How smart pump EHR integration could save a community hospital $2 million
Dave Baumgardner, chief information officer at Dover, Ohio-based Union Hospital, said there was one primary driver for the decision to link the hospital's 160 or so smart infusion pumps with its Meditech electronic health record system.
"First of all, for patient safety and quality," said Baumgardner. "Those were the main drivers. Our director of pharmacy has been a strong advocate of this for years."
Beyond the safety that automation provides, however, there were financial benefits for the project. It streamlined nursing workflow, he said, and in doing so enabled big savings.
The reduction of manual inputs has led to time efficiencies, and more accurate billing of medicine start and stop times has obvious benefits to the community hospital's bottom line.
"Cost savings from enhanced charge capture and reimbursement opportunities are about $2 million a year," he said.
The initiative was enabled by a recent partnership between Hospira, which makes infusion pumps, and Iatric Systems, which specializes in interfaces and interoperability.
Iatric's Accelero Connect technology enables two-way data exchange between devices and EMRs. Combined with Hospira's MedNet software, the integration can create efficiencies and quality improvement.
"On the clinical side, we're sending IV medication orders from the EMR to the infusion pump, which significantly minimizes the chance of human errors and helps improve patient outcomes," said Iatric President Frank Fortner in a statement when the partnership was announced this past December. "On the financial side, we're sending start times, stop times, and other infusion details from the pump back to the EMR, which saves nurses time and may improve hospital reimbursements."
"When Iatric and Hospira approached us about developing this, and being a beta site for the Meditech project, we jumped right on it," said Baumgardner.
Pursuing a project like this depends on strategy and collaboration.
"You need to assemble a very strong team, led by pharmacy, nursing, clinical informatics," he said. :With strong support from IT, quality education and executive sponsorship, including the CMO."
Robust Wi-Fi is also a must. "We have a strong wireless implementation across the hospital and had been certified a couple years ago by Hospira – and we just redid that certification this past summer," said Baumgardner. "From a technology standpoint it's best to be on one standard pump and have your wireless network certified to make sure you don't have any holes there."
He said one of the trickier hurdles so far has had to do with understanding of "how the smart pumps interact with the wireless technology when they're online, when they acknowledge the network."
Challenges such as those show why stakeholder involvement and careful planning are so important, he said.
"It's important that when you do have some hiccups, some hurdles in the implementation, that you keep the nursing staff engaged and not lose any of that momentum," said Baumgardner.
"We've had a couple hurdles in that area – some connectivity issue with the pumps. with the server losing that connection," he said. "The nurses were forced to do a manual entry. Expect some hurdles to happen in that rollout process. You want to have your IT staff involved so you can do testing in those locations with a nursing informatics specialist and the staff – work out those bugs and address them immediately."This was a huge project, but has been worth it on both the clinical and financial side, said Baumgardner, and the lessons learned along the way "reinforce the importance of having a cohesive, collaborative, communicative group between IS, nursing and pharmacy on these types of projects. You need that strong foundation and a commitment to making this a success."
This was a huge project, but has been worth it on both the clinical and financial side, said Baumgardner, and the lessons learned along the way "reinforce the importance of having a cohesive, collaborative, communicative group between IS, nursing and pharmacy on these types of projects. You need that strong foundation and a commitment to making this a success."