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The handheld form allows the pharmacist
to build consultation records for individual patients. Pharmacists
can select from thousands of different medications, which
are grouped by class (i.e., antibiotics, painkillers, and
stomach medicines) and then alphabetically. Pharmacists
can also specify the type of intervention required, such
as screening for allergies or to ensure that an antibiotic
is appropriate. Warning flags guard against duplicate therapy,
which can occur when multiple physicians are taking care
of one patient.
At the end of the day, pharmacists synchronize
the consult and medication intervention information captured
on their handhelds with the Pharmacy department's desktop
Access database. Any changes to a patient's medication therapy
are documented in the hospital's central information system.
Through the efficiency and ease of the handheld forms, the
number of pharmacist consultations has increased nearly
600%. "Because the process is so convenient, we have
much more time to perform consults," Lawton explains.
He can also easily update the form as
needed, for example to expand consultation categories, add
a new medication, or add a new floor to the drop down list
of locations. Forms are updated automatically using a Visual
CE option that copies updates to the handheld during synchronization.
Tracking Customer Service
With
the success of the consulting pharmacist application, Lawson
has started using handheld computers and Visual CE to streamline
some of the department's other functions. One example is
an application he developed for collecting and processing
customer service information. (In the hospital, "customers"
refers to physicians and nursing staff.) The Pharmacy department
conducts monthly customer satisfaction surveys and found
that overall satisfaction with pharmacy services has increased
about 25% since the tracking program began.
The application tracks service requests
from the time medication orders are received through preparation,
packaging, and delivery. As pharmacy technicians take orders
and make deliveries, they document events on a handheld
computer on their belt. "The user friendly forms capability
on the handheld allows us to easily track our customer service
data. If we had to write all that material down, we would
never be able to do it," Lawton adds.
Technicians sync customer information
to the central Access database, where average turnaround
time can be measured by factors such as medical specialty,
hospital floor, and type of medication. By tracking this
data over time, the Pharmacy department can validate the
quality of service as well as identify opportunities for
improvement. For example, some medications take significantly
longer to prepare, impacting delivery times - information
that can now be shared in advance with caregivers.
With the ability to track performance
over time, Lawton has found that the department is doing
a much better job in terms of order turnaround. "Our
technicians realize that quality service is important, and
they're trying harder at it. They're taking real pride in
trying to do a better job and turn medication orders around
faster and provide good customer service."
Monitoring Drug Utilization Trends
The latest Visual CE application is
being used to track drug utilization trends within the hospital.
The Pharmacy department conducts studies to identify changes
in medication usage that can improve the quality of patient
care or provide more cost-effective treatment. Typically,
pharmacists will visit patients taking a particular medicine,
review their charts, and gather all necessary information
to assess whether utilization of the medicine is appropriate.
The application captures information such as why a particular
medication was prescribed, the dosage, the patient's age
and physical condition, and how the patient responded to
the therapy.
At the end of the day, the pharmacist
synchronizes the medication data to the Pharmacy department's
central system at the same time as their consulting records.
A medication usage database is aggregated over time, and
provides the ability to generate reports by patient demographics
and medical conditions. Lawton or his staff present their
findings in the hospital's medical committee meetings, and
recommend changes in the utilization of the medication when
appropriate.
Branching Out
Lawton has become recognized throughout
the hospital as the handheld expert, with numerous potential
applications under consideration in different departments.
For example, emergency room physicians are intrigued by
the idea of using handheld forms to manage information and
provide decision support. In a sample scenario, a physician
seeing a patient with pneumonia would enter their age, weight,
test results, and any pre-existing medical conditions. The
application will then respond with the correct medication
and dosage - saving valuable time and helping prevent errors.
Another application under consideration
would assist triage nurses who see patients when they arrive
at the emergency room. A handheld form together with decision
support software would help the nurse assess how quickly
each patient needs to be seen, and prioritize their care.
The nurse would use a handheld form to capture patient information
such as age, primary complaint, medications they are taking,
and other medical conditions. The decision support software
would then make a recommendation, such as whether the patient
must be seen immediately by a specialist, or if their condition
can wait while the medical staff cares for more serious
cases.
Thanks to tools such as Visual CE, Lawton
is convinced that handheld computers will become ubiquitous
in hospital settings within a few years. "Visual CE
helped open our eyes, and now we see that we can automate
many routine tasks. There are all kinds of applications
- the potential is huge."
For further information, contact:
Frank Yacano, Director
of Business Development
SYWARE, Inc.
PO Box 425091, Kendall
Cambridge, MA 02142 USA
+1 617.497.1300
Fax: +1 617.497.8729
Email: frank@syware.com
Visit
SYWARE's Visual CE download page.
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