One More Reason to Go Electronic

Electronic evidence-based protocols used as a “shared baseline” at the patient bedside may help eliminate unnecessary medical care—and that can lead a health care entity down the road to being a top-performing organization, as one case study illustrates.

IT plays a crucial role in preventing health-care-associated infections (HAIs), according to a new white paper from GE Healthcare IT.

HAIs affect 1.7 million inpatients each year, and are the fourth leading cause of U.S. deaths. Additionally, they cost the U.S. health care system as much as $35 billion each year. According to the GE Healthcare IT report, however, HAIs can be prevented with emerging technologies, such as electronic medical records (EMRs).

As one example, the report highlights the case of Intermountain Healthcare, where 80 percent of care delivery is evidence-based (vs. less than 55 percent for the rest of the industry).

There, evidence-based care protocols are rolled into a clinical information system and used as a “shared baseline” at the patient bedside. Physicians are expected to base their treatments on these protocols, making any necessary adjustments to meet individual patient needs.

Evidence-based protocols can improve accuracy, as illustrated by the work of Anthony Lee, MD, of Columbus Children’s Hospital, Columbus, Ohio. Lee created a Web-based system that automatically calculated a patient’s next dose of insulin. Instead of reviewing multiple pages and performing manual calculations, nurses simply enter two variables and the system instructed what action to take next. As it turned out, nursed calculated the insulin rate incorrectly nearly 25 percent of the time with the paper system, but only 1 percent of the time with the Web-based system (and in 80 percent of cases with errors, the insulin infusion rate was miscalculated by at least one unit per hour).

According to the GE Healthcare IT report, using such evidence-based care protocols for clinical decision support also eliminates unnecessary care, which has helped make Intermountain a top-performing organization. Other health care organizations of all sizes may wish to emulate this practice.

The entire report is available here.

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