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    Children's National Medical Center
    This document provides a historical review of the evolution of clinical technology at Children's National from 1993 to 2008. It summarizes the transition from early use of "dumb terminal" computers to access lab results to the implementation of an interactive clinical system in 1997 that included order entry, billing, and nursing informatics. It describes the phased implementation of computerized physician order entry, clinical documentation, pharmacy systems, and other technologies over time to achieve a fully digital system by 2008.

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    This document provides a historical review of the evolution of clinical technology at Children's National from 1993 to 2008. It summarizes the transition from early use of "dumb terminal" computers to access lab results to the implementation of an interactive clinical system in 1997 that included order entry, billing, and nursing informatics. It describes the phased implementation of computerized physician order entry, clinical documentation, pharmacy systems, and other technologies over time to achieve a fully digital system by 2008.

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    This document provides a historical review of the evolution of clinical technology at Children's National from 1993 to 2008. It summarizes the transition from early use of "dumb terminal" computers to access lab results to the implementation of an interactive clinical system in 1997 that included order entry, billing, and nursing informatics. It describes the phased implementation of computerized physician order entry, clinical documentation, pharmacy systems, and other technologies over time to achieve a fully digital system by 2008.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    47 views8 pages

    Remember When?

    Uploaded by

    Children's National Medical Center
    This document provides a historical review of the evolution of clinical technology at Children's National from 1993 to 2008. It summarizes the transition from early use of "dumb terminal" computers to access lab results to the implementation of an interactive clinical system in 1997 that included order entry, billing, and nursing informatics. It describes the phased implementation of computerized physician order entry, clinical documentation, pharmacy systems, and other technologies over time to achieve a fully digital system by 2008.

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    Remember When?

    A Historical Review of Clinical


    Technology at Children’s National

    Susan G. Stanley, MSN, RN


    sstanley@cnmc.org

    Session Objectives

    At the conclusion of the session


    the participant will :

    Review how use of technology


    has evolved at Children’s
    National

    Dedicated in memory of
    Maggie Cox, MS, RN

    1
    In the Beginning

    • In 1993-1994, a Lab “dumb terminal” computer was


    used to obtain lab results.

    Early hardware in use

    2
    BIG computer change in 1997

    Children’s National embarked on their first interactive clinical


    computer system which included:

    • ADT system enterprise wide (admission, discharge and


    transfer)
    • Billing system
    • Utilization management
    • Results interface
    • Order entry interface (entered from paper by RN or Unit Clerk)
    • Statistics and trending data

    *This was the beginning of what is known today as Nursing


    Informatics – 3 nurses were selected to work on this project
    with no real experience in computer technology but years of
    clinical experience.

    The real phase 1

    • Nurses used a computer to verify written orders,


    print work sheets and patient labels. Paper Rules!

    3
    As a profession, we evolved

    • We began to ask questions of our practice


    • We collaborated and implemented Shared Nursing
    Leadership
    • We began a program to “grow” and nurture our new
    graduates
    • We recognize expertise and proficiency with our
    clinical ladder
    • We invested in research and collaborative practice
    • We define and strive for a safe care environment
    • Pediatric Trends was started to share excellence in
    pediatric care

    CTI Phase 1 Completed Solutions


    2005

    • Implemented in 12 months:

    – CPOE w/ Meds Integration


    – Basic Clinical Documentation (Allergies, Height,
    Weight, Vitals, I&O’s)
    – Inpatient Pharmacy w/ eMAR and Dose Range
    Checking
    – Alerts & Rules
    – Two months of historical data (Demographics,
    Lab Results, Radiology Results)

    4
    New Computers

    New East Patient Tower Opens


    2007

    Six inpatient units moved to floors 3,4, and 5.

    The NICU just moved May 18th to the 6th floor.

    The remaining inpatient units move by 2010.


    10

    5
    State of the art technology

    11

    CTI Phase 2 Completed Solutions


    2008

    • Implemented in 2008:
    – Full inpatient Nursing and Ancillary
    documentation
    – Full Physician inpatient documentation
    – HR Monitor and ventilator interface to flowsheet
    – Emergency department tracking board, CPOE,
    and full documentation, Discharge Instructions
    & Prescriptions
    – Surgical Services - Scheduling, Case Tracking,
    Billing
    – Medical Records - Transcription,
    Electronic Signature, Deficiencies

    12

    6
    What is in the future?

    • Primary Care implementation of a new computer


    system
    • School nurses implementation of a new computer
    system
    • Smart IV pumps
    • Perioperative documentation
    • Phase 3 – BCMA
    • Centralized refrigerator temperature monitoring
    • Always upgrades to the current systems and
    hardware!

    13

    Ideas for old computer use

    14

    7
    !!
    ycle
    c
    Re
    se
    P lea

    15

    • Thank You!
    • Next: Dr. Patti Abbott

    16

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