Corporate News and Events

Trinity Health Hospitals One of the First to Use
Paperless Medication Administration

Two Iowa hospitals combine bar-coding and CPOE to further safety

Novi, Michigan (Feb. 24, 2008) – Two Trinity Health hospitals belong to a select group of community hospitals in the nation that offer the safety benefits of paperless medication administration combined with the safety features of computerized physician order entry.

Mercy Medical Center – North Iowa (Mason City) and Mercy Medical Center – Dubuque, both in Iowa, now use “CareMobile,” a point-of-care medication tool that works with “Genesis,” Trinity Health’s state-of-the-art electronic health record (EHR) system. Unlike stand-alone bar-coding systems, the use of CareMobile with Genesis combines the safety features of computerized physician order entry (CPOE) at the time a medication is ordered, with the safety of bar-coding at the time a medication is administered.

“The combination of these tools provides the safety of a paperless medication ‘loop,’ from the time an order is placed until the medication is administered,” said J. Michael Kramer, MD, Trinity Health’s Chief Medical Information Officer. “Very few community hospitals in the country offer this.”

CareMobile, a Cerner product, conveniently works at the patient’s bedside. Using a small, hand-held device, a nurse first scans a patient’s bar-coded wristband to verify the right patient encounter. Next, a bar-coded medication is scanned to ensure it’s the same drug ordered by the doctor via the Genesis system. Once confirmed, the medication is dispensed, and the information is electronically transferred to the patient’s EHR. The small but significant step of using CareMobile allows nursing staff to verify the “Five Rights” of medication administration: right patient, right medication, right dose, right route and right time. The Cerner application also provides alert capabilities for dangerous drug interactions, duplicate therapies and drug-lab warnings. Technology such as this has been proven to prevent medication errors — one of the most significant results of patient mis-identification.

A July 2006 Institute of Medicine report published that at least 1.5 million adverse drug events (ADEs) caused by medication errors occur in the U.S. each year — the “true number” estimated to be much higher. The report suggests that one possible way of eliminating, or at least reducing such errors is through the use of electronic systems.

“The technology of CareMobile provides increased patient safety through the paperless medication loop,“ said Toni Ebeling, RN, Chief Nursing Office, Vice President of Patient Services, Mercy-North Iowa.

Clinicians at both sites said that using scanners takes some getting used to, but the effort is worth it. The possibility of misreading a label is an issue because many drugs on the market have similar spellings.

Before implementing CareMobile, both sites had been using another scanning system. However, it had to be replaced because it was not compatible with Genesis, and would not have been able to offer the benefits of a fully paperless medication process.

"We were well aware of the benefits of bar-coding in the medication administration process, and wanted to make sure that CareMobile maintained the standard of patient safety that had existed in Dubuque prior to our Genesis Go-Live,” said Kay Takes, Vice President of Patient Care Services & Patient Care Services, Mercy – Dubuque. “Clinicians and IT staff from Mercy - Dubuque, Mercy – North Iowa, the Home Office and Cerner worked literally thousands of hours to get CareMobile up and running. ”

“After several months of experience under our belt, our utilization is at or better than our target of 95 percent in most of the nursing areas. We’re excited about our progress with CareMobile, and highly recommend its use in any hospital interested in hardwiring a safer medication administration process."

Trinity Health is the fourth-largest Catholic health care system in the country. Based in Novi, Mich., Trinity Health operates 43 acute-care hospitals, 379 outpatient facilities, 26 long-term care facilities, and numerous home health offices and hospice programs in seven core states. Employing 44,000 full-time staff, Trinity Health reported $6.1 billion in unrestricted revenue and $323.0 million in community benefit ministry in fiscal year 2007. For more information about Trinity Health, visit www.trinity-health.org.