PHOENIX – Bob Sarnecki, CIO at Phoenix Children’s Hospital, one of the largest pediatric hospitals in the nation, figures the second time rolling out CPOE will be a charm.

Well, not so much “a charm,” as putting to work lessons learned from a previous implementation that resulted in many departments going back to paper. CPOE, computerized physician order entry, is critical to the hospital-wide deployment of its electronic health record system, Eclipsys Sunrise Clinical Manager, which the hospital completed last month.

The deployment of CPOE in 2002 resulted in two units – the primary care unit and the neonatal intensive care unit – continuing computerized order entry while the other units “caved in to paper,” Sarnecki said.

After a two-year phased rolled out, Phoenix Children went live with its electronic health record on May 5.
May 5 was what Sarnecki said was the hospital’s “line in the sand.” Today all units are live on the Eclipsys EHR and all units are using computerized order entry.

Sarnecki believes it will stick this time for a number of reasons, among them better training and better buy-in from the physicians.

On board at Phoenix Children’s is Vinay Vaidya, MD, chief medical information officer. Vaidya provides the clinical voice for IT strategies, and it’s made all the difference, says Sarnecki.

When Vaidya came on board in January, “everything changed,” Sarnecki said. “No matter what you do the physicians know you are an IT person,” he said. With Vaidya as champion, he said, physicians are more willing to adopt technology.

“The key thing was speaking the native tongue,” said Viadya, “speaking the physician language.” So, Vaidya paid attention to their concerns about the clinical work process and let them know their voices would be heard by the administration.

“They were a little worried of something being thrust on them,” Vaidya said.

The response from clinicians had been overwhelmingly positive, said Vaidya, who likened a CPOE deployment in 2002 to trying to use e-mail in the 1970s.

“The data is just amazing,” Vaidya said. “We know our world now.”

“We feel that CPOE handles the bread-and-butter functions,” Sarnecki said. “It’s a lot like Outlook, he said, referring to the Web-based, e-mail, calendar and contact system. “In our case, CPOE is Outlook,” Sarnecki said. “The wow factor is the content.”

With the EHR in place, Vaidya says his next focus will be “how to improve outcomes through IT.”
Sarnecki will move his focus to the ambulatory area and the IT demand expected to stem from new construction for radiology and orthopedics due for completion in 2011.

A study released in April by the healthcare watchdog organization The Leapfrog Group showed that only 7 percent of hospitals across the country have adopted CPOE.

“CPOE is challenging and it takes time, said David Bates, MD, chief of the Division of General Internal Medicine at the Brigham and Women’s Hospital in Boston.

“It is costly – typically representing the most expensive capital item for a hospital over a five-year period,” he said.
Sarnecki said Phoenix Children’s Hospital spent $2.3 million over the past two years on consulting and supplemental staff. The software costs were included in another package that was part of a 10-year deal.