College of American Pathologists
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cap today

June 2005

Raymond D. Aller, MD
Hal Weiner
Michael Weilert, MD

The future is now: new community hospital fully digital
Coalition pushes for single standard for patient information exchange
Orchard upgrades Harvest LIS
Medical Automation Systems acquires Epsilon Group
Doctors Company endorses interactive electronic health record

The future is now: new community hospital fully digital

Community hospitals nationwide may be looking to Baptist Medical Center South, Jacksonville, Fla., for a peek into the future of high-tech medical care.

The 92-bed, 248,000-square-foot facility, part of the Baptist Health system, opened Feb. 16 as a fully digital community hospital. Patient information is contained on electronic medical records and physicians order tests and medications electronically. The results of such tests as x-rays and computed tomography scans are also stored on computers.

Operations are running smoothly, says Roland Garcia, senior vice president and chief information officer for Baptist Health. “There is a sense of calm—busy, but calm,” throughout the hospital, Garcia says.

That may be because physicians agree to use the electronic system when they apply for hospital privileges. Then they go through training to learn how to use the new technology before they begin practicing at the hospital. More than 450 physicians have already been credentialed for Baptist South and the hospital is recruiting aggressively. About 240 physicians cared for patients during the hospital’s first eight weeks of operation. Nurses and other staff also went through an extensive training process.

On opening day and for about two-and-a-half weeks afterward, about 100 information technology staff members were available in three shifts around the clock to troubleshoot and answer questions. The number of IT personnel on call has dropped significantly since then, Garcia says, as employees have become more familiar with the new systems.

Our goal, Garcia adds, is to provide better care more safely and more quickly. To this end, the hospital plans to introduce telecommunication technology in the operating room. Through a video camera and computer link, surgeons will be able to consult in real-time with pathologists in the laboratory.

“The pathologist in the lab can look at exactly what the surgeon is seeing,” potentially before the sample gets to the lab, says David Foreman, a spokesman for Baptist Health. “If there’s something on a slide, it can be called up [via the computer], and both can be looking at it and talking about the same thing.”

The new technology added to the hospital’s price tag, about $84 million, but not as much as might be expected, notes Garcia, because some of the technology was already deployed at other Baptist Health facilities in the Jacksonville area. The digital equipment, on the other hand, was more expensive. For example, a digital mammography machine costs about two-and-a-half times as much as a regular machine. Garcia says the hospital hopes to recoup such costs in several ways, but mainly by eliminating redundancy, such as duplicate tests, and streamlining the patient care process. “If I can get a nurse to devote one more hour of her shift to patient care as opposed to paper shuffling, that adds up,” Garcia says.

In addition to affording an opportunity to build an all-digital facility from the ground up, the new hospital also offered Baptist Health the chance to link together into one system the various components of its electronic medical record used at its other hospitals. These included emergency department, dietary, and pharmacy applications, the picture archiving communication system, and other ancillary applications under the architectural umbrella of the Cerner Millennium system.

Physicians at Baptist Medical Center South can connect to the EMR via desktop computers at workstations, carts with wireless computers, or mobile devices, such as tablets from Panasonic, Hewlett-Packard, or Jujitsu, which are stored in cabinets that must be unlocked with name badges. Other solutions providers include Phillips and GE Healthcare, while some of the hardware came from large manufacturers, including Dell Computer.

The hospital will soon benefit from such technology as direct interfaces between patient monitors, and the EMR will eliminate manual entry of such information as a patient’s temperature, heart rate, and other vital signs, Garcia says.
The new systems will also offer additional intelligence capabilities that, Garcia says, will be implemented as physicians adjust to the current setup. “It’s not the end game, yet,” he notes.

Coalition pushes for single standard for patient information exchange

The HIMSS Electronic Health Record Vendors Association, a coalition of electronic health record vendors, in May published a white paper that endorses adopting a single universal standard for exchanging patient information.

The association proposed using a single XML schema and syntax, a content model defined and vetted by health professionals who use the content in their clinical practices, and extensibility to other document types and discrete data. The association also proposed implementing standardized integration profiles based on those developed by Integrating the Healthcare Enterprise, an initiative established by health care professionals.

To ensure that vendors comply with an adopted standard, the EHRVA also recommends that they be certified by the independent Certification Commission for Healthcare Information Technology. According to the EHRVA, this commission should be chartered to establish criteria for certifying electronic health record products, including defining the requirements for functionality and interoperability.

Health care providers should ask their information system vendors how and when they plan to implement interoperability standards. Simply having an HL7 interface is not enough.

Orchard upgrades Harvest LIS

Orchard Software recently released Orchard Harvest LIS version 6.5.

Many new features have been added to version 6.5 to meet the demands of small to medium-sized hospitals. Among the new features are flexible printing and faxing options for automatic result delivery; the ability to schedule automatic, unattended runs of the data browsers; the ability to configure microbiology to bill automatically; configuration options, saved criteria, and filtering options for existing reports; and the ability to configure system security to lock user accounts after a specified number of unsuccessful sign-in attempts.

Medical Automation Systems acquires Epsilon Group

Medical Automation Systems’ wholly owned subsidiary, TEG Virginia LLC, has acquired the assets of the Epsilon Group. The new company will conduct business under the Epsilon name.

The Epsilon Group will now offer Medical Automation Systems’ information management products for point-of-care testing, including MAS’s RALS (remote automated laboratory systems) solution, with its customized scientific research and consulting services.

Doctors Company endorses interactive electronic health record

The Doctors Company has endorsed the physician-patient communications network iHealth Record, which debuted online last month.

Medem’s iHealthRecord ( is a secure, interactive electronic health record that houses personal health data for physicians and emergency departments and provides patients with education programs specific to their medical conditions, automated reminders pertaining to medications and conditions, access to secure physician-patient online communications, and FDA-related safety warnings and recalls.

The Doctors Company is a leading physician-owned medical malpractice insurance provider.


Wray (Colo.) Community Hospital has contracted with Optio Software for its QuickRecord and MedEx electronic health record and forms management solutions.

The University of South Alabama Health System, Mobile, has signed a $1.2 million agreement to purchase the Misys Laboratory comprehensive information management solution suite. The health system purchased the Misys laboratory, blood bank, and microbiology modules, CoPathPlus, and expanded outreach functions.

Yale-New Haven (Conn.) Hospital has signed a contract to license Mediware’s transfusion software system to manage its transfusion services.

TheraDoc recently implemented its Infection Control Assistant software at the Veterans Administration Salt Lake City (Utah) Healthcare System.

Dr. Aller is director of bioterrorism preparedness and response for Los Angeles County Public Health Acute Communicable Diseases. He can be reached at Hal Weiner is president of Weiner Consult ing Services, LLC, Florence, Ore. He can be reached at Dr. Weilert is di rec tor of laboratories, Community Hospitals of Central California, Fresno. He can be reached at