: This application is for a three-year, health care information technology implementation and evaluation project led by Mercy Medical Center-North Iowa, a rural secondary referral center, in collaboration with Hospice of North Iowa, the Mason City Clinic, Mercy Medical Center-Clinton, Trinity Health, and the University of Iowa Department of Health Management and Policy. The project partners will implement a comprehensive, integrated, electronic health record (EHR) system using new uniform data standards, with computerized physician order entry and clinical decision-support tools, in several diverse, rural, north Iowa health care settings (hospital inpatient units, ambulatory care, primary care and specialty clinics, home health, and hospice care) and will evaluate the impact of this EHR system on patient care and organizational culture. The project has four major goals: 1) to improve the quality of patient care and increase patient safety to be in the top quartile of JCAHO and CMS indicators; 2) to improve patient care workflow processes; 3 ) to enhance organizational culture and safety among the project partners; and 4) to generate significant organizational learning about the effectiveness of the EHR system and the implementation process. The University of Iowa Department of Health Management and Policy will conduct the project evaluation using Mercy Medical Center-Clinton as the control site. Evaluation measurements will include: a) reported medical errors (including medication errors) and near misses; b) CMS/JCAHO quality measures; c) physician/clinician use of standard evidence-based practices, responsiveness to adverse drug alerts, and use of computerized knowledge databases and other new information tools; d) patient satisfaction scores; and e) physician/clinician/staff assessments of the implementation process and how the electronic health record system has improved the quality and safety of patient care, communication among physicians, other clinical staff, and patients, and daily work life.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
NIH Challenge Grants and Partnerships Program - Phase II-Coop.Agreement (UC1)
Project #
5UC1HS015196-03
Application #
7122504
Study Section
Special Emphasis Panel (ZHS1-HSR-W (01))
Program Officer
Harrison, Michael
Project Start
2004-09-30
Project End
2007-12-31
Budget Start
2006-09-01
Budget End
2007-12-31
Support Year
3
Fiscal Year
2006
Total Cost
Indirect Cost
Name
Mercy Medical Center North Iowa
Department
Type
DUNS #
City
Mason City
State
IA
Country
United States
Zip Code
50401
Brokel, Jane M; Ward, Marcia M; Wakefield, Douglas S et al. (2012) Changing patient care orders from paper to computerized provider order entry-based process. Comput Inform Nurs 30:417-25
Brokel, Jane M; Schwichtenberg, Tamara J; Wakefield, Douglas S et al. (2011) Evaluating clinical decision support rules as an intervention in clinician workflows with technology. Comput Inform Nurs 29:36-42
Roberts, Lance L; Ward, Marcia M; Brokel, Jane M et al. (2010) Impact of health information technology on detection of potential adverse drug events at the ordering stage. Am J Health Syst Pharm 67:1838-46
Wakefield, D S; Wakefield, B J (2009) Are verbal orders a threat to patient safety? Qual Saf Health Care 18:165-8
Wakefield, D S; Brokel, J; Ward, M M et al. (2009) An exploratory study measuring verbal order content and context. Qual Saf Health Care 18:169-73
Vartak, Smruti; Crandall, Donald K; Brokel, Jane M et al. (2009) Transformation of Emergency Department processes of care with EHR, CPOE, and ER event tracking systems. HIM J 38:27-32
Brokel, Jane M; Harrison, Michael I (2009) Redesigning care processes using an electronic health record: a system's experience. Jt Comm J Qual Patient Saf 35:82-92
Wakefield, Douglas S; Ward, Marcia M; Groath, Debra et al. (2008) Complexity of medication-related verbal orders. Am J Med Qual 23:7-17