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Improving Patient Handoffs at University Hospitals

Most Electronic Health Record users are forced to wait for the next upgrade to extend their system’s functionality.  At University Hospitals in Cleveland, we’re fortunate to use Sunrise Clinical Manager (SCM), an EHR that gives us a lot more flexibility.

With SCM we’re able to make the changes we want ourselves, by leveraging Medical Logic Modules (MLM) — a kind of artificial intelligence that queries the underlying EHR database and, depending on the if-then logic that you create, triggers advanced clinical decision support. Like the apps that make your smart phone smarter, these packets of artificial intelligence have improved patient care and even made our caregivers happy (no easy task for an IT team).

Our team has launched many MLM-powered innovations across the eight UH hospitals that use SCM. But I want to talk about just one: a patient handoff tool that adds safety to transitions of care.

We’re all aware of the potential dangers of patient hand-offs. The handoff is the time health care workers change shifts and the care of a patient is handed to a new set of doctors and nurses. It’s said to be among the most risky and error-prone times for a patient. Hospitalized patients are passed between doctors an average of 15 times during a single five-day hospitalization. If medication allergies or other vital information isn’t communicated or heard, the results can sometimes be disastrous.

UH has been able to substantially improve the hand-off process by deploying a special MLM-based tool within SCM.  Originally created for Sunrise users at NewYork-Presbyterian Hospital, and nicknamed “HOT” by our clinicians (for hand-off tool, of course), the solution automatically pulls patient data – nurse documentation, orders, medications – and displays it in an easy-to-read format in a special tab inside the EHR.  Now when caregivers start their shifts, one of the first things they do is open up the HOT tab to get a clear picture of the patients they’re responsible for.

HOT is one of the most popular applications in all of UH. We gave it to the residents but then the nurses and the attending physicians wanted it.  Today it’s practically their Bible.

While our IT team has created many MLMs ourselves that have made SCM better, what’s remarkable about HOT is that it’s the fruit of a rich interchange of MLMs between hundreds of SCM hospitals.  With the help of the Allscripts ClientConnect online community, we’re able to save time, resources and effort using a solution that another Allscripts client developed. And we’ve helped countless other SCM hospitals to add new capabilities to the EHR that we created. 

This process looks a lot like a virus moving from organization to organization. But thanks to the underlying open architecture of SCM, it’s a virus that benefits thousands of providers across the country.

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