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POINT OF CARE - Information When and Where It's Needed

Published: Synapse, 2010 - Vol. 3

From the moment you are admitted to the hospital as a patient, every single thing that happens to you is important to the clinicians providing your care. And all of those things are documented in your medical record.

CVD Patient CareIn the past, all medical records were kept on paper, including the observations and decisions nurses and doctors make at a patient's bedside. That has changed over the years with advances in technology. Now electronic medical records are the norm. But, in many hospitals, accessing and updating a patient's electronic medical record is still a cumbersome process that does not take place in "real time" or take place where patient care actually happens. Instead, patient care is often documented on paper and physician orders are often written after the fact in a location away from a patient's bedside.

Already ahead of the curve by implementing electronic medical records long before most local hospitals, The Chester County Hospital is now at the forefront again with new technology that is improving the use of electronic medical records and bringing the process closer to the patient. Working in collaboration with Siemens Healthcare and Unified Medical Solutions, The Chester County Hospital has developed a cutting-edge system that makes it possible for information to be shared by clinicians instantaneously across the Hospital as patient care happens and where it happens, including at the patient's bedside.

New computer workstations have been installed in all patient rooms. The computers use innovative, first-of-its-kind software to provide clinicians with immediate, easy access to each patient's electronic medical record. The system allows doctors, nurses, and other authorized clinicians to accomplish a wide range of tasks at the patient's bedside, such as administering medications, documenting key assessments and activities, placing orders, or checking on test results such as X-rays or lab results.

"The software we developed for The Chester County Hospital puts the Hospital in a unique position within the entire region, as the only Hospital with an innovative Clinical Virtual Desktop (CVD) solution and easy 'tap-in, tap-out' access to computers at the point of care," said David Holdan of Unified Medical Solutions. "Now clinicians can spend more time focusing on their patients and providing better or more attentive care instead of on the technologies they need to do their jobs."

With the new software and Siemens bedside computers, clinicians can get the information they need and input new information without leaving a patient's room. They are able to stay with the patient while they check on a lab test or make notations about the patient's condition. If a patient has a concern, their doctor or nurse can answer the question immediately instead of getting back to the patient at a later time. The doctor can check on an X-ray and show the image to the patient, order another test, or increase pain medication right there on the spot.

"It adds a level of transparency to the patient care process that I think is ultimately a very beneficial thing. It empowers patients and strengthens the patient/doctor relationship," said Karen Pinsky, MD, Chief Medical Information Officer. "When something needs to be done, the patient knows why it needs to be done and knows that the physician did it, because they are having a conversation literally as it is happening. There's no mystery. And, that is very reassuring to patients."

Not only is the new system advanced in the information it provides and the speed with which it provides it, the system is also sophisticated in how that information is accessed and shared. The process of logging in and out has been streamlined and security has been enhanced by the use of high-tech "smart card" badges.

"Nurses and physicians log on with one password, which gives them secure access to any applications they are authorized to use," explained Kathy Zopf-Herling, MSN, RN-BC, Director of Nursing Informatics. By tapping their 'smart card' against a reader on the computer in any patient room, clinicians are logged on or off that device. When they tap out, they are not actually logged off our system completely; their current session is just disengaged from the computer they are working on at the time. They can then move on to the next patient's room, tap their card, and pick up exactly where they left off." This also helps to ensure that patient privacy is maintained, as the ease of tapping in and out eliminates the concern that work is lost when a caregiver has to leave a workstation.

Access to a computer at the bedside is especially important for nurses using the new bar-coded medication scanning system - called Medication Administration Check - used by The Chester County Hospital to ensure that patients are receiving the right medication, in the right dose, at the right time and frequency, by the correct route.

Many hospitals use wireless computers on wheels for bedside documentation and medication verification, but they have some drawbacks that the new in-room computers do not.

"Computers on wheels have to be moved from room to room. The battery life on them is too short, and they aren't powerful enough for the robust applications we are now using," explained Mary Buckley, Vice President of Information Technology. "We wanted something better and more efficient that would allow for more flexibility. We wanted to give our nurses and clinicians access to the tools they need in the locations where they need them the most."

When the Hospital identified the benefits that would come from giving clinicians convenient access to their patients' medical records at the bedside, the Hospital didn't wait for current technology to catch up with the need. Instead, it engaged Unified Medical Solutions to adapt and develop technology to make it happen. Clinicians now have the tools and information necessary to make the best decisions quickly and precisely at the bedside, giving them more time to spend with their patients. And, that is exactly where they want to be.

By Beth Eburn


Siemens and The Chester County Hospital

The Chester County Hospital is a cooperative partner of Siemens and among the first hospitals in the nation to integrate and analyze its innovative processes and devices. Siemens Healthcare is one of the first companies to bring together medical imaging and therapy, laboratory diagnostics, and healthcare IT solutions across the continuum of care - from prevention and early detection, to diagnosis, therapy and ongoing care.

Last Updated: 10/11/2011