Client News: CPOE at WellSpan Marks the Beginning of Care Transformation

Source:  Around WellSpan Online



Leo Motter, M.D., a hospitalist at York Hospital, uses Computerized Physician Order Entry (CPOE) to enter discharge instructions for a patient. Physicians also use CPOE to directly enter medication orders, tests and procedures into a computer system, which then transmits the order to the pharmacy or appropriate department.

“CPOE (Computerized Physician Order Entry) marks the biggest change for physicians in the history of our organization,” said Charlie Marley, D.O., vice president of medical affairs at Gettysburg Hospital.

“If affects their workflow and requires them do things totally different than in the past.”

Despite the immensity of the change, the implementation of CPOE, first at Gettysburg Hospital in November 2010 and recently at York Hospital, has gone remarkably smooth.

“Early feedback from physicians has been positive,” said Geoff Nicholson, M.D., hospital informatics specialist. “We recognize that CPOE has some challenges, but it is a great system that gives us a lot of opportunities to optimize the care we deliver.”

Nicholson said the implementation of CPOE touched nearly every staff member at the two acute care hospitals. He added that the cooperation was excellent and much was learned from the initial implementation at Gettysburg Hospital, contributing greatly to the success of the project.

“CPOE is one of the capstones of the electronic health record,” offered R. Hal Baker, M.D., chief information officer for WellSpan.

“The implementation of CPOE marks the two-thirds mark of our journey to the electronic health record,” he added.
CPOE refers to any system in which clinicians directly enter medication orders, tests and procedures into a computer system, which then transmits the order to the pharmacy or appropriate department.

CPOE has the potential to greatly reduce errors by ensuring standardized, legible and complete orders.  A study of inpatient medication errors found that approximately 90 percent occurred at either the ordering or transcribing stage.

Recent research shows that if CPOE was implemented in all urban hospitals in the U.S., more than three million serious medication errors could be prevented every year.

Studies also have shown that CPOE reduces the length of stay; repeat tests; turnaround times for pharmacy, laboratory and radiology requests; and cost savings.

“Orders are instantly transmitted and processing can begin immediately,” said Peter Hartmann, M.D., vice president of medical affairs, York Hospital.  “It used to take up to two hours from the time an antibiotic was ordered to when it reached the patient.  Now, it’s 20 minutes.”

Baker added, “CPOE cuts out a number of non-value-added steps.  Medication requests have gone from 59 minutes to 13 minutes.” Additionally, fewer phone calls are required to clarify orders. Verbal orders have been decreased 75 percent, according to Baker.

Another benefit of CPOE is that serves as the basis for Clinical Decision Support (CDS), which checks for a variety of errors, including contraindications, drug allergies, drug-drug interaction as well as the absence of care.  It also prompts physicians for best practices. 

“CPOE and CDS have a tremendous potential to significantly improve patient safety,” said Nicholson.  “We will continue to optimize their capabilities over time.”

Nicholson emphasized that the implementation of CPOE is the beginning of care transformation, not the end.  There is still work to do.

Client News: MRI Breast Testing at Gettysburg Hospital Accredited

Source: Around WellSpan Online

WellSpan Imaging Services of Gettysburg Hospital is the first imaging site in the area to earn accreditation for MRI breast testing by the American College of Radiology (ACR).

The accreditation of its MRI breast testing services complements the hospital’s imaging services designation as a Breast Imaging Center of Excellence received in the fall of 2010.

ACR’s Breast Center of Excellence designation recognized the earned accreditation in mammography, stereotactic breast biopsy, and breast ultrasound (including ultrasound-guided breast biopsy).

“Being accredited for our MRI breast testing services further supports our designation as a Breast Imaging Center of excellence,” said Chuck Kyle, director of Imaging Services, Gettysburg Hospital.

“It’s a tribute to the efforts of our imaging team and to our commitment to improving services for our patients.”

Peer-review evaluations, conducted in each breast imaging modality by board-certified physicians and medical physicists who are experts in the field, have determined that WellSpan Imaging Services of Gettysburg Hospital have achieved high practice standards in image quality, personnel qualifications, facility equipment, quality control procedures, and quality assurance programs.

“We have put a lot of effort into ensuring that our technologies are state-of-the-art and it is great to be rewarded for this work by being recognized by ACR,” said Paul Williams, team leader of MRI services for Gettysburg Hospital.

ACR is a national professional organization serving more than 34,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services.

Client News: WellSpan Uses New Weapon for Treatment of Lung Cancer

Source: Around WellSpan Newsletter

Dr. Brian Pettiford, a thoracic surgical oncologist with WellSpan, became the first surgeon in Central Pennsylvania, and one of the few surgeons in the commonwealth, to employ a new minimally invasive procedure combined with brachytherapy to treat lung cancer.

The procedure is known as VATS (video assisted thoracoscopic surgery) sub-lobar resection with brachytherapy. Dr. Pettiford removed a cancerous portion of the left lung of a 71-yearold patient by using a thoracoscope, which was inserted through small incisions.

In collaboration with WellSpan Radiation Oncology, he then employed a technique known as brachytherapy by implanting a mesh seeded with radiation as a means to reduce the risk of recurrence while minimizing damage to surrounding areas.

Client News: Gettysburg Hospital Begins Construction of a New Emergency Department

Source: Around WellSpan Newsletter

A 19,000-square foot addition to Gettysburg Hospital will provide patients with a private, patient-centered care experience and meet the needs of the community well into the future.  The new emergency department will feature 18 private treatment rooms as well as new patient amenities such as a vending area, café seating, pediatric waiting area and an increase in patient and visitor restrooms.

Construction of the new emergency department is Gettysburg Hospital's biggest project in 20 years. It is expected to cost $18.1 million. The new emergency department is scheduled to open in February 2012. The project should be entirely completed by August 2012. The hospital's emergency department currently cares for 28,000 patients per year. It was originally designed to treat 15,000.

Client News: Gettysburg Hospital joins Campus Kitchens Project

Source: WellSpan Website

Gettysburg Hospital recently became the first medical facility in the country to be a formal partner with The Campus Kitchens Project, a national leader in community service for students and anti-hunger programs for communities around the country.

Working with Campus Kitchen at Gettysburg College and the hospital’s food service partner, Nutrition Management Services, the hospital is donating unused food to support The Kitchen’s efforts to provide hot meals to people in the local community who are economically disadvantaged.

By the end of 2010, Gettysburg Hospital will likely have donated more than 500 pounds of food items that include soups, casseroles and leftovers from various catering events to the college’s Campus Kitchen.

“The hospital’s dietary department reviews its production system to make sure it’s utilizing all food items possible. In the past, there were cases in which food was produced but couldn’t be utilized and it resulted in the item being discarded,” said Kevin Scritchfield, director of Gettysburg Hospital Dietary Services.

“There are strict regulations through the Pennsylvania Department of Health that govern how food is handled, temperature guidelines and rules related to safety and sanitation.

“Since the hospital’s dietary department meets all of these guidelines, we are able to donate unused food items to Campus Kitchen and help others in the process.”

Nationally, The Campus Kitchens Project empowers thousands of students each year to recycle food from cafeterias, turn these donations into nourishing meals and deliver those meals to people who need it most.

“While the Campus Kitchen helps families close the food gap, it also works to establish relationships that break down barriers and stereotypes. The result is the stronger, more united community. We are grateful that Gettysburg Hospital has become a partner,” said Kim Davidson, associate director of the Center for Public Service at Gettysburg College.

Students at each of the 25 Campus Kitchens around the country are responsible for running the program’s operation, including menu planning, collecting food, managing cooking and in some cases teaching culinary skills to unemployed adults.

The students also manage all records, organize fundraisers, develop nutrition curriculum and recruit new students to get involved.

The Campus Kitchen at Gettysburg College, the first in the state, began in November 2007. The project is managed by the College’s Center for Public Service and student program coordinators.

As it reaches its third year in operation, the Campus Kitchen has recovered more than 28,000 pounds of food and served more than 15,000 meals to local residents in need.

Client News: WellSpan Rehabilitation Slates Open House

WellSpan Rehabilitation is holding an open house:

When: Sunday, Oct. 12
Time: 12noon to 2 p.m.
Where: 1575 Bannister Street, Suite 4, York.

It’s an opportunity to learn more about breast cancer risk, prevention and rehabilitative options.

Attendees will be able to:

Learn risk factors and prevention for breast cancer from occupational therapists.
Test their balance and learn fall prevention techniques from physical therapists.
Tour the new facility and see the latest in rehabilitation therapy.
Talk with licensed therapists about rehabilitation treatment options.

For more information about the open house, call 812-5850.

Client News: WellSpan Physicians Sharing Their Notes With Patients

Source: WellSpan Newsletter

Before Ann Hagerty left Apple Hill Internal Medicine after her appointment with Dr. Brian Pollak, she received a preliminary copy of his notes pertaining to her visit.

The sheet included the physician’s assessment, orders needed and future plan of care. “Having a copy of the notes is very valuable to me,” said Hagerty.

“It lets me know what transpired. If I didn’t pick up on something during the appointment, I’ll be able to re-read the notes.

“The notes are clear and understandable,” she added. “I took a copy of the notes of my most recent visit with me when I traveled to Russia.

I knew they would come in handy if I had any medical emergency.” “By sharing our notes with patients, they are better informed, have a chance to make any corrections or amendments to the notes and are more of a partner in their care,” said Pollak.

Pollak said Apple Hill Internal Medicine physicians have shared their notes with patients for about three years. Physicians at Aspers Health Center also share their notes.

“Our patients appreciate receiving the notes,” he said. “I believe it helps strengthen the relationship between physicians and patients.

It’s also an excellent communication tool, which is valuable to patients as well as other physicians.” While the Health Insurance Portability and Accountability Act, or HIPAA, gave all patients the legal right to read and even amend their own medical records in 1996, few practices share notes with their patients.

“Our hope is that more practices will share notes with their patients,” said Dr. Hal Baker, vice president and chief information officer for WellSpan. Baker also practices at Apple Hill Internal Medicine.

Physicians have long cited a number of concerns about sharing notes. The concerns include: patients misinterpreting medical information and diagnoses, creating unnecessary stress and patients’ unfamiliarity with medical terms and abbreviations.

“The same concerns come up time and time again,” said Baker. “But, there’s little evidence to support those concerns.”

Baker hopes that an on-going study, funded by the Robert Wood Johnson Foundation, will alleviate physicians’ concerns and demonstrate the value of sharing notes.

Open Notes, the largest study of open access, was initiated this past summer. The study involves more than 100 primary care physicians and approximately 25,000 patients from three large health care centers across the United States.

In the study, patients who have just seen their doctors will receive an email message directing them to a secure website where they can view signed physician notes.

Researchers will analyze the expectations and experiences of patients and physicians. They also will examine the number of additional phone calls, emails and visits that may arise as a result of more patients viewing their doctors’ notes.

Client News: WellSpan Aspers Health Center opens

Primary care plus several outpatient services of Gettysburg Hospital under one roof

The WellSpan Aspers Health Center opened its doors on Monday, Aug. 2, offering the people of upper Adams County convenient access to primary health care services as well as outpatient lab, imaging and rehabilitation services.

The facility, located at 2060 Carlisle Road (Route 34) near Aspers, is the new home to two established WellSpan Medical Group practices – Biglerville Family Medicine and Adams Cumberland Family Medicine.

“WellSpan Aspers Health Center demonstrates WellSpan’s commitment to making quality health care services available and convenient for people in upper Adams County,” said Thomas McGann, M.D., president of WellSpan Medical Group and senior vice president of WellSpan Health.

“We believe the Aspers Health Center is convenient for people in this area to access. This will be critical as the area grows and the need for quality health care services increases,” McGann said.

The Aspers Health Center also offers several outpatient services of Gettysburg Hospital under one roof:

• WellSpan Imaging offers patients walk-in, diagnostic x-ray exams.
• WellSpan Lab Services offers patients a convenient location for routine blood draws, urine collection, EKG, glucose tolerance testing (by appointment) and specimen drop off.
• Beginning in mid-August, WellSpan Rehabilitation will offer patients physical therapy services.
• Around the same time, the center will begin hosting a Coumadin clinic each Wednesday from 8 a.m. to noon to assist patients with management of anticoagulation medication.

In addition to housing the two practices and outpatient services, the Aspers Health Center has been designed around a new patient care model.

During the project’s development stage, WellSpan Medical Group leaders spent extensive time researching physician care models around the country.

The Aspers Health Center incorporates several new patient care and access features that will serve as a model for other WellSpan Medical Group practices in Adams and York counties.

Client News: WellSpan Rehabilitation opens new facility

Pictured on left: Senior physical therapist Joel Garcia instructs Michelle Wilson on the use of a piece of rehabilitation equipment. The new facility at Queensgate Towne Center features cardiovascular and strength equipment and a multi-cervical unit for treating neck pain.

Patients who need rehabilitation services now have another outpatient location option. The new facility opened at Queensgate Towne Center, 2501 Springwood Road in York last week. “This is an exciting time for WellSpan Rehabilitation,” Hawk said. “From the construction of the Surgery and Rehabilitation Hospital to the new outpatient sites, we are making tremendous strides to improve the availability of rehabilitation services for area residents. I’m thrilled to be a part of this journey.” Read more about it on WellSpan's website