Electronic Medical Records: Charting Mayo Clinic's Progress - ' A Seamless System '

A Seamless System

When the hospital adopts the physician order-entry system later this year, a physician will be able to enter an order for a test, medication or procedure, automatically launching a series of activities associated with the patient's care.

Mentel gives this example of how the order-entry system will work: A person is admitted to the oncology department for a cancer treatment. A physician will click on an order for the patient to receive an anti-nausea medicine 30 minutes before chemotherapy, and then receive three different chemical agents at specific times and in a particular sequence. And that treatment is to be repeated every 12 hours. The order-entry system will automatically notify physicians, pharmacists and others in the hospital when a particular treatment needs to be performed, and monitor dosage amounts and method of administration (e.g., by mouth or through a vein).

The new system's seamlessness is in sharp contrast to the past.

In March 2001, a pilot project to adopt a computerized inpatient physician order-entry system, using software from Cerner, hit a roadblock.

At that time, St. Luke's was using a version of Cerner's pharmacy system that was not integrated with the computerized physician order-entry system. So, when a physician entered an order for a prescription, a pharmacist would have to print out the prescription and then type the information into the pharmacy system, according to Croft. Mayo's medical staff thought this arrangement was time-consuming and could result in data-entry errors.

Subsequently, St. Luke's installed a new version of PharmNet, ensuring that when a physician prescribes medications, the order automatically goes to the pharmacy—without requiring someone to re-enter the prescription.

Cerner did not provide a project manager assigned to the Mayo Clinic to discuss the deployment.

Is the computerized physician order-entry system ready for the November rollout at St. Luke's Hospital? "As we have analyzed, assessed and torn it apart, it looks as if it can handle [the hospital's] needs," Mentel says. In preparation, hospital staff have performed technical tests to make sure it does not crash or accidentally modify data, and clinical tests to determine if order forms meet the needs of the various departments and specialists.

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