Patient data can be used in more robust ways in hospital clinical systems to improve quality and patient safety, according to findings released by First Consulting Group, Long Beach, Calif., a healthcare research organization.
Dubbing it the "next generation of information technology," the report states there are even more ways to make patient electronic data work for hospitals. The systems that hospitals have spent so much money to implement are not being used to their full potential, said Jane Metzger, research director in First Consulting's applied research department.
The findings suggest hospitals should implement what First Consulting calls "clinical surveillance," through which patient data can be manipulated in real time across all hospital functions. Clinical surveillance can be most effective in preventing adverse drug effects, managing healthcare-associated infections, and monitoring quality and public reporting, according to the report. First Consulting's clients include health insurance plans, providers, pharmaceutical companies, government agencies and health IT vendors.
Most of the time, when hospitals have implemented costly, complex data systems, the staff is most focused on training and making sure they understand how to use the basics, Metzger said. But there are advanced tools in those systems for even deeper use, she added.
While applications such as computerized physician order entry, nursing and physician documentation, and electronic medication-administration records have all provided a base for reliable quality of care, the analysis of the data those applications provide is primarily conducted after treatment has ended and the patient has left the hospital.
Using clinical surveillance, hospitals would be able to speed the safety checks that nurses and doctors implement while monitoring patients for signs of adverse drug affects. Real-time monitoring of data could also identify patients at risk for or with actual healthcare-associated infections, and patient-condition updates during transfers among different hospital units.
Additionally, as quality reporting becomes more complicated and time-consuming, staff could reduce the amount of time required reviewing each patient chart to ensure all the data have been entered correctly because all the information is entered automatically throughout a patient's stay in the hospital.
Hospitals will be under increasing pressure to report and perform to quality standards, Metzger said. While current clinical systems provide transaction support, and already have been helping facilities reduce errors and adverse events, the continued focus on reporting and quality requires them to implement even more stringent data monitoring, she said.
"You go in hoping to help (a patient); everyone's nightmare is when something goes awry," she said.
At the 700-bed PinnacleHealth System in Harrisburg, Pa., nurses and physicians are using real-time data management to improve pain assessment, reduce falls with injuries, and monitor the number of patients required to be in restraints, said Sheri Matter, chief nursing officer.
A central data warehouse stores information that is updated throughout the day. Nurses receive reminders on hand-held medication administration devices to enter pain assessments, and if a condition changes, will help determine whether different treatment is needed, Matter said.
Documentation has increased to 97% since June 2006, according to Pinnacle records. "When we put that information system in, we consistently saw that improvement," Matter said.
Although data entry is labor intensive for nurses, the staff recognized that the real-time reminders have improved patient safety, she said. "We can be very proactive about it," Matter said.
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