Volume 25 No. 8 AUG.-SEPT. 2001

Implementation of physician order entry system continues

Hospital officials call bond rating "disappointing", but say financial picture is improving

PAMF places temporary freeze on new primary care patients

Gregory retires, duties split between COS, associate dean

Health insurance options announced for employees at Stanford, Packard hospitals

EB Bikers






Physicians enter patient orders on wireless computers on unit C-2 as electronic physician order entry (POE) is phased in throughout the hospital.

Implementation of Physician Order Entry System Continues

Officials say the transition from paper to electronic medical records went smoothly through the summer as information technology staff members and clinicians continued to fine-tune the system.

Implementation of the physician order entry (POE) system, called "LastWord," began June 20 on C-1 and is expected to continue through the middle of September as units are brought online incrementally, said Raymond Gaeta, medical staff president and chair of the Stanford Physician Computer Advisor Team.

"Realistically, electronic orders take a bit more time for doctors to input, but there is a real benefit because orders that are easier to read should reduce the possibility of medication errors," Gaeta said. Another benefit to practicing physicians is the resource of medical, drug and clinical information in one place, he said.

And orders can be entered from virtually any hospital workstation, "which should sharply reduce the need for verbal orders," Gaeta said.

Wireless computers and rolling carts have been placed in each patient unit for physician use during rounds, said Suzanne Taylor, a nurse who coordinates physician communications on information technology issues.

Taylor said changes requested by physicians during the start-up period are being analyzed and, if feasible, are implemented immediately.

Changes have already been made to online order sets based on physician feedback, and simple orders may now be made with fewer "clicks." An emergency department admission order set was added after physicians expressed a need, and the on-screen medication list of choices was altered to more effectively guide physicians to the optimal drug selections for patients, Gaeta noted.

Taylor said staff members will be available 24 hours every day as long as needed to troubleshoot problems and guide users.

"Users get one-on-one attention, and virtually everyone who has tried the system becomes fluent fairly quickly. For example, we've noticed we get very few requests for assistance anymore from the first units implemented," said Taylor. "It's been awfully quiet."

A variety of services are available to help users feel more comfortable with POE, Gaeta said. These include:

- An online tutorial available at http://lwcbt.stanford.edu.

- A drop-in lab to provide personal assistance is available through the implementation from 6:30 a.m. to 8 p.m., Monday through Friday, in HC005, near medical records.

- Pocket cards and information sheets are available in the drop-in lab.

- LastWord staff, wearing red visors for easy identification, are available on units to answer questions immediately.

For any questions or comments regarding POE, contact: Suzanne Taylor at (650) 725-0249 or Ray Gaeta at (650) 725-5852. The LastWord Command Center is also available around the clock at (650) 724-3000.