All-Digital Hospital Sets Pace for Florida Health System

In the less than six months that Baptist Medical Center South in Jacksonville, Fla., has been open, doctors have entered 80 percent of all orders directly into the 92-bed hospital's computerized physician order entry system. That was the plan all along at the facility, one of the nation's first privately operated acute care hospitals, which was built from the ground up with nothing but digital workflow and documentation systems.

"We knew from the very beginning that it was going to be all digital," says Mike Robin, who, as program manager for the five-hospital Baptist Health System, has overseen the technology implementation. "We believe that we're one of the first community – nonacademic, nonteaching, nonspecialty -- hospitals that's all digital."

To date, Baptist Health officials have credentialed 450 physicians for the new South facility. Robin says that 403 doctors have been trained on the information systems and that 255 are "actively" using CPOE. As for the 20 percent of orders not directly entered by physicians, those have come in by phone or have been verbally given to another computer user. Paper simply is unacceptable. "If they go to that hospital, they have to use CPOE and they have to do physician documentation online. It's in our bylaws. There's no paper here," Robin says.

The hospital cost $90 million, $8 million of which was for IT. Lead vendor Cerner (Kansas City, Mo.), provided 21 different technology packages, including full electronic medical records in all clinical, laboratory, pharmacy, radiology, and surgery departments, plus a complete, integrated picture archiving and communication system. Amenities for patients include movies on demand and high-speed data ports at the bedside.

Data workflow and design planning for the hospital began in September 2003. Early on, Baptist Health executives decided that the plan would follow three guiding principles: wireless connectivity would provide "unhindered" computer access; technical support staff would be available around the clock; and clinicians would be required to attend training sessions and sign an agreement to use the technology throughout the hospital, according to a statement released by Cerner. "By completing in advance the extensive training offered, our physicians were able to take advantage of every resource," Baptist Health Chief Medical Officer Keith Stein, M.D., said in the Cerner statement.

The health system is planning to retrofit its four other hospitals with full digital technology over the next two years. November is the target for rolling out CPOE and EMR at the 54-bed Baptist Medical Center Nassau in Fernandina Beach, Fla. Implementation will start next February at the 122-bed Baptist Medical Center Beaches, while the main, two-hospital campus in downtown Jacksonville will get the technology upgrades beginning in mid-2007, Robin says.
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