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The Paperless Hospital -- Really!

How Baptist Medical Center South built an all-electronic environment while bigger, more prestigious hospitals failed.

June 13, 2005 12:00 PM ET

Computerworld - Less than two years ago, cows grazed on the Jacksonville, Fla., site of Baptist Medical Center South (BMCS). Today, physicians at the brand-new hospital make their rounds toting wireless devices to check lab results, view X-rays, update charts, order prescriptions and send and receive e-mail.
At bedsides, nurses use wireless devices on wheels, or WOWs, to record progress notes and check doctors' orders. If they administer medicine or change a bandage, the supplies they use are electronically tracked and matched by bar code to individual patient records, enabling more accurate patient billing and automatic inventory replenishment.
What's conspicuously absent everywhere is paper. And for a busy hospital whose staff has just a few weeks of experience working in a totally electronic environment, the overall atmosphere is strikingly tranquil. The doctors and nurses seem completely confident and competent in their new digital workplace.
Yet digital by no means equals impersonal. Original artwork graces the walls, waiting rooms have the cozy feel of a private library, and lots of windows look out on the hospital's well-tended gardens.
You have to wonder: How did this small, 92-bed community hospital manage to succeed where larger and more prestigious hospitals have failed?
For example, Cedars-Sinai Medical Center in Los Angeles pulled the plug on its $34 million electronic medical record (EMR) system after just three months in 2002 because staffers refused to use it. Nationwide, only about 6% of hospitals have computerized systems for doctors' orders.
"It's all about changing the culture," says BMCS CIO Roland Garcia.
Seize the Day

Chief Medical Officer Keith Stein and CIO Roland Garcia of BMCS
Chief Medical Officer Keith Stein and CIO Roland Garcia of BMCS
Image Credit: Gene Bednarek/Silver Image
From the beginning, Garcia says, he and other hospital executives realized that they had a unique opportunity to build not just a new hospital, but an entirely new culture and health care delivery model that relies heavily on technology to enhance patient care and safety.
To seize that opportunity, they first had to secure the buy-in of the area's independent physicians, who have a choice of where to practice.
Before the ground had been broken, BMCS recruited a physician advisory board, which worked with cross-functional IT and operations teams on virtually every aspect of the hospital project, from choosing which technology to use to conducting exhaustive simulation testing in the months before the hospital opened on Feb. 16.
The teams spent months parsing the thousands of steps and processes involved in treating patients. Everything was dissected, from patient scheduling and clinical procedures to discharge and billing.

Ordering and filling a prescription, for example, involves 148 discrete steps carried out by different people and

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