Streamlining preoperative care: role of software.

A 65-year-old man with heart disease schedules a knee arthroscopy with his orthopedic surgeon. Thirty miles away, a note pops up to notify the hospital's presurgical clinic of the impending surgery. A nurse practitioner pulls up the patient's electronic health record (EHR), where she reviews the patient's history. Comparing the history with the preop screening criteria, she can see the patient needs to be seen in person before the day of surgery. An appointment is scheduled and preop tests ordered using the clinic's standing order set. At Geisinger Medical Center, part of an integrated health system based in Dan-ville, Pennsylvania, named 9 times to Hospitals & Health Networks Most Wired list, the preop preparation is largely paperless. " All of the clinics are up on Epic [the software platform], and we can exchange information in real time, " says Cindy Bird, BSN, RN, clinical director of the 28-OR main surgical suite. Even from medical clinics in neighboring cities, " we can pull up the patient information and see what was done during the clinic visit. " The result: a more accurate record at clinicians' finger tips, huge time savings, and powerful capabilities for reporting data on case delays, cancellations, and other met-rics. Once hospitals and physicians' offices share compatible EHRs, many cumbersome steps in the preop process−gathering faxes, rounding up lab results, and chasing down missing consents−will go away. Most organizations aren't there yet. Less than half (43%) of respondents in the 2011 Most Wired survey could share a continuity-of-care document across MD offices , hospitals, and other providers. The government's health IT initiative and the trend toward health systems' acquisition of physician practices are helping to move these initiatives forward. The trend, says David Young, MD, an anesthesiologist with a long interest in preop automation, is to have a single IT platform that enables patient information to flow seamlessly from physicians' offices and clinics to the hospital, where the patient's entire EHR is available in real time to any clinician treating the patient. " In a community, if you have a continuously shared EHR, it is an immense advantage , " he says. " Being able to see the whole continuum, the patient's history and all of their labs, just makes sense. " That's why, he says, a number of organizations are adopting EHRs from Epic Systems, which offers a single outpatient-inpatient platform. Epic was rated the top overall …