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 Pioneers

Increasing ROI from EMR/CPOE

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   By Wolters, February 2010

Trusted clinical content and advanced decision support drive outcomes

Achieving the levels of integration and clinician adoption necessary to meet the standards of meaningful use, drive improved outcomes and accelerate the return on HIT investments are the most significant challenges provider organizations face.

Success requires the application of advanced informatics technologies that push clinical content and tools into EMR/CPOE systems, enabling point-of-care access to intuitive CDS. Integrating order sets, care plans, drug information and other decision support with easy access to trusted medical evidence creates a powerful system that clinicians embrace. This is especially true when CDS fits seamlessly into existing clinical work flows and includes productivity-enhancing tools.

Wolters Kluwer Health recognizes that aligning these key pieces of the HIT puzzle is critical for organizations to effectively advance the practice of evidence-based medicine and realize the resultant clinical and financial benefits. That is why the company has implemented a three-pronged approach of content-driven software, informatics technologies and informatics managed services that leverage the industry's most trusted clinical content and advanced CDS to drive tangible results.

Content-driven software

Built upon an unmatched clinical content framework and developed by and for clinicians, Wolters Kluwer Health's point-of-care software advances the practice of evidence-based medicine by touching every aspect of the patient encounter. It brings together the full spectrum of best practices, trusted clinical content and intuitive CDS tools.

At the heart of the company's offerings is UpToDate®, the industry's foremost evidence-based clinical information resource. Maintained by more than 4,000 physician authors and editors and used by more than 360,000 clinicians worldwide to efficiently answer questions, make diagnoses, create treatment plans and share information, UpToDate covers more than 7,700 topics in 15 medical specialties. All topics are subject to rigorous peer review and are continuously updated.

UpToDate's superior clinical content combines with the best-of-breed technology platform from ProVation Medical to form the backbone of another key solution: ProVation Order Sets, powered by UpToDate Decision Support. An actionable, evidence-based order set authoring and management solution, ProVation Order Sets is designed for use in both electronic and paper-based environments and provides complete integration with most EMRs.

In addition to simplifying development of custom order sets, ProVation Order Sets includes hundreds of predefined content modules spanning emergency, inpatient and outpatient settings for adult and pediatric patients across many medical specialties. It also provides supporting links to evidence and CDS from multiple sources, including UpToDate, and automated evidence monitoring to ensure ongoing validity of existing order sets.

Other tools include: ProVation Care Plans, Medi-Span, Facts & Comparisons, ProVation MD and ProVation MultiCaregiver.

Informatics technologies

In addition to a comprehensive set of software solutions, Wolters Kluwer Health offers advanced capabilities and interfaces that facilitate rapid integration of medical content and CDS with CPOE/EMR. Technologies feature controlled data structures to maintain integrity across versions, enabling complex data maintenance and advanced functionality such as flexible rules for merging multiple data sets, intuitive anticipatory interfaces and advanced text rendering.

For example, the Order Set-CPOE Integration Platform enables exporting of content sets from an order sets application, maps them according to standard terminology, codes and/or proprietary system languages, and imports them into CPOE with minimal reformatting or manual intervention. It also enables restructuring of paper-based order sets or those residing in a legacy or other electronic environment for automated importing into CPOE.

Another key technology is the Order Set Updating & Maintenance Tool, which automates monitoring of supporting medical evidence. It integrates the UpToDate Practice-Changing Update feature with a user-friendly tool that enables comparisons between current and recommended orders and calls attention to new evidence impacting existing order sets and care plans.

Other technologies include: Order Catalog Integration Platform; CDS InfoButton; HL7, Custom and Clinical Device Interfaces; Structured Documentation and Text Rendering Engine; CDS Rules Platform; Computable Guidelines Engine; and Clinical Data Collection/Reporting Tools.

Informatics managed services

The third tier for maximizing EMR/CPOE investments involves applying deep clinical and informatics expertise to help client organizations evaluate needs, establish and maintain clinical processes, guidelines and rules, and manage integration of decision support functions into health IT systems.

Most engagements begin with a CDS Audit, a comprehensive analysis of an organization's processes, procedures, tools and utilization rates with regards to Core Measures and other key quality/outcomes measures. This provides the foundation for recommendations on how to improve utilization of CDS to better meet established goals.

Wolters Kluwer Health's experts also provide terminologies, crosswalk and mapping; order set creation, clinical integrity checks and maintenance; order catalog creation and maintenance; and clinical content creation. Also available are consulting services to help improve QI/regulatory measures, as well as to create, implement and maintain disease management guidelines.

Ultimately, the success of any HIT strategy lies with its ability to drive improved clinical outcomes. With its innovative, clinician-centered approach to delivering point-of-care medical content and intuitive CDS that does not disrupt clinical workflows, Wolters Kluwer Health helps ensure its clients achieve those outcomes — and a maximum overall return on their technology investments.

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