Universal Health Services wanted to improve patient care by enhancing its EMR usability and efficiency. The organization rolled out its EMR to all 25 acute care facilities where 97 percent of the 6,000 physicians are independent.
During the support process, the organization learned that users wanted better communications delivered in a no ndisruptive way, says Ori Lotan, MD, associate CMIO. For example, a physician might be in the system working on information about one patient when an alert fires about another patient. “That can be a nuisance.”
Lotan and his colleague, Ehab Hanna, MD, another UHS CMIO, developed an inpatient notification system designed to display pressing patient concerns face up in the tool with one-click renewal. Communications from nursing, pharmacy and ancillary staff as well as clinical alerts (such as sepsis) are posted and can be viewed and acknowledged by any provider caring for the patient.
The system works in the physicians’ favor, says Hanna, because it covers issues they have to address anyway. The system ties these “pain points” to each patient so there aren’t problems such as inpatient medications and orders for restraints inadvertently expiring.
UHS has a development license from its EMR vendor so the tool was custom developed in-house by its own staff. “We’re trying to innovate in a manner that is accelerated compared with the 18 to 24 months we see on the vendor side for enhancements they agree to do.”
Lotan calls the system the next generation of clinical decision support because it is “a little more intelligent than just something that fires that a user can dismiss.”
UHS plans to expand the notification system with more physician-to-physician communication, enabling, for example, correspondence between hospitalists and cardiologists. Feedback also has helped Lotan and Hanna direct other enhancements such as an option to view what medications and orders qualify for renewing but have not yet been renewed.