SALT LAKE CITY - Medical errors continue to exact a highly publicized toll on the healthcare system in the U.S., both in patient mortality and dollars. As more and more states introduce legislation to deal with the problem, information systems firms are developing alerting software that connects patient information to the people who need it, in hopes of reducing the incidence of medical error.
One of these companies, Sunquest Information Systems, hopes to address the problem with a new product launch at this week’s Symposium for Computer Applications in Radiology in Salt Lake City. The Tucson, AZ, company is introducing a radiology version of its Clinical Event Manager (CEM), an open-platform communication system that issues alerts and other messages via e-mail or pager.
"Doctors and technologists often don’t have the patient information they need," said Dave Jones, software development analyst. "They spend hours every week tracking down the pharmaceuticals the patient is taking and lab results relevant to the patient’s care. Expert-rule systems for pharmacy, laboratory, and diagnostic imaging interactions can help hospitals handle everything from adverse events like severe allergies that lead to coma, to inappropriate decisions about a particular patient’s medication or even meals."
Since the Institute of Medicine report detailing the cost and mortality of medical errors was released in 1999, 15 states, including Arizona, California, Florida, Massachusetts, New York, and Washington, have proposed legislation to deal with medical errors. California has already signed into law requirements that its hospitals must design and implement a plan to mitigate medical errors by 2005.
The stakes involved are high -- and not just for patients. Some lawmakers are considering rules that would link compliance to medical error legislation to a facility’s accreditation by the Joint Commission on Accreditation of Health Organizations (JCAHO), the entity that allows hospitals to function.
Although artificial intelligence and expert-rule technology have been in use in defense applications at least since the early 1980s, it’s only in the past five years that they've been applied to healthcare problems, according to Sunquest. Introduced in 1997, CEM has been used in laboratory and pharmacy departments; in 1999, the company began looking at radiology, conducting a survey of its client base to determine what were common medical errors or inefficiencies of care within their imaging departments.
Potential scenarios, or rules, that could lead to medical errors included the following:
- Pregnant patients receiving nuclear medicine studies.
- Patients with known allergies to a particular contrast agent receiving that agent in a diagnostic exam.
- MRIs being ordered for claustrophobic patients or those with metal fragments or pacemakers in their bodies.
- Patients receiving incorrect doses of a prescribed medicine because of shift changes or lack of communication between doctors and staff.
- Technologists being difficult to track down in critical situations because they are making rounds with portable x-ray machines.
From its survey results, Sunquest estimated that a mid-sized hospital could save up to $478,000 per year if technology like CEM were used.
Since it has open architecture, CEM can be used with a hospital’s existing IS network, whether regardless of whether or not it was developed by Sunquest. Hospitals can choose to have CEM installed at their facility, or can subscribe for services through Sunquest’s ASP division, e-Suite, according to the vendor.
"CEM allows all of a hospital’s departments to communicate with each other," Jones said.
If installed at a client site, CEM plugs into the hospital’s HL7 server and begins to read data sent over the network, searching for combinations that match its rules base. If there is a match, the data is stored until the expiration date for that particular information is reached. CEM delivers the matched data to the hospital’s e-mail or paging system within three minutes, and is then routed to the party requesting the information.
For security, CEM breaks the message into distinct segments and transmits them on different paths, reconstituting the data when it reaches the recipient’s unit. The alerting system has more than 500 built-in rules that can be edited or expanded, according to the client’s needs. Currently CEM is installed at seven sites, with 168 subscribers, or parties, requesting information matches.
In addition to highlighting CEM on the SCAR exhibit floor, Sunquest is showcasing its information products suite, which includes FlexiLab and FlexiMed, in addition to FlexiRad, its radiology information system. Upgrades to FlexiRad at the show include Web-View, a program that allows radiologists to view, edit, confirm, and sign reports for patients over the Web.
Sunquest will also highlight an integrated program that creates a procedure history report, allowing FlexiRad users to determine exam times, dates, events, and who performed a particular scan.
The company is also highlighting FlexiRad’s voice recognition capability, thanks to the vendor's January partnership with Talk Technology. Sunquest has 45 radiology contracts for FlexiRad, which is installed at more than 119 sites across the country.
By Kate Madden Yee
AuntMinnie.com contributing editor
May 3, 2001
Related Reading
Sunquest to unveil Diagnostix.com portal, February 12, 2001
Sunquest, Talk Technology reach VAR agreement, January 5, 2001
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