Emergency Department Takes Center Stage

I can’t remember if it was 3rd grade or 4th grade, but fractions were a whole new world to me as a student at Cedar Grove Elementary in Damascus, Maryland many years ago. Turns out fractions have been a big topic the last few weeks as well, as the final rules on Meaningful Use were published.

The biggest gotcha? CPOE counts in the ED. Surprised? Those focused elsewhere felt blindsided, while others cheered. The big deal is how this counts in the fractions game. With high volumes in the ED, the “patient denominator” goes way up. If you are automated there, it seems you can rest easy with those orders getting you over the threshold. Those sites that seemed to be in the driver’s seat, with high CPOE rates in the rest of the hospital, are now scrambling to figure out how to get orders going in the ED or else they won’t have enough of their patients with an electronic order. Interestingly enough, there is a significant tie in to your core clinical vendor on what side of the fence you are on.

The problem? Most of the enterprise vendors have early solutions for the ED (some seemingly in the PowerPoint stage), with only mediocre CPOE adoption (Siemens, McKesson, Eclipsys, GE, Meditech, QuadraMed). Some of these customers are using best of breed solutions from Wellsoft, Picis, T-System, MedHost, Allscripts, etc. and are finding good success. But, these can’t scale to the rest of the hospital, creating an inherent difficulty in getting to real MU. Build the interface, build the CPOE system twice, build the workflow…build, build, build. Rock and a hard place anyone?

So…Siemens Soarian customers may test Soarian’s flexibility by plugging in the CPOE module in the ED. McKesson customers may debate whether Horizon Emergency Care is ready for them and how soon it can be installed. Meditech customers may wrestle with their ED physicians on whether the ED module can meet physician needs. Eclipsys customers with deep adoption outside the ED may speed up plans for Sunrise Emergency Care. It’s a topsy turvy world, with these fractions just turned on their heads.

KLAS is speeding up current research on the ED. It will be out in October. Need a preview? Just give us a call.

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