Wednesday, September 11, 2013

EMAR Go live

On September 4, BIDMC went live with its innovative web-based, mobile, " shopping cart" inspired electronic medication administration record.

Using a combination of iPads, iPhones, bar code readers, and thin client (HTML, Javascript) cloud hosted software, we have eliminated paper-based medication records on a major medical floor.   As is typical with our user centered design methodology, we'll incorporate improvements as we incrementally implement the software across the enterprise.

Our standard user centered design process includes:
  *Clinicians define requirements in our governance committees
  *Clinicians and developers create products
  *Limited pilots are conducted and feedback gathered.
  *Revisions are made and re-piloted
  *When clinicians judge the product to be mature, pilots are expanded and phased rollout is done.
  *Governance committees meet monthly to review functionality and prioritize enhancements.

The entire process is agile, clinician focused, and continuous

Although BIDMC builds and buys software based on requirements and product maturity, EMAR is a perfect example of when clinicians writing software for clinicians makes great sense.

Nurses created the user interface following of the motif of the shopping cart - you "buy" medications with one click when giving them to a patient, then "check out" to record your "purchases" in the permanent medical record.    All of this happens in real time as bar codes are scanned.   iPhones show each nurse what has been ordered and what has been administered.  iPads at each Omnicell medication cabinet show nurses what work needs to be done.

Here are a few screen shots

Comments from nursing thus far have included "this saves me so much time", "an incredible enhancement", "a major safety gain".   Rarely have I attended a go live debrief in which all the stakeholders expressed such joy and satisfaction.

Clinicians designing software for clinicians, using mobile and thin client cloud hosted approaches, with continuous improvements during enterprise rollouts.   It's a formula that works for our culture.


Allison said...

Congratulations on a successful implementation. It's always good to read about software development that included user input. It happens less frequently than one would think it would. I am very impressed with the farm and with your professional responsibilities. When do you sleep?

Peter Jones said...

What an impressive & effective local solution. It clearly improves the process and it would seem iterations may have tested it as free of design-induced errors. Will it check records for all medications the patient currently is believed to be taking? This might be like the "Current Account" feature in Amazon ;) I'm curious about its level of backend integration and front-end interaction. Beautiful work from BIDMC.