Health Care Information Technology: The prescription for successful implementation | AccountingWEB

Health Care Information Technology: The prescription for successful implementation

On February 4, I attended the Massachusetts Health Data Consortium conference entitled HIT '11: The tools for meaningful and accountable care. It was a fabulous day packed with information from health care providers and health care payers across the nation.

Since I couldn't keep up with the information flow, I'm looking forward to reviewing the slides once they're up later this month.  In the meantime, the next few posts provide snippets from several sessions.

I hope you'll find it as interesting as I did.  This one focuses on the first session:  Clinical Decision Support: Technology at the point of care.

The pluses and minuses of alerts during the prescribing process

Electronic Medical Records systems alert physicians when their prescriptions may conflict with best practice.  Physicians then have the option of changing their orders-and overriding the alerts with an explanation of why they did so.

One problem is that if these systems provide too many false alarms, physicians just override all of them.  Another problem is that overriding alerts can expose the physician to malpractice claims.

The goal is to provide useful information, without impeding work flow

Michael Lee, Director of Clinical Informatics at Atrius Health, spoke about the steps his physician group is taking to provide physicians with tools they can use, at the point of care, to avoid medical errors.  Dr. Lee explained that one of his organization's goals is to strike the right balance between providing useful information-and impeding physicians' work flow.

Steps to success

Dr. Lee and his organization have addressed these concerns in a number of ways.  For one, the organization asked clinicians which alerts were driving them crazy.  Then, it formed a clinical panel to determine how important each alert is and which alerts the organization can suppress.

To ensure, however, that physicians have the information they require at the point of care, Dr. Lee has worked with Up-to-Date, a publisher of evidence-based guidelines, to incorporate a "quick reference button" .  This button enables physicians to access Up-to-Date's content directly from the electronic medical record .  As an incentive to consult this data, the organization provides physicians with Continuing Medical Education (CME) credit for the time they spend using Up-to-Date.

To expedite the work flow, the organization has also identified which decisions the physicians must make themselves.  The support staff makes the remaining decisions.  Future goals include decision support for high cost imaging services and involving patients more in their own care.

Automation of med delivery:  From brain to vein

Next, Dr. Daniel Nigrin, the CIO at Childrens Hospital introduced us to the Childrens Hospital Applications for Maximizing Patient Safety (CHAMPS) using medication administration as an example.  Here, the goal was to automate all aspects of the process "from brain to vein" and across multiple actors (i.e. physicians, pharmacists, nurses, technicians, and couriers).

Children have special needs

Dr. Nigrin, began by pointing out that children are at especially high risk for medication dosing errors.  They are smaller than adults; and there is a wide spectrum of patients, from premature babies to 18-year-old football players.  Because of this variation in patients, there are more than 1000 custom order sets, representing 70% of the total.

Better systems, in combination, reduce errors by 50%

The organization tracks the status and locations of the medication at each step of the process.  Since Children's implemented this process, there has been a 50% reduction in medical errors.

It uses barcodes to ensure delivery of the right medication, location codes to help nurses keep track of where the medication is, and time stamps to find bottlenecks.  The tool also provides alerts about doses that occur too often to prevent overdoses.

CPOE, alone, had a modest effect.  It was the combination with bar coding, that enabled Childrens Hospital to sustain the decrease in medical errors.

This blog

by Barbara Bix - In tough economic times, more and more clients are looking to their accountants to help them improve the bottom line. Often, the best way to do that is to start with the top line-since one can only decrease expenses so far. This blog discusses concrete actions you and your business-to-business clients can use to accelerate revenues.

More from this blog

Bloggers crew

Steve Knowles has spent 25 years in business and practice in the UK, but he also worked in the states and the years haven't dulled his way of seeing an alternative view to everyone else, and every day is a new adventure.


Joel M. Ungar, CPA is a lifelong resident of the Detroit area and a graduate of The University of Michigan. He is a principal with Silberstein Ungar, PLLC, a Top 15 auditor of SEC public reporting companies.


Allan Boress, CPA, with over 25 years as a practitioner and consultant to the accounting profession. Mr. Boress is the author of 12 published books in 6 different languages, including a best-seller, The "I-Hate-Selling" Book.


Larry Perry, CPA, CPA Firm Support Services, LLC, is the author of accounting and auditing manuals, author and presenter of live staff training seminars, and author of webcast and self-study CPE programs. He blogs about small audits, reviews, and compilations.

Sandra Wiley, COO and Shareholder, is ranked by Accounting Today as one of the 100 Most Influential People in Accounting as a result of her prominent role as an industry expert on HR and training as well as influence as a management and planning consultant. She is also a founding member of The CPA Consultant's Alliance. Sandra is a certified Kolbe™ trainer who advises firms on building balanced teams, managing employee conflict and hiring staff.

Maria Calabrese, CIR, Human Resources manager for Fazio, Mannuzza, Roche, Tankel, LaPilusa, LLC in Cranford, New Jersey, Maria's topics revolve around the world of: Mentoring, Performance management, and The "Y Generation," a.k.a. "The whY generation".


William Brighenti is a CPA, Certified QuickBooks ProAdvisor, and Certified [Business] Valuation Analyst, operating an accounting, tax, and QuickBooks consulting firm in Hartford, Connecticut, Accountants CPA Hartford.


Ken Garen, CPA, is the co-founder and President of Universal Business Computing Company (, a software development firm of high-volume, high-productivity accounting and payroll technology.


Eva Rosenberg, MBA, EA, is the publisher of, and author of the weekly syndicated Ask TaxMama column. She provides answers to tax questions from taxpayers and tax professionals worldwide.


Amy Vetter, CPA, CITP is the CPA Programs Leader for Intacct Corporation responsible for leading the CPA/BPO Partners nationally.

Brian Strahle is the owner of LEVERAGE SALT, LLC where he provides state and local tax technical services to accounting firms, law firms and tax research organizations across the United States. He also writes a weekly column in Tax Analysts State tax Notes entitled, "The SALT Effect." For more info, visit his website:
Scott H. Cytron, ABC, is president of Cytron and Company, known for helping companies and organizations improve their bottom line through a hybrid of strategic public relations, communications, marketing programs and top-notch client service. An accredited consultant, Scott works with companies, organizations and individuals in professional services (accounting, finance, medical, legal, engineering), high-tech and B2B/B2C product/service sales.

Rita Keller is a nationally known CPA firm management consultant, speaker, author, mentor and blogger. She has over 30 years hands-on experience in CPA firm management, marketing, technology and administrative operations.

Stacy Kildal is the mom of two fantastic kids, an Advanced Certified QuickBooks ProAdvisor, Certified Enterprise Solutions ProAdvisor, Sleeter Group Certified Consultant, a nationally recognized member of the Intuit Trainer and Writer Network, and co-host of RadioFree QuickBooks.
Michael Alter's blog specializes in providing practical advice to those who seek greater profitability and practice management tactics that enhance deeper client relationships.

Sally Glick, CMO, Principal, Marketer of the Year in 2003 and AAM Hall of Famer in 2007, leads a lively discussion of the constantly expanding roles of marketing and the professional marketers that drive this initiative in accounting firms of all sizes.


The IMA Young Professionals Blog features the insights of IMA’s Young Professionals Committee. Committee members share advice and experiences on careers, continuing education, work/life balance, and other issues affecting young accounting and finance professionals.


FEI Financial Reporting Blog provides highlights from SEC, PCAOB, FASB, IASB, and other regulatory news, including reporting under Sarbanes-Oxley Sect 404. It is written by Edith Orenstein, Director of Technical Policy Analysis at FEI.


Sue Anderson has 30 years of experience in continuing education for accountants. Currently she is the program director for online CPE provider CPE Link.


Jim Fahey is COO of Apple Growth Partners, a regional CPA firm in Ohio. His focus is on the effective and efficient use of technology within the firm by all team members.

Caleb Newquist is the Editor-in-Chief of Sift Media US, overseeing content for both AccountingWEB and Going Concern.

Leita Hart-Fanta, CPA, CGFM, and CGAP is the author of "The Yellow Book Interpreted" and owner of a website devoted to training for governmental auditors.


AccountingWEB is more than just a U.S. team of journalists and financial and technology experts - we have an international side, too! Members of our British team who publish share their ideas, insights, and perspectives from across the pond.