A special meeting of the Sharp Grossmont Medical Staff with the Sharp Information Systems Department (ISD) was held on September 6 to address issues with the Cerner application used in the hospital. Some of the highlights of the meeting were slowness/performance, description of the steps taken to this point, and future action plans.
System Slowness and Downtime - Where are we now?
The Cerner application was upgraded to the 2012 code level on July 22, 2012 to meet the requirements of ICD 10 and Meaningful Use part 2. After the upgrade the system became unstable resulting in slowness and crashes. This made it difficult for the medical staff to place orders, perform medication reconciliation, and complete the depart summary.
In August several packages were installed to address issues with FirstNet, orders, and system stability. The last was implemented on August 28th. Since that time the IS department has not seen the behaviors that lead to the system freeze and slowness. The feedback from the hospitals is the application no longer freezes and is as fast as or faster than before the upgrade in July. The way orders are processed in Cerner was also changed to reduce the time it takes to place an order from 1-2 seconds to less than 1 second. Several improvements in the way software packages are installed have been implemented that will reduce the number and the duration of scheduled downtimes to mitigate the impact to care providers.
ROMACC
Several physicians expressed frustration about the Medication Reconciliation process. Sharp has formed a system-wide task force to analyze and improve the medication reconciliation process. Sharp also participated in a summit with other Cerner sites with the goal of streamlining the product. The hospitals have also hired Pharmacy techs in the ED to assist with home medication process. The IS Department is testing the option of defaulting medications to "continue" for admission and transfer medication reconciliation. Clean-up activities continue to remove obsolete medications from the list of available medications to make easier to search for medications. The Sharp Cerner team is ready to implement the improved Transfer Advisor Mpage and other systems preferences once training is complete.
Downtime Procedures - Where do we go from here?
One of the other concerns expressed in the meeting was access to patient data when the system down. Sharp has adopted several solutions to provide critical information such as medications, vital signs, lab results, and medical imaging reports. These programs: PowerChart Local Access (PCLA), 724 and DB Motion are currently available on the units to be used during downtimes.
Cerner Issues - Who are you going to call?
Going forward, an action plan will be developed to address specific problems with the Cerner application. The IS Department will work closely with the vendor and the Clinical Informaticists to identify problems and optimize the system. If you have questions or concerns please email Dr. Vaughn, Director of Medical Informatics and Dr. Lemoine, CMIO (define CMIO) at
CMIO@sharp.com<mailto:CMIO@sharp.com>. You can also reach the Physician Focus Hotline 24 hours per day at 858-627-5202.
Other important contacts:
