New hospital information systems transform patient safety programs and delivery of services

October 13, 2008

The Soarian information management system will enable Virginia Hospital Center to revolutionize every aspect of patient information management.

Key Points

The hospital, which opened a $150 million facility four years ago, is launching a medical information system named Soarian, manufactured by Siemens Medical Solutions. Due to begin operation next year, it includes clinical, financial, physician order management, scheduling, internet portal and health information management applications - as well as individual electronic patient medical records. A significant safety component is a best-practices checks and balances database founded on information provided by Zynx Health and customized by hospital physicians.

Soarian's pharmacy component will automate, track, and provide quality assurance at each step of the ordering, dispensing, and administration process. "The principle behind the entire design is the enhancement of patient safety," Anderson said. "Everything we've done, every decision that has been made about what to do and how to accomplish it, has been to implement technology that will eliminate medical errors."

Martin points to Soarian's critical results notification function as an example of the safety advantage inherent in a fully-integrated system. Appropriate medical staff, including pharmacy, can be notified and mobilized by e-mail, pager, and cell phone in the event of a patient emergency, and referring physicians can be contacted immediately if results of a diagnostic screening require a response. Radio frequency armbands track where patients are in the hospital and which services they are receiving at any given time. And digital archiving allows physicians to access medical records and imaging studies from anywhere inside the hospital or from home.

The most important safety enhancement as far as pharmacy is concerned is the implementation of single-dose bar-coding, integrated by Soarian into a hospital-wide information database."

Soarian is being implemented in stages. The computerized physician order entry (CPOE) component won't go online until 2010. Until CPOE is implemented, medication orders will be scanned at nurses stations using Soarian technology and electronically transmitted into patient medication administration records at pharmacy workstations.

Anderson's staff is now customizing a MAR drug safety and protocols database for Soarian, with a foundation based on available data from First Data Bank and others. The system's work flow engine will be capable, therefore, of generating pop-up alerts for possible drug and food interactions, dosage problems, contraindications with a patient's existing medications, and other safety flags at the MAR level. In some cases, the system may suggest an alternate medication in view of a patient's medical history.

The pharmacy will see some significant changes well before CPOE is online. One application being installed is a robotics system manufactured by Swisslog, named PillPick, that will automate the packaging, storage, and dispensing of tablets, capsules, ampoules, vials, cups, and syringes. Once bulk medications are packaged in bar-coded, unit-dose form, they will be stored in a high-density robot that can accommodate thousands of unit doses. When meds are needed, unit doses will be pulled from the robot into a unit that assembles patient-specific, 24-hour medication orders, arranged alphabetically or by order of administration. A bar-coded tag specifies the drug, administration time, and other patient-specific information.

A significant innovation is also occurring at the administration level: Anderson and his staff are designing medication-dispensing cabinets for each patient room. Right now, the hospital stores medications in Pixis units on each of four patient floors. Once the cabinets are installed, medications will be dispensed from the pharmacy and distributed to the in-room cabinets.