HIMSS coverage: CPR shows royal colors at Queens Health Network

A successful computerized patient record implementation at Queens Health Network has earned the New York City hospital the 2002 Nicholas E. Davies Award. The award is given annually by the Healthcare Information and Management Systems Society for excellence in the pursuit of the ideal of improving patient care through better health information management.

QHN, which serves a population of over two million people in the New York City borough, became the first public hospital system to win the prestigious prize.

The goal of Queens' initial CPR software implementation was to gain the support of the medical staff by resolving the doctors' most glaring issues.

"For the first year of the project, attending physicians, as well as residents and midlevel providers directly supervised by attendings, were the only users of the system," said Diane Carr, Queens' assistant executive director, to a HIMSS audience last week.

Previously, in the paper world, physicians were required to document patient diagnoses three times: once in the physician's progress note, again on the summary required by the Joint Commission on Accreditation of Healthcare Organizations for patients receiving continuing ambulatory care, and a third time on the billing form.

The HIS Patient Problem List collapsed the three steps into one automated process.

"Long-standing complaints by physicians under pressure to see a high volume of patients - and loath to duplicate efforts seen as bureaucratic and of little value to patient care - were immediately addressed," Carr said.

PCs and printers were installed in every exam room across the network to provide immediate access to legible patient information. The implementation of the electronic Patient Problem List immediately reduced duplicate documentation required by payers and regulatory authorities.

"We began not only with computerized physician order entry, but also with clinical documentation in ambulatory care," Carr said.

Now, all physicians at Queens contribute documentation to the paperless primary-care chart:
? patient diagnoses
? patient and family medical histories
? physical examinations and reviews of systems
? patient assessments and care plans
? progress notes
? medication prescriptions and renewals
? referrals to specialists, including orders for all diagnostic tests and procedures

The QHN CPR includes digital radiography and an Agfa PACS, as well as voice recognition, replacing film with digital images available at every clinical desktop.

"This has dramatically reduced the percentage of studies never read, as well as the time required to issue radiologists' reports," Carr said.

The result is 100% image availability to clinicians, faster interpretations, less repeat x-ray exposure to patients due to misplaced films and duplicate procedures, faster patient discharges, and better teaching opportunities for residents and fellows.

More than 1600 physicians and clinicians access the system daily. In the ambulatory care area alone, the system is used to document approximately 3000 patient visits daily.