IT Update: SLCH Health Information Technology Works to Support Superior Patient Experience

Integral to St. Louis Children’s Hospital’s goal of providing a superior patient experience are the systems developed by its health information technology (IT) group. Headed by Feliciano Yu, Jr., MD, SLCH chief medical information officer and medical director of the Washington University Pediatric Computing Facility, the information systems team has one goal: to support the work of the hospital’s medical professionals so they may deliver the best possible care to patients.

“We are in the business of ensuring that the people caring for our patients have the right tools and information so they can make better decisions about patient care while at the same time making their workflow more efficient,” says Dr. Yu.

It is also essential that the information gathered through these health IT tools can be re-used to help SLCH physicians, nurses and other medical professionals advance care through the conduct of practice-based learning and improvement. “At Children’s Hospital, we work in an academic environment where research is basic to everything we do,” says Dr. Yu. “It is incumbent upon us to develop systems that help us determine the manner in which we are delivering care, how well we are doing with that delivery, and how we can improve upon our performance. We really want to serve as a catalyst for research and for increasing our partnership with Washington University in that regard.”

The most significant example to date of health IT’s system implementation is the KiDDOS (Komputerized Inter-Disciplinary Documentation and Ordering for Safety) project, the hospital’s computerized physician order entry (CPOE) system for the inpatient setting. Today, 100 percent of the inpatient orders are entered into the CPOE system—succcesfully implemented with more than 2,200 providers entering about 130,000 orders a month.

“We have basically eliminated medical errors related to illegibility with the KiDDOS project,” says Dr. Yu. “The use of CPOE has resulted in significant safety and efficiency advances in many other ways as well.”

Among those are:

• A 128 percent improvement in patient weight documentation. Since pediatric patients’ medications are mostly calculated by weight, this is essential information to have recorded.
• A 61 percent decrease in duplicate orders of common blood tests. In addition to decreasing the cost of hospitalizations, unnecessary needle sticks for patients are also eliminated.
• A 46 percent improvement in the timeliness of medication administration of frequently ordered drugs,
• A 66 percent decrease in the number of adverse drug events.

“KiDDOS has more than 600 order sets built into the system that standardize the ordering of medical interventions we provide to patients for specific conditions. These have built-in reminders so physicians don’t forget to order a medication or a certain intervention,” says Dr. Yu. “This is a significant improvement over the pocket checklists physicians previously carried, most of which were different from each other.”

SLCH’s information systems team is composed of people with a broad range of experience, from computer programmers and engineers and data base administrators to nurses, pharmacists and physicians with experience in health IT. When implementing and developing new IT systems, the team works with domain experts or end users throughout the hospital to ensure the systems developed work as planned.

“This is key to our current and future success at Children’s Hospital. We don’t build a ‘widget’ on our own that then gets deployed and doesn’t fit the end user’s needs. Our process is to engage clinical domain experts at the earliest opportunity to ensure we develop a system that is useful to them,” says Dr. Yu