Electronic Health Records

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Children’s Hospital Los Angeles Lauded for EHR Integration

“This distinction attests to 11 years of technological advances CHLA has made and continues to make to protect and improve the health of our infants, children and teens.”

By Frank Irving

The ongoing electronic health records deployment at Children’s Hospital Los Angeles (CHLA) was certified this week as having achieved Stage 6 on the Healthcare Information and Management Systems Society (HIMSS) EMR Adoption Model (EMRAM). The benchmark measures the extent and proficiency of healthcare institutions in utilizing digital recordkeeping tools.

CHLA digitally tracks physicians’ orders, nurses’ clinical notes and medication management. The 568-bed hospital also actively monitors changes in each record such as when a patient is flagged with a specific diagnosis; in such a case, the physician is automatically informed of a need for a corresponding treatment plan.

Less than 30 percent of hospitals in the United States have achieved Stage 6 or higher on the EMRAM scale, according to HIMSS, and only about 60 of those hospitals are pediatric care facilities. A public dashboard maintained by HIMSS Analytics shows that California currently has 115 Stage 6 hospitals, and 47 Stage 7 hospitals. (At Stage 7, all documentation is electronic; no paper charts are used.)

CHLA reports that electronic medical records are being used across the emergency department, inpatient units and hospital-based outpatient clinics, as well as satellite outpatient centers run by its medical group in five surrounding communities — Arcadia, Encino, Santa Monica, South Bay and Valencia.

“Our patients are safer as a result of Children’s Hospital Los Angeles’ commitment to technology, said CHLA Vice President and CIO T.J. Malseed in a public statement. “This distinction by HIMSS attests to 11 years of technological advances CHLA has made and continues to make to protect and improve the health of our infants, children and teens.”

The cumulative capabilities of Stage 6 hospitals include the use of templates for physician documentation, a full clinical decision support system and a closed-loop medication administration system. The full specification for EMRAM Stage 6 is as follows:

Full physician documentation with structured templates and discrete data is implemented for at least one inpatient care service area for progress notes, consult notes, discharge summaries or problem list and diagnosis list maintenance. Level three of clinical decision support provides guidance for all clinician activities related to protocols and outcomes in the form of variance and compliance alerts. The closed-loop medication administration with barcoded unit dose medications environment is fully implemented. The eMAR and barcoding or other auto identification technology, such as radio frequency identification, are implemented and integrated with CPOE and pharmacy to maximize point-of-care patient safety processes for medication administration. The ‘five rights’ of medication administration are verified at the bedside with scanning of the barcode on the unit does medication and the patient ID.

The HIMSS recognition adds to CHLA’s impressive resume. It has been named the best children’s hospital in California and among the top 10 nationally for clinical excellence as determined by U.S. News and World Report. CHLA is also home to The Saban Research Institute, one of the largest pediatric research facilities in the United States. As a teaching hospital, CHLA has been affiliated since 1932 with the University of Southern California’s Keck School of Medicine.

CHLA will be honored at the HIMSS16 conference in February 2016 for achieving the Stage 6 milestone.





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