HIMSS coverage: CPR moves into the fast lane

Those in a hurry to implement a computerized patient record can try following the Cleveland Clinic, which deployed a CPR to 30 of their clinics in 100 days.

"The project was established in August 2001, and all sites were completed by the end of the year," said Nancy Folz-Murphy, regional director of clinical applications, in a presentation Tuesday at the Healthcare Information and Management Systems Society meeting.

While this schedule may sound ambitious, it was actually a compromise between Cleveland Clinic's desire to proceed quickly and a realistic assessment of available resources.

"The more physicians using the system, the more benefit to each patient and physician, and to the overall organization," she said.

The rapid deployment strategy used for this project was successful due to strong leadership, sheer determination, and physician buy-in.

"The goal of the project - to improve timely access to patient data to help all facets of patient care and do this with minimal disruption of services - can't be achieved without full physician participation," Folz-Murphy said.

The project chair quickly established CPR guidelines and a steering committee composed of one physician site champion from each satellite clinic. The steering committee would not have been effective without strong participation by physician site champions, Folz-Murphy said.

"The site champions became strong advocates for the project," she said. "But they didn't let their enthusiasm cloud their judgment or diminish their support for the concerns and challenges raised by the practices at their sites."

Still, the chair heard the usual complaints from those recalcitrant physicians who wanted it understood they didn't go to medical school to become computer programmers. A transition model was developed to relieve the anxiety that all patients would have to be entered in the CPR on the first day.

"Instead, it was expected that initially, physicians would enter only one of three patients in the CPR, generally choosing simple, routine patients, such as sore throats," Folz-Murphy said.

By the end of the first week, though, it was expected that 50% of the patients would be in the CPR, and 100% by the end of the second week. After the dust settled from the whirlwind implementation, the benefits were clear to for all to see.

"If given the choice today, the physicians would not let us take this system away," Folz-Murphy said.