|
| |
 
In order to facilitate decision making, the Informatics Center has developed a "straw man"
time line to illustrate how VUMC might sequence the development of information systems and technology
necessary to meet the recommended priorities described above. The timeline shows that
projects are sequenced fairly evenly over a five-year time horizon, assuming resource
availability. It is expected that this timeline will be modified regularly as decisions
are made at the institutional or other organizational levels about funding for individual
projects.
The timeline reflects the following factors:
- Current status of ongoing projects and infrastructure. Some recommended
high priority projects are already well underway. For example, aspects of the
computer-based patient record, electronic mail, network access, new billing systems.
- Project dependencies. Even though a project is one of high priority,
its implementation may well depend on the completion of prior projects to provide
prerequisite hardware, software, networks, or databases.
Impact: What will it mean to the people working, learning, or receiving care at
Vanderbilt if we are able complete the projects outlined in the five year "straw man"
sequence? The following scenario describes changes that could be expected year by year
in the clinical arena. Changes of similar magnitude could be expected in areas that affect
education and research.
December 1995:
- After entry of a single secure password, appropriate professionals will be able
to browse a patient's electronic medical record from any location: patient care unit,
clinic, office, home. The record will contain up-to-date copies of discharge summaries,
laboratory reports, anatomic pathology reports, and radiology reports. This record will
be available around the clock and maintained on-line indefinitely.
- Each practice group will be working regularly with reports that identify variations
in practice patterns that might be modified or eliminated to reduce cost and increase
quality. A computer program will expedite building collaborative care pathways from a
database of care steps, rapidly calculating the cost of alternatives. A set of forty-nine
data items, captured for each inpatient or outpatient visit, will be available as a
starting point for outcome studies within the practice groups.
December 1996:
- A flexible patient scheduling system will expedite movement of patients through
the clinic and hospital, making all Vanderbilt resources available through a single
telephone call. State-of-the-art systems will streamline back office physician billing
operations while eliminating redundant work by departments.
- Patient care orders will be entered directly into work stations by the appropriate
member of the care team. Information related to contraindications, drug sensitivity
profiles, less costly alternatives, etc., will provide decision support during the
process. State-of-the-art systems will allow the care team to tailor a collaborative
pathway to the patient and chart actions by exception reporting. Reports from ancillary
areas will print directly at the appropriate locations: the care unit, clinic, and/or
office of our affiliates. Providers will use flow sheets that are tailored to their
specific needs to streamline their work. Radiology images will be available at work
stations in emergency and the intensive care units. Information from the patient's
electronic medical record will be pulled together into a brief note at the time of
discharge for transmission to the primary care provider via electronic mail or fax.
- Each of the practice groups will work regularly with bench mark reports that allow
them to examine variation between their practice patterns and those of groups at other
institutions.
December 1997:
- Detailed information about patient management contract terms will be available
in a database. Determination of patient eligibility and authorization tracking will be
automatic whether a patient appears at home base or at an affiliate.
- Patient care orders will be generated and displayed for counter signature as a
patient is advanced on a collaborative care pathway. Patient problem lists will be kept
up-to-date on the work stations as part of the encounter and rounding process. Cross
coverage notes will be prepared rapidly by annotating portions of the patient's electronic
record.
- Professional services will be tracked as they are delivered and state-of-the-art
systems will automate processes in the operating rooms and laboratories.
- Each practice group will work regularly with reports that identify patient outcome
in terms of satisfaction and morbidity.
December 1998:
- A patient's course of care will be scheduled across different facilities in the
integrated health care delivery network.
- Annotation of information gathered from monitoring and treatment devices will
streamline charting in the intensive care units and operating rooms. Information from
patients' self monitoring tools will be fed directly into the patients' electronic records.
December 1999:
- Collaborative care pathways will be tailored to individual patients needs based upon
their problem lists. Regional care plans will outline the care process across the facilities
that make up the regional health care delivery system. Regional outcome databases will
support quality improvement and negotiations with payers.
- Progress notes and charting will be done on-line throughout the regional health care
delivery system. All radiology images will be captured digitally without the use of film.
Back to Informatics Center
Back to Top of Page
|
