A Road Runs Through These Order Sets

This article appears in the December 2012 issue of HealthLeaders magazine.

Can a wiki share and standardize order sets? R. Dirk Stanley, MD, MPH, aims to find out.

"The fact that they're not standardized across the country leads to enormous costs and inefficiencies in healthcare," says Stanley, chief medical informatics officer at Cooley Dickinson Hospital in Northampton, Mass. "For example, if you have a doctor who's moonlighting, you know if you have a doctor from hospital A that you need to fill a shift in hospital B, if the doctor doesn't know what order set, kind of how the clinical functions operate, then it means you basically have to retrain the doctor on your clinical functions, but that's a lot of time and a lot of money."

Informally, order sets are finding their way from provider to provider through several routes today. Incoming residents are a source. Another is occasional informal exchange of order sets on the online forum run by the Association of Medical Directors of Information Systems.

Stanley recently began meeting with colleagues all along the Interstate 91 corridor in New England to help build a structure for sharing information.

"If you invent safety belts, is it really fair that you keep the patent for safety belts all to yourself?" Stanley says. "If you know you have something that can help improve care and improve safety and reduce costs, why wouldn't you share it with other people? I figure if I can share things with other people, then maybe they'll help share their lessons with me, and together we can actually reduce each others' operations costs and improve each others' safety."