In this video, Charles Ross, chief medical information officer of Summa Health System, shares his experience with CPOE implementations and the value of meaningful use with the editor of www.whatismeaningful.com. Below is the video and a transcript of the interview.
What is Meaningful Editor: What issues were most important to Summa in selecting a CPOE system?
Charles Ross: I think, oh, seven or eight years ago when we first decided to obtain a CPOE, we looked at multiple vendors and there were a lot of things that went into this but the major thing that we were looking at was quality. I think at that time if you look at this, I think there were issues that were very, very valuable and I think one of those issues was the ability to change this application to meet our processes and policies. And the second thing was to be able to change our order sets. To put decision support within our order sets that allowed us to go ahead and get the best quality so we would improve the physician buy in.
WIM Editor: What do you attribute to your high physician adoption of CPOE?
Ross: I think, like any other organization that has been successful with this, I think there is a number of things that we did and I would think that they would answer the same way. I think one of those things that was positive certainly we had a lot of support and administrative buy in. We also had nursing buy in. We also had physician buy in although some of it was skeptical to start off with. And I think that we had a lot of nursing IT analysts and also quality people that helped us and I think that that was very, very important as we move forward. One of the things that we were really afraid of was the multiple alerts within all of these systems and as we rolled this out, it became very obvious to us that we needed to change that and so what we did is to add decision support within our order sets which would allow better quality. And having better quality, we had physician buy in. If you really take a look at this, there were many outcomes that we had and it was very important that we show these outcomes to physicians. They needed to have that buy in to really accept this and this increased their buy in as we moved along so that is very, very important. If you look at the number of order sets that we had prior to putting in the CPOE, it was still only 13%. If you look at the percentage after we put in CPOE, it was 93%.
WIM Editor: How important is it to include CPOE in the ARRA meaningful use definition?
Ross: I think it would be hard for companies making CPOE to really define exactly what they need as a certified application. I’m also not absolutely sure that an institution which is starting CPOE today can get this done within a two-year time frame. But what I am sure is that if they put CPOE in and they implement it well, that it will improve outcomes and quality.
WIM Editor: What role has CPOE played in your clinical outcomes?
Ross: It was important because we felt quality in outcomes was the reason… or the reasons that we put in CPOE. If you look at this, we improved the outcomes and we’ve shown this to other institutions and presented it around the country, actually internationally but if you look at this, we’ve improved the outcomes on pulmonary embolism. We’ve improved the outcomes on diabetes. We’ve improved the outcomes on pneumonia….stroke outcomes…and as I said before, what we have shown is that we have increased the order set use from 12% to 93%.
WIM Editor: What is the key to achieving meaningful use?
Ross: Technology is extremely important. You have to have a technical application that works well but I think the most important thing you need to move forward is that the hospital has to understand what the process policies and flows are. We have to know what those are and secondly what we have to do is make sure that the physician and nurses all agree to that before you move on. So, technology is important but understanding these policies and procedures are fine. I think if you look at what I would say are the most important things to get physician buy in, and this is whether you have an ambulatory system or whether you are putting in an inpatient CPOE, the major thing is that you really have to have is that you have to make sure that you do not effect productivity. And the second thing you have to do is you have to show the physicians that you have improved outcomes. And if you can show that you’ve improved outcomes, you’re going to get better buy in.
WIM Editor: How has Summa been able to accomplish its technology goals?
Ross: The board of trustees and the administration of Summa Health System believes that qualities and outcome are the best things that we can …the best things that we can achieve… I think that the physician buy in is the major thing that has helped this but it is also nursing buy in to support this and I think that it is this type of thing which allows us to happen. We have a lot of nurse technical analysts and these nurse technical analysts have achieved what we really need to do as far as implementing and also maintaining this product. And I think the other thing that is extremely important is that we have tied ourselves very closely to quality and I think it is extremely important that the IT part of this ties itself to quality because quality is really what we want to achieve.
[End of of video transcript]
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