Emphasis on Support in Decision Support

The results were impressive:

• A 38% decrease in preventable deaths over several years, ranking the Hospital of the University of Pennsylvania as a national leader in this category, due in part to electronic alerts in patients' EMRs. For example, the system requires clinicians to consider the risk of venous thromboembolism for all patients they admit and offers support ordering prophylactic medications.
• Reduction in many hospital-acquired infections by introducing evidence-based initiatives whose outcomes are built in to the inpatient CPOE system.
• A 50% improvement in the appropriate use of blood thinners and a 10% reduction in complications through the introduction of evidence-based order sets that were designed in part by physicians.
   
• Increased internal hospice referrals within the health system by more than 24% in a 12-month period supported by changes to inpatient discharge documentation and electronic referrals.
   
• Increased ambulatory patient volume by 6.8% through the opening of the new Perelman Center for Advanced Medicine facility, which uses an EMR system throughout the facility.
• Improvements in patient flow based on interventions that have resulted in significant decreases in length of stay, transport time, and bed-turnaround time.

At Adventist Health System, based in Altamonte Springs, Fla., CMIO Phil Smith, MD, says the system's clinical decision support is provided in two ways. First, the system provides order sets, reminders, and suggestions to clinicians regarding patient care, and then, after orders are placed, the system checks for allergies, drug interactions, and other possible problems.