Presbyterian Intercommunity Hospital recently went live with a centralized pharmacy information system that hospital executives say will help close the medication loop.

The 444-bed acute care hospital implemented Sunrise Pharmacy software from Atlanta-based Eclipsys. By replacing paper processes with an automated system, the hospital also initiated a system-wide electronic medication record (eMAR) to boost communication, speed and accuracy in dispensing medications.

The implementation marks a critical step toward a closed-loop medication process and builds upon the Whittier, Calif. hospital’s adoption of Eclipsys’ computerized physician order entry (CPOE) solution last year. With 300 active physician users, Presbyterian claims CPOE adoption rates of approximately 99 percent.

“The activation of the medication management solution is a natural progression in our strategic plan to replace inefficient and often illegible handwritten orders with enabling technologies that support improved clinical workflows, clinical decision making and accuracy,” said Davis Lee, MD, the hospital’s medical director of informatics. “The tight integration between the Eclipsys CPOE solution and the pharmacy system has eliminated the need to manually transcribe nearly 2,000 medication orders placed daily. It’s made a dramatic improvement in the pharmacy department workflow and it is an essential step toward providing truly excellent patient care across environments.”

Alan Endo, Presbyterian’s director of pharmacy, said Eclipsys' CPOE system has helped reduce medication delivery time by 60 percent, from an average of 60 minutes to 24 minutes.

“Our daily pharmacy processes have been dramatically changed,” he said. “Instead of deciphering handwriting, we receive orders that are easy to read and very clear, and the order sets reflect evidence-based guidelines for medication protocols. We’ve been able to redeploy resources to focus on using the pharmacy system to improve patient safety and clinical pharmacy services. Plus, the system is such that you can constantly make enhancements and take advantage of its rich safety check features.”

Adoption goal set at 100 percent

Presbyterian officials set a goal of 100 percent adoption with its big-bang activation of Eclipsys’ CPOE solution, Sunrise Acute Care. They said strong physician and nursing leadership and a focus on physician workflows helped to ease resistance among affiliated physicians and enabled the hospital to take away all paper order forms on day one.

“Our deep CPOE adoption rate is attributable to the collaborative environment between our informatics department, the adoption committee and the clinical decision support committees,” said Lee. “We made it a priority to map out physicians’ workflow, including those of specialties, to overcome fears that the system would slow down order entry. What physicians eventually found is that the Eclipsys CPOE solution actually enabled them to expedite placing orders because it would allow them, for example, to click on 50 orders from an order set, versus placing them individually.”

“Because CPOE fundamentally changes the ordering process, it can substantially decrease the overuse, under-use and misuse of healthcare services," said Jay Deedy, Eclipsys’ executive vice president of client solutions.

He said Presbyterian exemplifies the concept that deep CPOE adoption – close to 100 percent within as little as 15 months – is achievable, even in community hospitals.