Centra makes top 100 ‘most wired’ hospitals list

A trade journal this month named Centra one of the 100 most wired hospitals and health systems in the country.

“Wired” is a descriptor for the hospital’s capacity to use electronic means to achieve in an instant what other hospitals are doing in hours of paperwork.

Becoming one of the electronic elite didn’t happen overnight.

“We started on a path back in 2003 and started laying in an infrastructure as well as the technology to get ready for this,” said Ben Clark, Centra’s vice president and chief information officer.

Wired systems range from voice-recognition phones and electronic physician order entry to barcode pharmacy transactions and radiology images.

For example, at the nurses’ station in the oncology unit at Lynchburg General Hospital, Jennifer Claybrook, R.N. touches the button on the phone she wears attached to her jacket. The caller simply says the nurse’s name into the phone system — no numbers needed — although they’ll work, too.

The system recognizes voices. Using it cuts out intermediaries needed to search for the nurse, give her the message to return the call to find out the question.

Another application: If a patient asks for pain medication, explained Valerie Holmes, R.N, the nurse can use the wireless COW (computer on wheels) and view when the patient last received pain medication.

The nurse can look up the orders entered by the doctor, get the exact medication dose from the automatic dispensing machine, and take it to the patient.

At the bedside, she will scan the patient’s identity wristband, then double check by asking the patient for two personal identifiers, scan the bar code, and match it to the doctor’s orders.

But if the medication is the wrong dose or wrong type — or if it is the wrong patient — an error message warns the nurse. If everything is correct, the medication is entered in the computer and instantly becomes part of the record.

Without it, the nurse would be rifling through a stack of papers to find what she needed, and always aware that important information might not yet have been entered.

A wired hospital has physicians write orders directly into the computer, something that improves patient care and safety, said Dr. John Paul Jones, a Centra emergency department physician working for the past two years on the wired transition.

Physicians are dealing with an ever-enlarging body of knowledge. A system that instantly supports decision-making helps patient care, he said, whether it’s an antibiotic choice for a particular viral pneumonia or choices among lab tests needed.

Nationwide efforts started in the 1970s, but only made inroads during the 1980s and ’90s, and then primarily in university settings with tenured physicians.

Jones noted that only about 2 percent of the community hospitals in the nation have made such a conversion.

Centra is a community hospital, where physicians are customers, partners and employees, Jones said.

“It’s harder to cater to a diverse group of needs,” he said. “The practice of medicine is an art and a science, you don’t want the technology to take away from the art. You want it to support the science and support how the

physician thinks.”

Centra began the transition as a technical pilot with a group practice of psychiatrists in 2007. In February, the 15-member hospital medical group began using the system; now the program is underway among physicians working with patients in the medical intensive care unit.

Physician order entry clears up potential pileups — such as entering an order “knee X-ray” without saying which of the three possible is needed. With the electronic order, the pick list requires the specific view “and the information goes directly to radiology,” Jones said.

Ordering medications means also getting instant information on potential drug interactions, or side effects. Then the physician can decide if the benefits of that medication outweigh the risks for the patient because there might not be any other choice.

Centra handles 290,000 doses a month.

Jones was pleased to see Centra get the wired nod. “It’s good to get the recognition, but what’s a lot neater is seeing the physicians use it.”

Planners at Centra made the technology shift deliberately and quickly.

“Our systems were getting older, said Terri Ripley, director of information services. A decision had to be made, and rather than putting in sporadic upgrades, as parts of the old system failed, they opted to go with a single system, McKesson, which has a variety of applications for hospitals use.

Clark said in October 2005, Centra put in 24 applications from McKesson and also redid the wireless infrastructure.

“Twenty-four applications at one moment in time — all 5,000 users, both hospitals,” Clark said.

“They were able to execute the foundation of today’s system in a three-year window, said Peggy Pollard, R.N., director of clinical informatics. “We’re now deploying advanced technology.”

most wired 

- Centra of Lynchburg was recognized as one of the 100 Most Wired Hospitals and Health Systems in the nation. The honor went public in this month’s edition of the Journal of the American Hospital Association’s Hospitals & Health Networks H&HN magazine.
- Centra also earned the 2008 VIP Award by McKesson Technology Solutions for Centra’s feat of installing 24 new applications successfully at once.