OBJECTIVES OBJECTIVES Describe paperless hospitals Describe and
evaluate the hardware and software utilized in Paperless Hospitals
Describe and evaluate the information systems used in Paperless
Hospitals
Slide 3
OBJECTIVES OBJECTIVES Assess the role and function of the nurse
of paperless hospitals List the advantage/disadvantages of
paperless hospitals Examine legal/ethical issues
Slide 4
INTRODUCTION INTRODUCTION Paperless hospitals are the wave of
the future. The key concept is to minimize the amount of paper and
convert all forms of documentation to digital form. It will be the
integration of all disciplines to one system. Patient images and
information are readily available from parts of the hospital and
thru a secured network.
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INTRODUCTION INTRODUCTION Paperitis is becoming an epidemic
(Omtool 2007) 5% of hospitals are computerized Electronic
prescriptions to be mandated by 2010 (Schlesinger 2003)
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INTRODUCTION INTRODUCTION Incentive programs for successful
electronic prescribers (AHA 2008) Medicare payments increase for
paperless physicians (MSNBC 2008)
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Computer based records may include: Computer based records may
include: EHR (Electronic Health Record) Prescriptions Test order
& result retrieval Physician orders & progress notes
Messaging & reporting Documentation & VS Billing &
Scheduling
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HARDWARE USED IN PAPERLESS HOSPITALS WebcamsMonitorsMouse
Wireless networks Bluetooth
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WEBCAMS WEBCAMS Video cameras Images can be accessed through
WWW, instant messaging or video conferencing. Images upload to a
web server, continuously or timed intervals. Wikipedia (2008)
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WEBCAMS WEBCAMS Monitors traffic, weather, volcanic activity
Tracks weather Educators use for virtual classes Interpretation
service (Gately 2008)
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(Dunbar, 2008) WEBCAMS WEBCAMS Rooms at Sloan Kettering ICU are
equipped with web cameras that allow staff to monitor patients from
locations outside the ICU, and physicians now enter orders on a
computer system that produces an electronic medication
administration record that calculates dosages and sends reminders
to the nurse when medications are due, or are late.
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Sloan Kettering ICU
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SOFTWARE IN PAPERLESS HOSPITALS SOFTWARE IN PAPERLESS HOSPITALS
Microsoft Office, Excel Spreadsheets Visualization & Imaging
software Anti-virus software Billing software Scheduling
software
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SOFTWARE SOFTWARE Adobe reader Health & wellness Discharge
planning Bed management Patient tracking Medicare coding
Slide 15
STATCOM SOFTWARE Facilitates workflow and escalates task
completion Provides staff with real-time logistical information
Focus remains on patient care Acquires data from: hospital
information systems phones and wireless devices phones and wireless
devices touch-screen input panels voice over IP badges barcodes
RFID scanners (StatCom 2008)
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STATCOM Emergency Department Bed Management Patient-Stay
Management Discharge Planning Hospital Support Services Business
Activity Monitoring Perioperative Services (StatCom 2008)
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USABILITY EVALUATION USABILITY EVALUATION Training minimal
Implementation months not years User friendly displays Cost
effective Information easily entered through touch pads (Staggers
2003)
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USABILITY EVALUATION USABILITY EVALUATION Proven to increase
patient & staff satisfaction Automatic time-stamp for patient
safety & security Real-time communication No written
documentation on HIPPA (Staggers 2003)
Slide 19
3M HEALTH INFORMATION SYSTEMS 3M HEALTH INFORMATION SYSTEMS
Used by all healthcare professionals Functions: Health information
management Documentation Creation Documentation management &
imaging Case management Revenue cycle management Performance
improvement Health information exchange (3M 2008)
Slide 20
3M Workstation configuration Healthlevel 7 data standard ICD-10
LOINC and SNOMED CT LOINC and SNOMED CT
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3M 3M From the research that has been done, this system would
be recommended because it has been around since 1983. 3M has over
55,000 products ranging from post-it notes, bandages, stethoscopes,
to computer technology.Their products and ideas are simple to use,
enhance and improve lives. From the research that has been done,
this system would be recommended because it has been around since
1983. 3M has over 55,000 products ranging from post-it notes,
bandages, stethoscopes, to computer technology. Their products and
ideas are simple to use, enhance and improve lives. (3M 2008)
Slide 22
ADVANTAGES OF PAPERLESS HOSPITALS Reduces medical errors
Prevents deaths by mistakes Alerts nurses to allergies Eliminates
hard to read handwriting Eliminates transcription errors 24 hour
access
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Slide 24
ADVANTAGES OF PAPERLESS HOSPITALS ADVANTAGES OF PAPERLESS
HOSPITALS Avoids duplicate ordering Time efficient Accurate billing
Automatic inventory replacement Patient satisfaction improvement
Prior treatment instantly available
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DISADVANTAGES OF PAPERLESS HOSPITALS DISADVANTAGES OF PAPERLESS
HOSPITALS Initial cost $500,000-$1,500,000 Ongoing costs Continuous
need for upgrades Reduced hospital revenue Difficult
transition
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DISADVANTAGES OF PAPERLESS HOSPITALS DISADVANTAGES OF PAPERLESS
HOSPITALS System failures Resistance to change Violation of HIPPA
Still generates paper
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(McCracken 2008)
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ETHICAL/LEGAL ISSUES ETHICAL/LEGAL ISSUES Access only to
employees with need Time and signature stamped Biometric devices
Voice recognition Retinal patterns Fingerprints Computer hackers
Legal rights
Slide 29
INFORMATICS COMPETENCIES OF THE PROFESSIONAL NURSE INFORMATICS
COMPETENCIES OF THE PROFESSIONAL NURSE E-learning based
competencies CEUs On job training MAGNET Recognition
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FUNCTIONS AND RESPONSIBILITES OF THE PROFESSIONAL NURSE
FUNCTIONS AND RESPONSIBILITES OF THE PROFESSIONAL NURSE Restrict to
relevant information Keep passwords safe and to self Patient
confidentiality
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FUNCTIONS OF THE INFORMATICS NURSE IN THE PAPERLESS HOSPITAL
SELECTS AND EVALUATES SOFTWARE TROUBLESHOOTS SELECTS NURSING
TERMINOLOGY TRAINS YEARLY COMPETENCIES
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SUMMARY The paperless system improves patient care and saves
billions of dollars, yet less than 20% of hospitals have gone
paperless. The ultimate goal is a nationwide network. Benefits
could reduce medical errors, redundant tests, and shorten length of
stays. Advanced computerized records can signal dangerous drug
combinations and potentially save a life.
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SUMMARY SUMMARY Files will be stored electronically, reducing
the storage space needed. Paperless hospitals goals are for all
health care workers to have access to all patient records from
anywhere in the hospital. Physicians also may have access to
records away from the hospital setting. President Bush has set a
goal for all hospitals to be paperless by 2014.
Slide 34
REFERENCES REFERENCES OmtoolLTD. (2007). YouTube. The cure for
paperitis-Creating the paperless hospital. Retrieved September 05,
2008, from youtube video Web site:
www.youtbe.com/watch?v=5fje4pehkt8
www.youtbe.com/watch?v=5fje4pehkt8 Schlesinger, A. (2003).
Paperless hospitals' popularity grows. Retrieved September 05,2008,
from CBS News Web site:
http://www.cbsnews.com/stories/2003/01/13/tech/main53626 7.shtml
http://www.cbsnews.com/stories/2003/01/13/tech/main53626 7.shtml
Conway, M. (2004). MSNBC. Retrieved September 06,2008, from Health
officials back paperless prescriptions Web site:
http://www.msnbc.msn.com/id/25787848/
http://www.msnbc.msn.com/id/25787848/
Slide 35
REFERENCES REFERENCES King, J. (2005). AHA News. Retrieved
September 05, 2008, from The Paperless Hospital -- Really ! Web
site:
http://www.computerworld.com/industrytopics/healthcare/story/0,10801,102387,
00.html
http://www.computerworld.com/industrytopics/healthcare/story/0,10801,102387,
00.html McGonigle, D, & Mastrian, K. (2008). Nursing
Informatics and the Foundation of Knowledge. Sudbury, MA: Jones and
Bartlett Publishers. Gately,(2008) iHealthBeat. Retrieved September
16, 2008, from Arizona hospitals use webcams to overcome language
barriers Website:
http://www.ihealthbeat.org/articles/2008/9/15/Arizona-Hospitals-Use-Webcams-
To-Overcome-Language-Barriers.aspx?topicID=89
http://www.ihealthbeat.org/articles/2008/9/15/Arizona-Hospitals-Use-Webcams-
To-Overcome-Language-Barriers.aspx?topicID=89
Slide 36
REFERENCES REFERENCES SNOMED. (2008). In Wikipedia Free
Encyclopedia [Web]. Retrieved October 2, 2008, from SNOMED. (2008).
In Wikipedia Free Encyclopedia [Web]. Retrieved October 2, 2008,
from www.wikipedia.com www.wikipedia.com 3M.(2008). Retrieved
October 4, 2008, from The spirit of innovation. Web site:
http://solutions.3m.com/en_UShttp://solutions.3m.com/en_US
McCracken, T. (2008). Retrieved September 19, 2008, from Cartoons
by T.McCracken. Web site: http://www.pioneer.net/~mchumor/
http://www.pioneer.net/~mchumor/
Slide 37
REFERENCES StatCom. (2008).Retrieved September 10, 2008, from
Patient flow logistics & tracking software Web site:
http://www.statcom.com/healthcare-technology/hospital-software.aspx
ANCC., (2008). MAGNET program overview. Retrieved October 09, 2008,
from American Nurses Credentialing Center Web site:
http://www.nursecredentialing.org/Magnet/ProgramOverview.aspx
http://www.nursecredentialing.org/Magnet/ProgramOverview.aspx
Associated Press. (2005, September 14). Promises, challenges of
digital medical records. Retrieved October 10, 2008, from MSNBC Web
site: http://www.msnbc.msn.com/id/9336861
http://www.msnbc.msn.com/id/9336861 Staggers, N. ( 2003). Human
factors: Imperative concepts for critical care. AACN Clinical
Issues14 (3), 310-319.