Wednesday, July 18, 2007

Our geeks excel again

Back in February, I wrote a post unabashedly touting our hospital information systems, and giving lots of credit to our CIO, John Halamka. I found out today that we have been named to the list of the nation's Most Wired and Most Wireless Hospitals. This is found in the July issue of Hospitals & Health Networks magazine, which has named the 100 Most Wired hospitals and health systems since 1999. Here's our press release on the topic, which has the following tidbit:

BIDMC is one of three hospitals or health systems in Boston to be named Most Wired and the only to achieve both designations. It is the seventh consecutive [year] on the Most Wired list and the third year in a row as Most Wireless.

Congratulations to John and his staff for this recognition. The key to their success is that, not only do they build great information systems and applications, but they work closely with our clinicians in designing them. So those systems are actually in use every day to provide support to the delivery of clinical care.


Will said...


Is there a link to this year's list online somewhere? The article link in your text appears to only be an explanation of the list from 2004.

Anonymous said...

Sorry, I haven't found it yet either. Maybe you have to subscribe to get the actual list.

Hmm, didn't realize I linked to the 2004 description. I'll try to upgrade.

Anonymous said...

No, wait, it does links to the current date's issue.

Anonymous said...

Paul, I know from former posts that you realize this already, but you are a fortunate man with your IT dept. and personnel. Many are the hospitals which, after their latest IT disaster, wish to be in your shoes. (:

Anonymous said...

Bravo to John’s team, BUT-
It isn’t enough! Quality of Patient Care is directly correlated to the quality of medical record documentation. Oh some of my fellow colleagues might huff and puff about ‘documentation’, but I truly believe if BIDMC wants to provide the best care, we must truly vest ourselves to these facts taken from the basic Health Care Medical Record Guidelines:

“General Principles of Medical Record Documentation
Medical record documentation is required to record pertinent facts, findings, and observations about a patient’s health history including past and present illnesses, examinations, tests, treatments, and outcomes. The medical record chronologically documents the care of the patient, and is an important element contributing to high quality care. It also facilitates:

•The ability of providers to evaluate and plan the patient’s immediate treatment and monitor his/her health care over time;
• Communication and continuity of care among providers involved in the patient’s care;
• Accurate and timely claims review and payment;
• Appropriate utilization review and quality of care evaluations; and
• Collection of data that may be useful for research and education.

The general principles of medical record documentation for reporting of medical and surgical services for Medicare payments include the following, if applicable to the specific setting/encounter:
• Medical records should be complete and legible;

• Documentation of each patient encounter should include:
- Reason for encounter and relevant history;
- Physical examination findings and prior diagnostic test results;
- Assessment, clinical impression, and diagnosis;
- Plan for care; and
- Date and legible identity of observer”

Sounds great in theory, but it is practiced routinely? I think not. How many records do you look on a daily basis at that you cannot easily read because of illegibility? How can a clinician make a fast emergent decision about a patient’s treatment if they cannot read the information presented, does that mean- {guessing what it says?, making a phone call, thereby wasting a few minutes? or simply doing those tests/assessments all over again themselves?}. Can many of us say that these previous statements are more frequent that we would like to admit?

Ok, now what can we as a collective group do about this? We can embrace the truism that quality healthcare is directly correlated to quality medical record documentation and start being accountable for what we document and see documented. Start holding our colleagues accountable when the document illegibly. {We expect patient’s to remind us to wash our hands, but we won’t dare to ask a peer/colleague to write legibly so we can provide good continuity of care!}

I challenge my fellow BIDMC co-workers to the following:

• Think of the medical record as a continuum of your direct care.
• Embrace, facilitate and adopt online medical record documentation 100%
• Monitor the record as needed and speak up when something needs to be addressed (stop the assembly line).
• Be accountable and hold others accountable to the care and the documentation that describes that care permanently in the medical record. .

If you were the patient wouldn’t you want it to be this way?

Will said...

After searching all day (just kidding), I found a link to the Cover Story 2007 Most Wired page which includes a link to this year's list.

Anonymous said...

Thanks, Will.

Janak Joshi said...

Kudos to Dr. Halamka and his team. It would be interesting and actually very relevant to think about how being te most wired actually helped patient care, billing, scheduling, referral management, etc. The old order of business arguement around 'reducing errors' and 'decision support' is good, but let's take this to a new level and display to the world what healthcare informatics is all about by truely offering a connected environment at the patient level - not just at the provider level.