comparing AnMed Health hospitalists, who universally embraced the CPOE and CDS system, the hospitalists reduced the average length of stay from 6.7 to 5.5 days, lowered the cost of care by 20 percent, and reduced the mortality index by 56.5 percent. Physicians also noted a dramatic reduction in callbacks for order clarification related to allergies and dosing. Horizon Expert Orders is available on all inpatient units, with more than 110 physicians trained on the system and an average of 55,000 electronic orders placed per month.
Concord Hospital, part of Capital Region Healthcare, set out to improve outcomes for patients at risk for venous thromboembolism (VTE,) a leading cause of preventable hospital deaths. The use of prophylaxis reduces the rate of VTE by 50 percent or more, yet national data show that only half of inpatients at risk of VTE receive appropriate prophylaxis. With VTE prophylaxis compliance rates already higher than national averages, Concord achieved 100 percent compliance through physician use of CPOE/CDS. In addition to order sets "hot linked" to evidence-based guidelines for VTE, Concord staff addressed 42 other conditions, including management of ischemic stroke, isolation guidelines, fall prevention and treatment, diabetes, delirium and angina. Concord Hospital also wanted to improve documentation of reasons for radiology exams. With the addition of a required "reason for test" field for all imaging test orders, Concord went from 47 percent to 100 percent compliance in documentation for radiology exams. More important, imaging orders entered in the CPOE system were deemed appropriate for reimbursement 78 percent of the time, a 140 percent improvement that will favorably impact revenue. The system is available on all inpatient units, 63 physicians are trained and electronic orders average 25,000 per month.
Providence Health and Services - Oregon Region has been using CPOE/CDS since October 2005. In that time, medication turnaround times have been reduced by 50 percent and close to 600 pharmacy callbacks have been eliminated each month. With these calls averaging three minutes each, this frees up physicians and pharmacists, who now have 30 more hours per month to spend on patient care activities rather than spending time on the phone clarifying orders. STAT lab turnaround times improved by 45 percent and compliance with overall regulatory measures also improved. In addition, more than 80 percent of physician users express high satisfaction with having patient and reference information readily available.
They also are happy with the faster treatment times and overall team responsiveness. To date, 132 physicians at Providence are using Horizon Expert Orders, with order volume averaging 50,000 per month.
A panel of industry and McKesson experts served as judges for the CPOE metrics competition. The judges evaluated entries using a point scale to evaluate written and oral presentations. Criteria used in selecting winners included the use of CPOE to solve specific business issues, clinical and financial results and the methodology used to measure results.
For more information: www.mckesson.com