As we approach the year 2000, picture this scenario:
A doctor at Thomas Jefferson University Hospital steps into an inpatient room in the Gibbon Building to greet a patient recovering from surgery. While chatting with the patient, the physician clicks on a lightweight wireless laptop computer he or she carries.

Within seconds, the patient’s “MAR” (Medication Administration Record) shows on the screen. The doctor completes the patient exam, keys in a new medication order, orders a new round of blood tests, updates the patient’s nutrition order and requests a consultation. After more bedside conversation with the patient, the doctor moves on to continue patient rounds.

Sound futuristic? Not really.

With training of more than 4,000 Jefferson staff and employees completed in Phase I of the new LastWORDŽ Information System, Phase II is now under way to facilitate patient care uses by physicians and nurses at Thomas Jefferson University Hospital.

Electronically linked and driven, LastWORDŽ is a powerful new clinical information system focusing on the patient and permitting ease of access by doctors, nurses and technicians.

“The primary goal of LastWORDŽ Phase II is to implement automated physician orders and to begin incrementally to add clinical documentation to our electronic record,” says Mary McNichol, Assistant Director, HealthLink Information Systems.

What It Means for Doctors and Patients
This means doctors will be able to order electronically the entire range of care directives for inpatients including medication, laboratory tests, radiology studies and nutrition orders as well as consultations with other physicians or social workers, explains Linda Gehring, RN, MPH, Assistant Director, HealthLink Information Systems. Moreover, the results or outcomes of all such physician orders will be electronically stored for follow-up access.

Logging on with individually assigned passwords – each physician’s “electronic signature” – doctors can place their electronic orders from any of various locations, including patient bedside, nursing stations and physician offices. And each patient’s Medication Administration Record (MAR) will be updated electronically and be available to all caregivers from these same locations.

Following an October 21 kick-off, LastWORDŽ Phase II is expected to take 14 months of planning, screen tailoring and workflow redesign, says Ms. McNichol. In February 2001, the new software will be introduced in the North Center patient wing on Gibbon 3, selected as the first pilot unit in part because it generates a large number of varied physician orders.

The remainder of the rollout plan, involving combinations of Medical Staff physicians and nurses, will be determined from analysis of the pilot results, says Ms. Gehring. Establishing an ordering process that is standard and consistent for all users is key to success, she adds.

Also participating in Phase II planning were Margaret Cunningham, RN, MSN, Julie Frissora, MS, RD, Eleanor Gates, RN, MSN, Clint Holumzer, MD, Joanne Lowry, Sharon Millinghausen, RN, MSN, Bart Murtaugh, Lori Ross RN, Stephen Scholand, MD, Barbara Schraeder, RN, PhD, Joan Tannebaum, LSW, Dennis Traeger and Sandra Weibel, MD.

LastWORD Phase II Project Teams
All training and implementing of LastWORDŽ Phase II are expected to continue into the year 2002. Six project teams are carrying out its design and implementation:

Ancillary – for coordinating orders with ancillary systems such as lab, dietary and radiology, and for documentation of improved workflow supporting an automated orders environment.
Pharmacy – for transition to physician orders, and the changes brought about by going to an electronic medication administration record.
Patient Care – for nursing unit transition from a paper-based to automated workflow, including the Medication Administration Record.
Physician Orders – for automated physician orders, including ordering of consults, workflow changes, design of order screens and implementing electronic signature.
HealthLink Technical – for new report and online printing requirements, and for coordinating orders and hardware.
Workflow Process Improvement – for review and efficiency of workflow by all involved departments to support optimal care delivery.

For questions about LastWORDŽ Phase II contact the Co-Project Managers for Phase II – Mary McNichol at 5-8431 (Mary.McNichol@mail.tju.edu) or Linda Gehring at 5-9866 (Linda.Gehring@mail.tju.edu).

News Briefs | Photo Album | Calendar | Announcements | Notables