1. Paperless Hospitals

2. Melanie Hood Mike Kramer Alyssa Grayson Sarah Smith
Authors
Melanie Hood
Mike Kramer
Alyssa Grayson
Sarah Smith

3. Objectives Define and describe trend
List and describe trend hardware and software
Identify, describe and review trend information and system
Describe advantages/disadvantages of using trend
Examine legal and ethical issues related to the use of trend
Describe technology - related competencies needed by the professional nurse working with trend
Describe functions of the informatic nurse working with trend

4. What is a paperless hospital?
A computer-based record containing health care information.
This system will increase patient care and safety.
It is the potential of electronic medical records to provide large-scale improvements in the efficiency, safety, and cost-effectiveness of health care
 They will eliminate or substantially reduce medication related errors in the facility
 This system will eliminate problems with legibility, ambiguous abriviations, and delays in order communication. 
 It will clinically benefit by automatically verifying orders by checking dose, drug to drug interations, and allergies. 
 (Russ, 2010)

5. HARDWARE

6. Wireless tablet PC's Scanners Printers Stylus Touch Screens Keyboards
Available Hardware
Wireless tablet PC's
Scanners
Printers
Stylus 
Touch Screens
Keyboards
Farcus, page 17.

7. Wireless PC
A wireless PC is a computer that has the ability to become wireless and carried from patient room to room.
(Ellison, & Evans, 2003)

8. Wireless PCs will have WiFi capability.

9. The PCs that the hospitals would be equipped with would have software with the ability to turn these hospitals paperless.

10. Available Software Billing Electronic prescriptions Physician's orders
Nurse’s notes
Laboratory results
H&P
Advanced directives
Nutrition
Non- physician orders
Etc.

11. Electronic Prescriptions
Increase patient safety and reduce pharmacy callbacks.
Quick prescription refill processing
Increases prescription accuracy
Color-coded patient drug history maintains current, expired, ineffective, discontinued, and sample prescriptions.
(Allscripts electronic prescribing, 2009)

12. Clinical Information System:
Accustat EMR: 
 Order entry system
Manages transcription cycle & reduces errors & costs
24/7 Access to transcription
Dictate, prioritize, and tracks jobs in real time
Automatic attachment to patient EMR (
-Manages transcription cycle from beginning to end by integrating voice recording, digital scripting, delivery of voice files to the medical transcriptionist, and final transcript receipt.

13. Who Uses and benefits from AccustatEMR?
     Primarily used by Physicians 
 Benefits:
Nurses
Patients 
Medical secretaries 
-Physicians have multiple options for dictating
-These include:
1. Toll free telephone number. Voice is recording and voice files are sent to medical transcriptionist for conversion.
2. Digital recording. The voice files can be uploaded to the Accustat server using desktop software.
3. PDA recording. Doctors can dictate and save files on a PDA. The PDA is synchronized with the PC and transmits the data.

14. AccustatEMR enables the physician to:
Provide online billing
Document test results and lab findings
Document physician's progress notes and orders
Prescribe new medications for patients
-Reports are transcribed and delivered to the account within the turn around time that you deisgnate
-This enables urgent reports to be as quick as 1 hour
-Available 24/7 daily which allows convenience for physician

15. More About Accustat EMR...
Configuration: Point of Service system
Regularly exceeds the American Healthcare Association Integrity Standards (AHIMA)
Routine audits by HIPAA compliance team
The HIPAA compliance team guarentees that their employees respect your patient's information just as a member of your own staff would

16. Reasons we recommend Accustat EMR:
Personalized to individual facility needs
Physician and patient convenience
Cost effectiveness
Reduction in serious medical & prescription errors
Easy access to edit, search, and view medical transcriptions
-Great "all-inclusive" package. The company provide training, billing, networking, installation, scanning, and transcripting.
-Fast turn around
-Reduces errors caused by difficulty reading physician notes and orders

17. Personalized care More accurate patient billing Less med errors
Legible physician orders
ing of charts
No way of wrong patient charting
Personalized care
More accurate patient billing
Less med errors
(Lamburg, 2008)

18. Disadvantages Cost Educating Staff Complete Cooperation
Time Management
(Lamburg, 2008)

19. Ethical/Legal Issues
Paper-era state regulations that may not permit EHRs
state regulation of medical records is based upon the rules of paper records
HIPAA’s privacy and security regulations
unrelated physicians of record sharing organizations can locate, request and obtain the medical records of patients
(Shay, 2005)

20. Ethical/Legal Issues Anti-trust Laws
 The laws prohibit anti-competitive behavior, including price fixing
Sharing payment information could enable competing providers to collude on prices and violate the anti-trust laws. (Shay, 2005)
 Creating a Legal Document 
EMRs must be stored legally, if not they may be deemed invaild
if they do not meet legal requirements, the payor can sometimes deny the claim

21. Competencies required to work in Paperless Hospitals:
Ability to:
Access and use s
Search databases and obtain information
Navigate institution specific software regarding charting and administering meds
Operate Windows applications
(McGonigle, 2009) 

22. Functions and Responsibilities of the INS:
Possess the knowledge and skills specific to paperless hospital software, hardware, and the clinical information system used by their facility
Use critical thinking and computer skills to assist with hospital technology
Teach and assist others with learning new information and technology
Assist with implementation and evaluation of the Clinical Information System
(McGonigle, 2009)

23. In conclusion: A paperless hospital will require new hardware/software
There are many different software to choose from
A customized software is needed for each area of healthcare
This system will require all staff to transition to a different way of thinking
The advantages out weigh the disadvantages
A paperless hospital will change the way of nursing 

24. References
Cucina, Russ. "Information Technology in Patient Care" (Chapter). McPhee SJ, Papadakis MA, Tierney LM, Jr.: CURRENT Medical Diagnosis & Treatment 2010:
Allscripts ( 2009, July). Electronic prescribing - TouchChart eRx. Retrieved [date] from MDS Medical website:
Ellison, C., & Evans, D. (2003, October 14). Wireless networks. Retrieved from
Farcus, N. (2009). Introduction to computer hardware lecture. Nurs 457.

25. References:
(2009). Accustat EMR. In Digital Medical ASP Transcription.                                    Retrieved December 1, 2009, from
             
McGonigle, D. & Mastrian, K. ( 2009). Nursing informatics and the            foundation of knowledge. Boston: Jones & Bartlett Publishers.
 Lamburg, S.I. (2008, May 24). Paperless or less paper. Retrieved from
Shay, Edward F., and Esq..(2005). "Legal barriers to electronic health records." Physicans News. N.p., n.d. Web. 4 Dec <
"Legal Issues of the ELectronic Medical Record." Medical Practice Management Trends. N.p., n.d. Web. 4 Dec <