UPMC Physician EMRs Using Integration Technology

University of Pittsburgh Medical Center (UPMC) of Pittsburgh, PA recently implemented a technology solution that helps emergency medical services personnel provide better patient care and allows them to get bills out more efficiently.

Before the change, EMS crews bringing patients to one of UPMC’s 20 emergency departments couldn’t leave immediately after completing their run. They had to wait for an ED employee to print a paper with patient demographic information that was used for ambulance services billing.

That slowed the EMS workers down, took away clinician time, and prompted questions about patient privacy, according to Lisa Khorey, chief information officer at UPMC Shadyside, Pittsburgh, PA, and UPMC Braddock, Braddock, PA.

New EDIS Took Away Paper Printing Option for EMS

“Providing paper information really delayed their ability to move quickly and caused a lot of problems getting out into the field again,” adds Myron Rickens, director of UPMC’s prehospital care program. “EMS services workers want to arrive, drop off the patient, restock if necessary, and get back out there. Any delay in that process is a problem.”

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The Battle of a CV Surgeon

In my years working in the CVICU, one thing I have learned is how cardiovascular surgeons are extremely territorial. They take a great deal of ownership over their patients’ care. We have a policy at my hospital stating that only the cardiovascular surgeons can write orders for the first 48 hours after surgery. This way, no other doctors are writing for blood transfusions, antibiotics, or diuretics that the surgeon does not want.

Of course, the other doctors on the case will round during this 2 day “no orders allowed” period and write orders, forcing the nurse to get in the middle and make a phone call to the surgeon to get the order approved or denied. It’s situations like these that can take a toll on the nurses, causing us to be the middle-man and take a lot of flack from physicians on both sides.

For example, a patient is post-op day #1 after a valve replacement, the patient received 3 liters of fluid during/after surgery the previous day- so, the cardiologist comes in and orders 40mg of Lasix (a diuretic) to remove fluid. It’s now up to the nurse; according to the policy we cannot follow through on this order, but we know that receiving this medication is in the best interest of the patient.

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