Big Ideas: Device Integration With the EHR: Saving Time, Improving Safety
Cedars-Sinai is improving nursing workflow by integrating devices around the hospital with its electronic health record.
This article first appeared in the December 2016 issue of HealthLeaders magazine.
At most hospitals, standalone devices capture such vital signs as pulse oximetry, weight, temperature, and blood pressure, but values from these devices must be reentered into the EHR manually, creating extra work for nurses and introducing data entry error possibilities.
Enter Cedars-Sinai, a nonprofit academic medical center in Los Angeles with 886 licensed beds, 2,100 physicians, 2,800 nurses, and thousands of other healthcare professionals and staff. At Cedars, device integration is already eliminating much manual work.
In a talk at the 2016 HIMSS conference, Jennifer Jackson, Cedars-Sinai director of clinical engineering and device integration, described the origins of the initiative, the outcomes of which she is now in the process of preparing for publication in a peer-reviewed journal. She is also preparing a paper about previous work integrating IV pump data into the health system's EHR.
In the case of pump integration at Cedars-Sinai, the Electronic Medication Administration Record (EMAR), which lives inside the EHR, pushes the medication order information to the pump. In that sense, the EHR programs the IV pump. The pump sends data back to the patient's EMAR. However, the EHR does not start and stop the IV pump itself. That still needs to be done by a nurse. The nurse reviews the settings prepopulated into the pump by the EHR before starting the pump.
"On both ends it saves us a lot of time and it also now removes a high degree of potential error when it comes to data entry and the timing of that data entry," she says. "We're now in the process of reviewing the data and seeing how significant the results are."