Innovator Award Past Winners

2014 Winner | University of Pittsburgh Medical Center

Convergence—A breakthrough clinical platform for physicians

Articles by Geri Aston first appearing in H&HN, August, 2014.

Physicians at the University of Pittsburgh Medical Center were frustrated by the amount of time they spent pulling patient data needed at the bedside from various clinical information systems, so they set about designing a better way for physicians to interact with and view clinical data. The result was Convergence, a touch application for Windows 8 tablets that extracts patient data from a variety of clinical information systems and presents them to physicians in an easy-to-navigate, visually meaningful way. Clinical pathways are built into the application to guide physicians in using evidence-based practices.

Cardiologists at UPMC Presbyterian are testing the Convergence platform. They access it at the bedside using tablets that can be docked in a desktop computer. In Convergence, physicians are able to move back and forth through various applications with the correct patient record displayed in each.

Rasu Shrestha, M.D., UPMC vice president of medical information technology uses the example of a cardiologist seeing a patient who was just transferred to the cardiac intensive care unit after a procedure for a heart attack. The physician would log into Convergence on the tablet and immediately see that person on his or her patient list. When the cardiologist touches the patient’s name, “the patient’s chart comes to life on the Convergence screen across a longitudinal record, but highlighting specific aspects in the context of the physician as the subspecialist cardiologist,” Shrestha explains. The physician can swipe into the clinical pathways module and see what parts of the care pathway have been taken and see if any care gaps exist. If a test needs to be performed, the cardiologist can swipe to the order entry screen, where all the necessary patient information is populated automatically, order the test and swipe out of order entry into whichever application meets the cardiologist’s needs given the workflow, Shrestha says.

UPMC, which operates 20 hospitals, plans to spread cardiology use of Convergence to other hospitals in its system and to expand its application to internal medicine physicians and hospitalists, says Rebecca Kaul, president of the UPMC Technology Development Center. By the end of 2014, UPMC wants to launch Convergence in the commercial market. The product, built with external sales in mind, works with multiple electronic systems.

Winner | Baptist Health South Florida, Coral Gables, Fla., baptisthealth.net

Electronic Medication Reconciliation Visits for Home Health Patients

Leslee Gross, R.N., assistant vice president for operations at Baptist Health South Florida, oversees several disparate departments — home health, the e-ICU, telemedicine and the transfer center. Having a hand in so many areas gave Gross a unique perspective that allowed her to see an unfilled need and come up with a solution. She leveraged her knowledge of telemedicine, home health and the e-ICU to develop a program that allows e-pharmacists to conduct medication reconciliation visits with home health patients by computer.

At the time, speech therapists, though not trained in pharmacology, were handling medication reconciliation during their home health visits. Meanwhile, the e-ICU had e-pharmacists on staff. Baptist already had the needed software through its telestroke program. The addition of cameras on home health nurses’ laptops rounded out the necessary components for an e-pharmacy medication reconciliation program for home health patients.

The program focuses on home health patients with congestive heart failure, but the nurses also organize e-pharmacy medication reconciliation sessions for home health patients who take many medications, for patients who have fallen at home, when a medication is unfamiliar to a nurse, when a patient is on a high-risk medication, or when a nurse has questions about a patient’s medication.

A review of the pilot in late October 2013 found that the 17 participating patients with heart failure required an average of five interventions per patient, for a total of 74 interventions during the program’s first five months. The interventions included education, correction of duplicate medication orders, medication compatibility issues, drug omissions and adverse drug reactions. Thanks to the interventions, the readmission rate for those patients was 11.6 percent, well below the 24 percent national readmission rate for Medicare patients.

Because the home health nurses and e-pharmacists already had the necessary equipment, most of the program costs come from licensing fees. Those costs are far outpaced by the savings the program generates by preventing complications and readmissions.

Winner | Citizens Memorial Hospital, Bolivar, Mo., www.citizensmemorial.org

Electronic Patient Room White Boards

Nurses at Citizens Memorial Hospital thought the hospital’s dry-erase boards didn’t provide patients and caregivers with enough useful information, so the rural hospital in Bolivar, Mo., decided to replace the boards with electronic white boards that would feature pertinent information.

Since financial constraints ruled out buying technology from a vendor, the staff had to design a solution. A small team built the white boards using existing software and inexpensive, off-the-shelf hardware. The system pulls data from the EHR and nurse call system into custom tables. Specific information is pulled from those tables onto each board based on the bed.

The price tag for creating the system and installing 53 electronic white boards in the hospital’s medical-surgical, ICU, telemetry and emergency department beds was just under $50,000.

Network Administrator Jon Moores and Webmaster Lauren Fraser used empty patient beds to get the patient perspective, looking at whether the boards were the right size, whether they felt invasive, whether the background was too bright or too dim, and whether the text was easy to read from that perspective. The legal department made sure the data posted on the boards didn’t violate HIPAA and that the boards weren’t visible from the hall.

Initially, the boards included room and bed number, care team names and numbers, the room and other phone numbers, diet, fall risk, the patient’s pain level and pain goal, the date, time, and patient number. The boards were so well-liked that staff asked for more information to be posted. At the request of rehab, patient activity level and weight-bearing status were added. Discharge planners got the anticipated discharge date on the boards. To support the nurse rounding program, the last four rounding times were displayed.

The electronic boards contributed to an increase in patient satisfaction, McColm says, and communication among providers and between providers and patients has improved. The electronic boards also enhance quality and patient safety because the patient’s diet, activity level, weight-bearing status, fall risk and pain level are clearly communicated to the care team, patients and their families.

Citizens Memorial plans to install the boards in the obstetrics department down the road and is exploring other uses. Ideas include creating patient self-check-in kiosks for certain types of visits and electronic staffing boards that would display in real time who is assigned to which bed. The staffing boards eventually would list in real time which physician is responsible for each patient.

 

2014 Finalists

St. Joseph Mercy Oakland, Pontiac, Mich., www.stjoesoakland.org

Early-Warning Detection System

St. Joseph Mercy Oakland aimed to improve patient safety and reduce mortality rates when the 443-bed hospital in Pontiac, Mich., installed a patient early-warning detection system in a medical-surgical unit and a neuro unit, neither of which had continuous monitoring. The system tracks patients’ blood pressure, pulse rate, respiratory rate, pulse oximetry and body temperature and is able to detect signs that a patient might be deteriorating. Monitors in patient rooms and at nursing stations display the detection system’s assessment of patients’ status with color coding — red for patients who could be deteriorating, green for patients whose metrics are in range, and yellow for patients with one or more metrics outside the normal range. The system has reduced mortality by 34.5 percent, the code blue rate by 50 percent and average length of stay in those units by 5.3 percent, all the while increasing the rapid-response team activation rate by 21 percent and ICU up-transfers by nearly 73 percent.

Texas Health Resources, Arlington, Tex., www.texashealth.org

Electronic Medicare Reimbursement Compliance System

Medicare rules adopted in 2013 that require physician certification of the medical necessity of inpatient hospital services prompted Texas Health Resources to create new processes to comply and optimize reimbursement. The project included new patient lists for case managers that automatically populate with patients who meet the two-midnight rule; changes that make it easier for physicians to certify medical necessity for inpatient services; and best-practice alerts that prompt physicians to complete the certification form when an admission order is placed or when a discharge order is made but certification hasn’t been completed for a patient who falls under the requirements. The health care system used electronic collaboration tools that allowed clinicians to provide input or test new workflows without having to travel to a central location.

Broward Health, Fort Lauderdale, Fla., www.browardhealth.org

Wireless Workflow Improvement

To increase efficiencies in its radiology department, 716-bed Broward Health Medical Center, Fort Lauderdale, Fla., embarked on a multidisciplinary workflow improvement project that included re-engineering standard operating practices and innovative use of wireless technology. One component of the initiative reworked the way portable ultrasound results are uploaded. Wireless technology that transfers images directly into the electronic image archive system replaced the old process that required a technologist to physically return to the radiology department to upload each study into the system. The change saves an average of six hours a day. Another arm of the project reduced STAT radiology report times in the ED from an hour to less than 15 minutes. Because of the initiative’s success, it was implemented in Broward Health’s other hospitals.

 

2013 Innovator Awards

Articles by Douglas Page first appearing in H&HN, August, 2013.

Winner | Kootenai Health, Coeur d’Alene, Idaho, www.kootenaihealth.org

IT Outsourcing

While many other health care organizations are turning to outsourcing to cut costs, Kootenai Health, a 246-bed nonprofit, community-owned hospital in Coeur d'Alene, Idaho, looked in the opposite direction. Kootenai decided to keep all responsibilities for IT technology and services in-house.

The IT localization strategy is meant to ensure accountability and the delivery of consistent, reliable and controlled services.

"We are invested in the success of the community because we are a part of it and we are able to build trust in a way that an outsourcing company never could," says Chief Information Officer Steve Garske. "In the end, it is not just technology that we deliver, but service."

From March to December 2012, Kootenai endured a $5.9 million innovation explosion, which included tripling the size of the information services staff to 75; instituting ITIL (Information Technology Infrastructure Library) core processes; reclaiming IT services from vendor control (which cut outsourcing costs by nearly 60 percent and saved the enterprise $2.7 million); insourcing server, network support and help desk; transitioning to single sign-on, virtual desktops and Voice over Internet Protocol; replacing email with a unified communication system; and implementing a full hardware replacement project.

Garske says without careful planning, financial stability and complete support from the executive team, the insourcing project could not have succeeded to the degree it did. It's also important, he says, that CIOs be technically savvy.

"The decision to insource should not be taken lightly," Garske says. Before deciding to insource, it's important to determine whether the organization has the stability and resources to make the required capital investment, whether long-term benefits will outweigh costs, whether IT leaders have a thorough grasp of current and emerging technologies, and whether the intricacies of vendor contracts are understood well enough to achieve extrication.

"The greatest challenge, however, is finding a way to measurably demonstrate to key decision-makers the value of long-term IT investments at a time when outsourcing seems like such a temptingly easy answer," Garske says.

Kootenai's current lower annual operating costs are directly attributable to insourcing information technologies and IT support services, Garske says, predicting that within five years the initial capital investment will be offset by decreasing operating costs and increased revenue.

In the first year alone, the IT department boosted organizational revenue by more than $3.6 million and reduced operating expenses by more than $2.7 million — while at the same time improving patient care and satisfaction. "We are now able to provide a full range of low-cost IT services to our community without the industry standard profit margins of 25 to 65 percent," Garske says. "This leads to an improved bottom line and a higher quality of service than otherwise could be afforded by a small health care provider."

Winner | Texas Children’s Hospital, Houston, www.texaschildrens.org

Rapid Communication System

Rapid and efficient communication among on-the-go health care providers is always a challenge. Phone calls go unanswered, returned calls are missed, pagers have time lags and space limitations, and emails sit unnoticed on unattended workstations — all potential liabilities in life-and-death hospital environments.

Texas Children's Hospital, Houston, solved the problem with its Rapid Communication System. RCS uses standard iPhones and a proprietary application from Voalte to handle voice, two-way texting, alarm queues, staff availability and directory access.

"From the sender's perspective, we needed a system to answer two primary questions: Is the recipient available and was the message received?" says Myra Davis, senior vice president of information services. From the recipient's perspective, Texas Children's needed a system that provided all-in-one access to calls, text messaging and clinical alarms, as well as a way to indicate sender ID and message priority.

Davis says RCS provides senders information about who's online, their availability status and message-received confirmation. "For recipients, RCS provides a single device that consolidates voice, two-way text messaging and alarm management, as well as sender identification," she says.

iPhones were distributed to staff to carry at all times, each loaded with special software that not only restricts the device to the hospital wireless infrastructure, but also disables the phone's entertainment options. The devices are cloaked in a protective case with a built-in battery that extends the charge life cycle through an entire shift.

RCS provides directory management, including contact name, title and photo to ensure the right message gets to the right recipient. Real-time updates let users know who is online and available, busy at bedside or in a meeting.

High-priority alarms appear first in the alarm manager. Users can accept or reject any alarm with the touch of the screen. If the intended user is unavailable, the alarm manager automatically escalates to the next available user to ensure prompt response.

The network backbone is composed of redundant voice and data server pairs, integrated with the existing hospital PBX using SIP (Session Initiated Protocol) technology, standard telephony components and commercially available hardware.

"Rather than being based on closed, proprietary standards, the Voalte application is built on industry standards, uses commercially available phones and integrates with other middleware platforms," Davis says.

All legacy communication devices are to be replaced in the enterprise by the end of 2013. The $2.9 million system includes approximately 2,000 iPhones, plus integration with existing platforms, such as nurse call, data center infrastructure and implementation services.

"The system also is staged to leverage the iPhone for more advanced workflows, ranging from simple reference material like rapid transfusion protocol to working with EHR vendors to provide seamless access to the electronic health record," Davis says.

Winner | University of Utah Health Care, Salt Lake City, http://healthcare.utah.edu

Value-Driven Outcomes

One of the biggest challenges for any business is understanding and managing the cost of services. For hospitals, the problem is compounded by the levels of complexity behind the services.

University of Utah Health Care, Salt Lake City, separated itself from the rest of the industry more than a year ago by deciding to understand the true cost of health care through an initiative called Value-Driven Outcomes, or VDO.

"To reform health care from a delivery perspective, we must do two things — develop transparency and know our costs," says CEO Vivian Lee, M.D. "To be transparent, we must know what we are being transparent about."

Lee says VDO gives the organization the ability to understand patient-level costs for physician and facility services across a variety of circumstances, including time, patient and provider. "The tool allows us to quickly identify potential opportunities for improvement," Lee says. In many cases, change can be implemented immediately, for example, by eliminating non-value-added testing. In other cases, VDO provides guidance to identify an opportunity to modify or redesign care and implement value-added changes in care delivery within a matter of weeks.

Lee says, unlike some third-party systems that can only determine charges, the internally designed VDO yields a perspective on cost. The Web-based tool also gives providers the ability to use graphical displays to explore data and drill down as needed.

VDO consists of concrete cost methodologies that calculate cost per unit at the patient-utilization level for services such as labor, supplies, pharmaceuticals, imaging and lab tests. Data warehousing expertise brings together clinical and financial data points for cost comparison. Business intelligence tools produce detailed end-user reports that show cost associated with each service. Lee says there were three keys to VDO success:

1. Obtain a mandate from senior leadership to prioritize the project, despite competing needs.

2. Develop a robust technology that provides in-depth visibility to physicians, administrators, managers and analysts on how they can be more cost-effective while improving outcomes.

3. Nurture an innovative and collaborative institutional culture where people with varied skills can come together and work efficiently toward a common goal. "For instance, our physician assistants are familiar with a different set of practices than the MDs or RNs, but their ability to all work together and share solutions for particular procedures is invaluable for determining and implementing change," Lee says. In this environment, VDO serves as an immediate conversation starter; by looking at variance in cost data, conversations about "Why?" can happen in real time, rather than the traditional way of waiting for reports, which often are based on charges rather than actual cost.

"In a collaborative culture, this serves as an accelerant to implement meaningful change," Lee says.

2013 Finalists

Peconic Bay Medical Center, Riverhead, N.Y., www.pbmchealth.org

Network infrastructure makeover

When 182-bed Peconic Bay Medical Center, Riverhead, N.Y., realized the last major upgrade to its information infrastructure was more than 10 years ago, it undertook a six-month, $1.8 million makeover. The wide area network was upgraded, switches replaced and VLANs created. Tom Chiasera, director of network services and communications, replaced mobile medication carts with stationary devices in every patient room to ensure availabity to clinicians. The new network environment allowed him to virtualize 17 servers and create a virtual pool of 180 Windows 7 desktops. To meet the added power demands, Peconic uses Power over Ethernet, or PoE. "This way, we were able to achieve our goal without running additional power to every room," Chiasera says.

Carolinas HealthCare System, Charlotte, N.C., www.carolinashealthcare.org

CeQOL app

Since Todd Heniford, M.D., director of the Carolinas Hernia Center in Charlotte, N.C., part of Carolinas Healthcare System, announced the availability of his CeQOL smartphone app last year, it has been downloaded thousands of times in 57 countries. CeQOL (for Carolinas Equation for Quality of Life) helps male inguinal hernia patients better predict postoperative discomfort. Historically, surgical success was marked by a lack of hernia recurrence. The next phase is tracking the patient's quality of life. "If we can do this with hernia, then we should be able to also help patients make quality of life decisions about limb fracture, head trauma, chemotherapy and congestive heart failure," he says. CeQOL is free at iPhone and Android stores.

Middlesex Hospital, Middleton, Conn., www.midhosp.org

Automatic mattress tracking

Middlesex Hospital, a 209-bed facility in Middletown, Conn., uses an inflatable patient transfer mattress to lift patients. The problem: More than half of the 200 mattresses were lost during a recent three-year period, most discarded accidentally, at a cost of $2,000 each. IT Director Rick Schubach decided to implement a real-time locating system. Wireless RTLS tags were attached to each mattress. Compliance for using them rose to about 90 percent, since staff can always find one, and better use can reduce staff-related lift injuries and associated workman's compensation claims. Also, an automatic alarm positioned near the dumpster sounds when a mattress is detected nearby. Since it was implemented, Middlesex has not lost another mattress through accidental discarding. "This alone paid for the $20,500 project," Schubach says.

2012 Innovator Awards

Articles by Douglas Page first appearing in H&HN, August, 2012.

Winner | Avera, Sioux Falls, S.D., www.avera.org

eEmergency Services

The eEmergency system installed by Avera, a 29-hospital system headquartered in Sioux Falls, S.D., connects minimally staffed rural clinics and emergency rooms to board-certified emergency physicians and specialists 24 hours a day. "Geography should not dictate the quality of care that you receive," says Don Kosiak, M.D., Avera's director of emergency medicine.

With the press of one button, rural health care providers in 57 communities across six upper-Midwestern states have immediate, two-way video access to emergency physicians staffing the system's hub in Sioux Falls.

"Medicine is a team sport," Kosiak says. "It was never meant to be practiced in isolation." With more than 14,000 coded diagnoses, 6,000 medications and 4,000 medical procedures, no one can know everything, every time. "Emergency physicians should have the ability to ask questions of colleagues," Kosiak says. eEmergency provides that capability.

The system uses several technologies, including high-definition videoconferencing supported by a dedicated broadband network. Throughout rural hospital EDs, 32-inch, high-definition, flat-panel monitors are mounted on walls. Ceiling microphones and the button — a Viking emergency speaker phone that automatically calls the hub — also stand at the ready. The hub launches a video connection within 20 seconds.

Hub physicians have access to electronic health records at each remote site, saving time in the event of transfers. Several PACS allow sharing of DICOM images, including X-ray, CT and MRI studies. Some remote sites have installed telehealth stethoscopes and examination cameras.

So far, the eEmergency system, installed in 2009, has provided assistance for more than 2,580 rural patients. The system gets triggered twice a day on average. The majority of cases are trauma (28 percent), cardiac events (26 percent), neurological issues (18 percent), respiratory distress (10 percent) and behavioral health (10 percent).

Timeliness is critical in most emergencies. In more than 600 cases, hub physicians were available an average of 14 minutes before local providers. "The system also has helped rural sites avoid 561 unnecessary transfers, saving patients' payers and providers an estimated $3 million in ground and air ambulance costs," says Jim Veline, Avera's senior vice president and chief information officer.

One key obstacle in eEmergency implementation, according to Veline, has been cost. The system has an annual budget of $3.5 million, with the majority of costs going toward salaries for hub physicians and staff. Also, each eEmergency remote site requires approximately $24,000 in videoconferencing equipment to implement the program. Broadband expenses are estimated at $6,000 per year per remote site.

"Funding the equipment need can be burdensome to small facilities with limited budgets," Veline says. He adds that Avera works with remote sites to secure federal funding and private grants to help offset fees.

Winner | Cullman (Ala.) Regional Medical Center, www.crmchospital.com

eWhiteboard Surgery Tracking

At Cullman Regional Medical Center, inefficient communication in its surgery-anesthesia unit resulted in an estimated 200 telephone interruptions each day. There was a monotonous loop of calls among the one-day surgery unit, registration and anesthesia to determine if a patient had arrived and was prepped for a procedure. And that doesn't even take into account family members who were left in the waiting room wondering where the patient was and how he or she was doing.

To gain efficiency, Cullman formed a performance improvement team using Lean and Six Sigma and charged it with developing a homegrown system to communicate with registration, preadmission testing, surgery staff, surgeons and families. The solution was a network of eWhiteboards updated by the various departments as patient location and status changed.

"Initially, the tracking system focused on reducing phone calls to determine the whereabouts and status of surgery patients," says CRMC President Jim Weidner, "but the project mushroomed into much more of a comprehensive, visual communication tool that not only improved communication and efficiency, but improved family members' ability to track loved ones."

Using $9,916 of a $10,000 budget, Cullman purchased five eWhiteboards and Apple Mac minis to run them. The board in surgery required a touch screen overlay. Programming was done by Cullman's IT department using systems already in-house.

The eWhiteboards in registration and one-day surgery show a patient's expected and actual arrival times. The surgery board reflects medication alerts, anesthesia plan, status of surgeon site markings, pre-op medication, surgical suite occupancy and patient status.

There is also an eWhiteboard in the surgical lounge so surgeons can track patient prepping, and in the family waiting room so families no longer have to wonder while they worry.

As a result, there's been a 46 percent drop in phone calls among departments, with more decreases expected as the system becomes more robust.

"We put tight deadlines in place to complete the tracking board initiative," Weidner says. Completion was targeted for 90 days from concept to finished product, which gave the team an early win, while also minimizing invested capital.

Weidner's advice for team motivation and achieving such early success: Give the team the tools and resources necessary, insist on a sense of urgency and purpose for the team, and reward the team once it completes the project. Once the system went on the air, Cullman's performance improvement team was treated to a dinner at a local five-star restaurant. "It was worth every penny," Weidner says.

Winner | University of Pittsburgh Medical Center, www.upmc.com

Clinical Smart Phones

For all of its potential promise, computerized provider order entry also carries some heavy baggage, not the least of which are communication gaps between clinicians. The problem is that orders, including "stat" orders, can be entered from any device connected to the hospital EHR without any way to notify staff that an order has been placed. Nurses must check the computer continually to see whether an order has been entered into the EHR, interrupting bedside duties.

The University of Pittsburgh Medical Center addressed that problem with what is now a nearly ubiquitous tool — the smart phone. UPMC interfaced CPOE with BlackBerry smart phones to provide instant order notification.

"Nurses now receive alerts of new orders, improving the timeliness of order completion," says Debbie Balcik, director of clinical operational informatics. Balcik says nurse smart phones also receive alerts of arrhythmias or other life-threatening cardiac conditions. RNs acknowledge alerts directly on their smart phones, saving callbacks. The phone also is used to escalate alerts if they are not acknowledged in a specific time frame.

Balcik says the CPOE-BlackBerry system has improved communication throughout the campus. "Nurses and other caregivers can now be reached immediately, whereas before you had to call the nursing station, try to figure out which nurse was caring for which patient, and then send someone down the ward to find them," she says. UPMC also has seen an increase in productivity in nursing, nursing assistants, technicians and ancillary services.

While Balcik says the smart phones have been well-received by staff, there have been some bumps in the road. For instance, the small size of the screen and small keys were challenging for some nurses, but that was addressed by increasing font size and reducing the number of screen icons.

Another issue uncovered during the pilot was patient perception. Some patients and family members thought nurses were using their personal phones instead of attending to nursing duties. This was addressed by installing signs describing BlackBerry use to improve health care and also by a large label on the phones identifying them as nursing phones.

Costs included $149,700 for 300 BlackBerrys and $49,400 for a smart phone enterprise server, plus the monthly fees. UPMC used its existing wireless data infrastructure for all messaging and alerts. It contracts with a cellular carrier for voice-only services — $36.99 per month for each device.

"The smart phone is giving us the edge by providing a new technology to improve communication and decrease errors," Balcik says. "Strategically, the smart phone provides a platform that can be built upon to develop enhancements to support the clinical environment into the future."

Future enhancements include nurse call bell alerts and applications using the smart phone digital camera.

2012 Finalists

Lehigh Valley Health Network, Allentown, Pa., www.lvh.org

Digital pens

An EHR infrastructure of software, laptops and workstations is cumbersome to organize in a makeshift emergency care area, such as at a major NASCAR race venue. Give doctors digital pens though, and they can travel. Lehigh Valley Health Network, the official medical provider for NASCAR at Pocono Raceway in Long Pond, Pa., has a digital pen solution that allows clinicians to document patient encounters in medical tents on familiar forms, which are then synchronized to the EHR. "Rapid deployment of digital pens with emergency care paper templates allows us to bring emergency care and the EHR to the raceway," says Nadine Opstbaum, associate director, information systems, clinical systems. It didn't make sense to implement Lehigh's EHR network for race events a few times a year. Lehigh found the digital pen technology (DigitalShare, from Shareable Ink, Nashville, Tenn.), coupled with customized emergency medicine templates, to be a speedy, intuitive alternative to EHR deployment at Pocono, or at disaster sites. The digital pen solution also streamlined the process of submitting claim forms to the federal government for disaster relief reimbursement. "Our network has a comprehensive immunization program and the digital pen technology was utilized to document the thousands of people in the community who received flu shots," Opstbaum says.

Texas Health Resources, Arlington, www.texashealth.org

Infection prevention

Texas Health Resources earned finalist recognition for using collaborative and social media tools to incorporate best-practice protocols to help prevent catheter-associated urinary tract infections. By using Sharepoint, a collaboration tool that facilitates workflow and manages components of the EHR, and Yammer, a social media tool that allows rapid sharing of ideas and updates to stakeholders and caregivers, Texas Health Resources was able to quickly modify and test changes to 1,639 EHR order sets and deploy best practices to the organization within three weeks. Success soon was apparent in a more than 26 percent reduction in the length of catheter-line days within 60 days of protocol deployment. "Use of the EHR to help reduce catheter-associated urinary tract infection aligns with our efforts to achieve one of the goals of the federal Partnership for Patients — to reduce preventable all-cause harm rates, including hospital-acquired infections, in our hospitals by 40 percent by the end of 2013," says Ferdinand Velasco, M.D., chief medical information officer.

University of Utah Hospitals & Clinics, Salt Lake City, http://healthcare.utah.edu

Bridging EHRs  

When different EHRs are used in an organization's ambulatory and inpatient settings, easy access to patient data can be difficult for clinicians. The University of Utah Hospitals & Clinics found a way to avoid separate sign-ons, patient selection and navigation paths using an EHR bridge, achieving Innovation Award finalist recognition in the process. "The bridge enables easy access to multiple EHRs from within the primary application used by the caregiver," says Travis Gregory, director of clinical transformation. He adds that now information is available with a single click and there is no need for additional sign-ons or patient selection. Gregory says they first investigated HL7-enabled tools to solve the problem, but quickly found limitations for their complex deployment. They also tried to build a single-view using federated data sources, but this became cost-prohibitive and potentially expensive to maintain. In the end, the bridge solution was found in Web capabilities that already existed in the two EHRs. "Many EHR vendors provide Web access tools within the application," Gregory says. "These tools can be leveraged for creative solutions with much less complexity and cost."

2011 Innovator Awards

Articles by Douglas Page first appearing in H&HN, August, 2011.

Winner | Avera, Sioux Falls, S.D., www.avera.org

ePharmacy

The ePharmacy service lets pharmacists at a central hub remotely review and approve medication orders for the mostly rural hospitals in the Avera network. That helps reduce or prevent potential errors and takes the sting out of the shortage of pharmacists in those communities. So far, Avera has implemented the system in more than 20 of its 29 hospitals in four Midwestern states.

The service uses a combination of existing infrastructure, new technologies and pooled resources, making it possible for every medication order to be reviewed and approved in inpatient settings.

Senior Vice President and Chief Information Officer Jim Veline says ePharmacy has become a critical vehicle in Avera's meaningful use journey. "It's an invaluable resource for our rural health care providers," he says. The system provides around-the-clock access to remote pharmacy support, which translates into safer medication practices.

Veline says during a 12-month period, more than 75,000 scans representing approximately 300,000 orders were processed by ePharmacy. "Utilizing intervention tracking, ePharmacists have performed over 5,000 interventions, including dosing issues, therapeutic duplication avoidance, inappropriate abbreviations, drug-drug interactions, allergy and anticoagulation issues," he says.

The hardware and software behind ePhar-macy includes an integrated electronic health record and order scanning devices. The system also supports automated medication dispensing at remote facilities and bedside medication verification. When clinicians from various hospitals write orders, the prescriptions are sent to the ePharmacy hub, where they are prioritized and reviewed manually. ePharmacists use the EHR to check patient treatment and medication histories.

Once approved, the order is electronically sent to the appropriate dispensing unit, devices that resemble automated vending machines. These units unlock and release specific medications to caregivers. "With ePharmacy, a remote pharmacist can virtually ‘hand' the medication to hospital staff, delivering the correct dosage and medication for each patient," Veline says.

Avera says initial capital equipment costs were $2,073,542 plus another $844,347 so the implementation team could get the initial 14 pilot sites installed and operational in the first 12 months. Front-line services staff and five full-time pharmacists to provide 24-hour service came to $896,347.

Implementing ePharmacy in more than 20 facilities meant working with dozens of individuals and legacy systems. "We had to carefully watch and eliminate work-around as we moved front-line staff from an environment with little or no pharmacy review to a process that may require a short wait for order approval," Veline says.

The organization now is partnering with other hospitals within and outside the Avera system. Through secure networks connecting the nonsystem sites, Avera is able to focus expansion on rural, independent hospitals that also have a need for ePharmacy services.

Winner | Baptist Health South Florida, Coral Gables, www.baptisthealth.net

A Hotline to Health Care

South Florida patients no longer have to wonder where the nearest urgent care center is. There's an app for that. Baptist Health South Florida earned an Innovator Award after introducing a free iPhone, iPad and Android application called PineApp that quickly locates the nearest BHSF emergency room or urgent care center based on the user's location. The name comes from the pineapple logo associated with BHSF's brand.

When initialized on a 3G, 4G or Wi-Fi device, PineApp lists all eight BHSF emergency departments and 13 urgent care facilities in the Miami-South Florida area, sorted by proximity, along with a building photo, address, phone number, distance, map and driving directions. An iPod Touch can be used but, because this device has no GPS, no driving distance can be calculated.

"One unique feature PineApp provides is genuine door-to-doctor wait times at each facility," says Wayne Brackin, BHSF executive vice president and chief operating officer. Wait times are given in 30-minute increments for urgent care (e.g., under 30 minutes, under one hour) and one-hour intervals for EDs (under one hour, under two hours). The times are updated manually every 30 minutes by designated staff, but BHSF plans to automate that by calculating wait times using data from an existing clinical system used to track patients.

Since its launch in October 2010, PineApp has been downloaded more than 5,000 times.

PineApp exploits mobile computing technology to help confront the challenge of emergency departments overcrowded with nonemergent patients seeking routine health care. BHSF previously addressed that issue by opening several after-hours urgent care centers to treat minor illness and injury. PineApp was the next step in this process.

Brackin says BHSF physicians initially were concerned that an emphasis on short wait times might create the appearance that speed was more important than quality of care. "Also, our doctors and nurses wanted to be sure we were providing legitimate wait times, not just a marketing ploy," Brackin says.

In the end, BHSF opted for door-to-doctor wait times, which might be longer compared with other EDs that promise patients will be seen within 30 minutes. That often means they'll be seen by a triage nurse or other staff member, not necessarily by a physician. BHSF leaders believe consumers want to know how long it will take to see a doctor, not a nurse and not the inside of a treatment room.

The wait-time feature actually created an interesting intramural rivalry between BHSF facilities. "The emergency departments and urgent care centers began to compare wait times with each other," Brackin says. "That fact alone lowered some wait times."

BHSF spent about $170,000 to develop and publicize the app, including $23,700 for initial vendor contracts, $31,000 for ongoing development and $115,000 for advertising.

Winner | University of Pittsburgh Medical Center, www.upmc.com

eVisits

The University of Pittsburgh Medical Center leveraged its electronic medical record to offer nonurgent patients an online means to avoid office visits or emergency department waits altogether. A system called eVisits is the result.

With the secure eVisits portal, registered patients who have an existing relationship with a UPMC physician complete a detailed questionnaire similar to triage interviews covering more than 25 common complaints, ranging from back pain, bronchitis and sunburn to shingles, sinus conditions and strep throat. Forms can be submitted at any time from any Internet-enabled device.

After submitting the forms, patients receive physician responses, often within minutes, more typically within 4 hours and always within 24 hours. Some physicians have conducted eVisits while traveling. If treatment includes medication, the physician uses the prescribing function and the order is sent electronically to the patient's pharmacy of choice.

An early challenge was physician adoption, which got a boost when a reimbursement model was designed. Approximately 1,000 UPMC physicians now participate.

eVisits now has more than 54,000 registered patients. Since 2009, when eVisits became reimbursable, more than 1,700 eVisits have been submitted. Figures show patients between ages 34 and 49 use the system most frequently, followed by the 50-64 age group. Women tend to use eVisits more than men. The service is offered from 8 a.m. to 8 p.m. daily. During off-hours a medical call center handles eVisits submissions and contacts the on-call physician.

The program began as an effort to develop new service models to manage both chronic and episodic illness, particularly for those patients with limited mobility. Other objectives were to increase patient access to their physicians while reducing wait times in physician offices. Now, patients who use eVisits do not sit in a waiting room. Appointment slots in busy clinician offices thereby are made available as more patients are served online, increasing the convenience for patients who prefer or require a personal appointment.

"This tool allows UPMC to provide convenient and cost-effective care for patients and is part of our broader effort to expand access to care that includes urgent care and after-hours primary care centers," says Jody Cervenak, CIO of UPMC's physician services division. Cervenak believes eVisits also will improve patient safety because the system is integrated into the UPMC electronic health record.'

The largest expense associated with eVisits is the licensing fee for the patient portal module from the hospital's vendor partner, which is $2.40 per year per registered patient, or about $125,000. This cost is recovered, however, as long as patients have at least one reimbursable encounter during the year. Trends show most users have more than that.

2011 Finalists

Texas Health Resources, Arlington, www.texashealth.org

VTE Risk Assessment

Texas Health Resources' interactive venous thromboembolism risk assessment application automatically identifies at-risk patients and then suggests appropriate interventions. The Web-based system is integrated in THR's electronic health record; when a clinician clicks the right button, a routine is triggered that queries the EHR for diagnosis, procedures, labs and other information. A score is automatically calculated and an intervention regime suggested. Ferdinand Velasco, chief medical information officer, says pulmonary embolism-deep vein thrombosis has been reduced 20 percent and utilization of VTE prophylaxis has increased. "Prior to this implementation, VTE prophylaxis could be overlooked," Velasco says. "Now, clinicians either use the order set or must document the reason it wasn't used."

Lehigh Valley Health Network, Allentown, Pa., www.lvh.org

Lehigh Valley Health Network was a dual finalist with both innovations related to burn injuries.

TeleBurn

The first innovation, TeleBurn, allows remote physicians to photograph burn injuries, then upload the high-resoution images online so specialists at Lehigh's Burn Center can decide whether patient transport is indicated, thereby preserving precious bed space for the most severe burn patients. Previously, these consultations were done by phone, and patients who could have been treated at their local hospital sometimes were transported to the center. TeleBurn delivers images to any Internet-enabled device, including smart phones, allowing consultation to be carried out wherever the burn specialist happens to be. "It's amazing how a relatively simple process can provide such a large impact," says Randy Bankes, an associate director of Lehigh's information services.

Snow World

LVHN's second innovation is Snow World, a "cool" virtual reality, pain management alternative for burn patients who must endure sometimes unbearable intrusive daily dressing changes, wound debridement and physical therapy. Most burn patient pain management solutions involve opioids and sedatives, with negative side effects. "Our nontraditional approach reduces or eliminates the need for these medications," says David Pucklavage, manager of clinical applications in information services. Lehigh enlisted a virtual reality helmet company to design a device with a head-mounted, overlapping dual display that provides 90-degree visibility. The device is suspended from an articulating arm on a mobile tripod. Once Snow World is activated, the patient is fully immersed in a fun-filled, snowlike VR environment.

2007 Innovator Winners

Winner | Columbus Regional Hospital, Columbus, IN, www.crh.org
The wireless nurse call system at Columbus Regional Hospital eliminates third-party contacts by providing direct access to nursing staff for patients, physicians and ancillary departments through the use of portable handheld phones. The highly integrated system incorporates the wireless phone system with RFID tagging to provide real-time location of staff and a bed management system that immediately notifies environmental services and the dietary department of a patient discharge. The end result is enhanced patient care and satisfaction by addressing patient needs in a more timely fashion. Employee satisfaction has improved as a direct result of improved communication among the patient care team.

Winner | Lehigh Valley Hospital and Health Network, Allentown, PA, www.lvhhn.org
To achieve universal CPOE compliance by the end of 2006, Lehigh Valley Hospital needed to address parenteral nutrition, required by about 4 percent of the organization's patients daily. PN ordering is complex—numerous ingredients may be needed and are mixed based on patient weight and medical condition. A multidisciplinary team developed an online ordering system that makes use of drop-down boxes, required fields, and alerts and warnings. Implementation of the Web-based system enabled Lehigh Valley to achieve universal CPOE utilization. Legibility and transcription errors have been eliminated and mathematical errors reduced by about 50 percent.

Winner | University Hospitals, Cleveland, www.uhhospitals.org
University Hospitals integrated more than 15 data resources, containing information for more the 700,000 patients, into one physician portal. This secure tool provides physicians with point-of-care wireless access to clinical information, addresses HIPAA compliance requirements for mobile computing and creates a potential for cost reductions through decreases in errors, adverse events, and redundant ordering. Patients ultimately receive better care as clinical data is available to clinicians at all locations.

Finalist | Mountain States Health Alliance, Johnson City, Tenn., www.msha.com
Mountain States Health Alliance needed a solution to address emergency department overcrowding and improve patient satisfaction. The solution: post ED wait times online for the public. This initiative was facilitated through implementation of an ED patient-tracking system. The Web team worked with information systems analysts responsible for implementing the tracking system; together, they developed a product that posts up-to-the-minute wait times at all five facilities. For non-urgent cases, patients can check the Web site to determine which emergency department has the shortest wait time.

Finalist | Texas Health Resources, Arlington, Texas, www.texashealth.org
Interactive training, skills assessment and progress monitoring are the keys for a successful electronic health record at Texas Health Resources. The courses are Web-based and employ an intuitive navigation tool for ease of use. Content was created under the rapid development model, resulting in cost savings of 30 percent. The modular content is more easily updated, resulting in long-term cost savings as well.

Finalist | Texas Health Resources, Arlington, Texas, www.texashealth.org
To obtain financial and productivity information from a single source, Texas Health Resources put together an interactive financial portal offering in-depth information for its leadership. Monthly departmental and productivity reports are accessible through the online portal, eliminating costly and labor-intensive collection, printing and distributing of the data. Automatic notification of updates and posts is sent via e-mail and the previous day's financial data is available by 10 a.m. each day.

2006 Innovator Winners

Winner | Columbus (Ind.) Regional Hospital, www.crh.org
A team of clinicians and other professionals redesigned and automated the medication reconciliation process to reduce steps from 42 to eight and improve process efficiency by 81 percent. The new method ensures that patients and clinicians are aware of the medications with which the patient arrived, those that were prescribed during the hospital stay and those prescribed to take at home. The medication reconciliation process eliminated illegibility issues, transcription errors and duplication of efforts.

Winner | Lehigh Valley Hospital and Health Network, Allentown, Pa., www.lvhhn.org
The organization's Advanced ICU incorporates video and photo technology with provider order entry, medication administration records, real-time documentation charting, and medical device data and patient monitoring. The system uses a variety of components and internally and externally developed technologies, and can oversee the care of up to 90 critical patients at one time. The organization has reduced mortality rates, lengths of stay, costs per case and complication rates while increasing admission capacity. In addition, nurse, physician, patient and family satisfaction rates have improved.

Winner | Health Quest, Poughkeepsie, N.Y., www.health-quest.org
Health Quest developed a multidisciplinary wireless strategy for implementing bar-code-assisted medication administration at the point of care. The strategy includes wireless, cellular phones, pagers, two-way radios, voice, biomedical telemetry, and personnel and equipment tracking. Since this project was introduced, the medical center has documented more than 167 adverse drug events, two of which would have resulted in sentinel events. Unexpected benefits included cellular and software vendors renegotiating their existing contracts in anticipation of using the wireless network and increased cell phone reception as well as expanded Internet access.

Finalist | Crozer-Keystone Health System, Springfield, Pa., www.crozer.org
Challenged to replace a legacy system and add additional functionality, Crozer-Keystone Health System developed an in-house application that combined bed tracking and administration, and patient transport systems at three hospitals. The application allows users to check and report job status using voice recognition. Environmental services and transport employees receive pages notifying them of job assignments. Managers get an electronic alert when employees haven't responded to a page with a defined time period. The bed tracking module gives an overview of each room with indicators such as sex of patient, cleaning status of room and transport status of patient. Users can drill down to a more detailed description of each room.

Finalist | Texas Health Resources, Arlington, Texas, www.texashealth.org
Texas Health Resources formed a committee to develop a strategy for adopting an electronic health record. To increase participation and simplify communication, an application was created that allows participants to view and respond to survey questions and enables an administrator to manage and disseminate information, and export survey results to a presentation. The group is able to respond via PDAs or PCs. Because committee members find the application flexible and easy to use, they provide more timely feedback on specific topics.

Finalist | Skaggs Community Health Center, Branson, Mo., www.skaggs.net
In its emergency department, Skaggs Community Health Center implemented CCOW, a context management tool that enables physicians to smoothly move among disparate clinical applications. It speeds up the computerized processes and increases the staff's accuracy and comfort with the applications. CCOW relieves staff of navigating multiple systems while caring for the patient.

2005 Innovator Winners

Winner | Baylor Health System, Dallas, www.bhcs.com
Employed a wireless e-clipboard for registration that integrated existing information technology systems. The e-clipboard minimized wait times, lessened congestion at the front desk and reduced the need for paper forms. Patients in the breast imaging center, where the e-clipboards were introduced, can swipe a driver's license or credit card through an electronic card reader, thereby eliminating the need for repetitious data entry, allowing quick confirmation of registration material, verification of current and future appointments, and processing of any co-pay requirements.

Winner | Richard L. Roudebush VA Medical Center, Indianapolis, www1.va.gov
Implemented a point-of-care, tele-diabetic eye screening program to reduce clinic wait times and no-show rates, and to address patients' dissatisfaction with having to travel to a centralized clinic for annual eye exams. The program is linked into the existing electronic health record system. The system identifies patients at risk for diabetic retinopathy and generates annual reminders for eye screens that are sent to call center nurses. The nurse contacts the patients to ask if they have already received an annual eye screen. The reminder can be cleared if the patient has received the necessary treatment or the nurse can schedule an eye exam at the patient's previously scheduled clinic visit. The system ensures patients receive timely eye exams and don't fall through the cracks.

Winner | Texas Health Resources, Arlington, www.texashealth.org
Created a Web-based application that collects and analyzes actual medical errors and near-misses. The Safety Action Learning Tool was deployed to 21,000 employees within nine months. The system pushes nightly e-mail reminders to managers, pharmacists and risk managers for appropriate action. Catastrophic events are pushed to appropriate managers immediately. Managers can review events for their specific department, risk managers are able to access all events within the hospital and pharmacists have access to all medication events within the hospital. The review component allows the appropriate person to communicate, coordinate and learn from each event, resulting in a 75 percent reduction of adverse event cycle time.

Finalist | Bon Secours Richmond (Va.) Health System, www.bonsecours.com
Provided laptop Internet access for parents in the neonatal intensive care units. Using NICU.net, parents are able to view the neonatal unit from home, reassuring them that their baby is comfortable and that his or her needs are being met. Parents call the NICU when they would like to view their baby and the nurse places a camera at the baby's bedside. The hospital found that the system builds parents' confidence in their ability to care for the infant because they become more familiar with the baby's routine and appearance. The system is relatively inexpensive, employing laptops and cameras for 16 patient beds. Privacy aspects were addressed by positioning the camera on the baby only, providing no sound or recording capabilities and automatic cutoff after two hours (parents are able to reactivate the camera any time). Parents are informed that cameras may be turned off during treatment.

Finalist | Miami Children's Hospital, www.mch.com
Improved infant survival rates following congenital heart surgery by combining clinical information systems with point-of-care diagnostics. Clinicians and intensivists are able to access patient data through a single Web interface. The program generates and saves patient progress notes, vital signs, radiology reports, lab results and real-time patient images on a daily basis as well as intraoperative digital images. It also connects the heart team and referring physicians across the state. The solution provides health information whenever and wherever treatment decisions are being made. It has produced a 74 percent reduction in infant mortality rates among the highest risk groups and a 63 percent decline in overall deaths.

Finalist | University of Colorado Hospital, Denver, www.uch.edu
Developed a Web-based system to provide direct communication between the CEO of the hospital and clinics and patients immediately following clinic visit. Patients receive a standardized, personal e-mail and are asked to respond to three questions and provide comments. The CEO personally responds to all comments, negative or positive. Survey results are available to physician and clinic leaders. A summary of the previous year's results are posted on the hospital Web site. The system provides timely feedback from patients, rapid response to patients' concerns and creates a population of connected patients that the organization believes will be valuable for the success of future Web-based initiatives.

2004 Innovator Winners

Winner | Abington (Pa.) Memorial Hospital, www.amh.org
A web-based Virtual Anticoagulation Clinic was created to improve and measure patient safety and efficacy of warfarin therapy. It is able to track dosing in all practice offices, standardizes warfarin education for clinicians and education for patients.

Winner | Central Dupage Health, Winfield, Ill., www.cdh.org
Central Dupage Health expanded its portal and Web-enabled applications to securely deliver clinical information wirelessly to privately owned PDAs and laptops. Patient data had to be repackaged to fit PDA-sized screens and data was encrypted to be broadcast over a wireless or cellular network.

Winner | Texas Health Resources, Arlington, www.texashealth.org
This health system developed a Web-enabled HIPAA training system accessible from the desktop. More than 18,000 employees and clinicians have participated in 112,000 classes and 200,000 online assessments.

Finalist | Berkshire Health Systems, Pittsfield, Mass., www.berkshirehealthsystems.com
The system collaborated with small businesses, government and others to create Berkshire Connect, a telecommunications co-op that provides long distance, local Internet and data connections at service prices comparable with major metropolitan centers.

Finalist | Integris Health, Oklahoma City, www.Integris-Health.com
The 15-hospital network created Project Phoenix to detect potential adverse drug events by triggering alerts. A Web monitor display shows the status of occupied beds and utilizes red, yellow and green dots to display the status of patient alerts. The touchable screen integrates and extracts data from multiple systems throughout the network.

Finalist | Saint Luke's Health System, Kansas City, Mo., www.saint-lukes.org
A clinical kiosk makes computer applications easier to understand and use. This project increased the number of effective computers, increased desk space, increased the monitor viewing area and allowed for implementation of online physician order sets and clinical pathways.

2003 Innovator Winners

Winner | Baptist Memorial Health Care, Memphis, www.bmhcc.org
Physician portal expands the types of patient data that the 700 subscribed physicians and 600-plus office staff can see—from lab results to fetal monitoring to MRIs—and shows data in real time anywhere they have Internet access.

Winner | Cozer-Keystone Health System, Springfield, Pa., www.crozer.org
A creative plan to address the radiologist shortage: international on-call radiology coverage for night call using their newly implemented Picture Archiving and Communications System.

Winner | Ochsner Clinic Foundation, New Orleans, www.ochsner.org
To boost bed turnaround, a Web-based application that displays the status of all beds on a single screen in real time was loosely patterned along the lines of air traffic control concepts.

Finalist | CareGroup Healthcare System, Boston, www.home.caregroup.org
Patient-provider communication portal that empowers patients to actively participate in their own health care through online access to physicians and records, including the ability to track and graph health data over time.

Finalist | Intermountain Health Care, Salt Lake City, www.ihc.com
A data warehouse system to "slice and dice data on the fly" and identify where best care is not being provided and intervene to change the care process for patients at risk, such as diabetics, asthmatics and cardiovascular patients.

Finalist | St. Joseph Healthcare, Lexington, Ky., www.sjhlex.org
The glucose management system measures and records patient glucose levels on handhelds, produces graphed reports that replace handwritten flow sheets and allows physicians to view the reports online in real time.

2002 Innovator Winners

Winner | CareGroup Healthcare System, Boston, Mass., http://home.caregroup.org
Personlized computer message system allows patients access to various services including prescription renewals, referrals and access to medical records through a secure server.

Winner | Community Health Network, Indianapolis, Ind., www.ehealthindiana.com
A Web site/recruitment tool to combat the nurse shortage: nurses for hire can take a virtual tour of the hospital, chat with administrators and apply for a position, all from their own homes.

Winner | Ohio State University Health System, Columbus, Ohio, www.osumedcenter.edu
Wireless clinical reporting system enables staff to retrieve radiology images and other medical records via the Web using a laptop, handheld or PDA.

Finalist | Borgess Health Alliance, Kalamazoo, Mich., www.borgess.com
With a wireless keyboard and using a television screen instead of a computer monitor, patients can surf the Internet to research their illness, e-mail loved ones, or chat with physicians all from the comfort of their beds.

Finalist | Overlake Hospital Medical Center, Bellevue, Wash., www.overlakehospital.org
A secure Web site allows docs easy Internet access to medical records, including billing and insurance information.

Finalist | Saint Luke's Shawnees Mission Health System, Kansas City, Mo., www.saint-lukes.org
Using the Internet and wireless transceivers worn by the patients, physicians can monitor patients' heart rhythms without being bedside.

2001 Innovator Winners

Winner | Borgess Health Alliance, Kalamazoo, Mich., www.borgess.com
Access to electronic patient records was dramatically improved without adding expensive computer hardware by exporting patient information to physician-owned Palm Pilot/Visor devices.

Winner | Memorial Health Services, Long Beach, CA, www.memorialcare.org
The hospital system uses familiar smart-card technology to give people easy access to their own personal and family medical information.

Winner | Pacific e-Health Innovation Center, Honolulu, Hawaii, www.tamc.amedd.army.mil
The Department of Defense established this government-owned, contractor-operated program office in Hawaii to develop practical technological solutions for public- and private-sector health care delivery.

Finalist | Ascension Health, Evansville, Ind., www.ascensionhealth.org
Medical data from different clinical information systems can be accessed via a single Web browser—eliminating the need to sign on to multiple systems.

Finalist | Community Hospitals Indianapolis, www.ehealthindiana.com
A comprehensive e-health and e-business initiative has resulted in applications designed to be customized easily across the network's many organizations and market areas.

Finalist | The Washington (Pa.) Hospital, www.washingtonhospital.org
Working with the local physician network, a community wide patient information system was implemented, improving the process, documentation and quality of care.