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“The ability to conduct an online collaborative review that our clinician reviewers understood the process, what

process was felt to be conducive to streamline the process needed to be accomplished and how they could partici-
of reviewing clinical order sets in the large geographi- pate,” he adds. “With this collaborative review process,
cal area where Aurora-affi liated physicians practiced,” physicians became active stakeholders in fi nalizing order
says Gorczynski. “Our goal was simple – drive clinical sets. Clinicians found it easy to participate.
evidence to the point of care, ultimately increasing the “The executive team recognized that with increased
number of evidence-based, standardized order sets used clinician participation, physicians would more likely

via CPOE.” adopt the fi nalized order sets once a consensus was

reached,” says Smith. “Given that the ZynxOrder
Online review now possible online collaboration environment was easy to use,

Aurora decided to deploy ZynxOrder to achieve there was a culture shift resulting in more physicians
its goal and, by fall, Aurora was able to deploy its on- participating in the order-set review process. They felt
line solution. ZynxOrder they could directly impact and improve their work-fl ow
For more information on is a content-management process, while contributing their clinical expertise.”
Zynx solutions:
system for developing and
maintaining evidence-based
order sets, alerts and reminders. Clinicians are now able
“The ability to conduct an online collaborative
to navigate the review process of standardizing order sets review process was felt to be conducive to
online, rather than at inconvenient meetings.
streamline the process of reviewing clinical
A team of Aurora pharmacists previewed order-set
templates for formulary- and medication-related con-
order sets in the large geographical area
cerns. They were then forwarded directly to the physi-
where Aurora-affi liated physicians practiced.”
cians for review via the online collaborative application.
Physicians and other clinicians across Aurora’s wide
network can share order sets and give their input online. By late 2009, 220 order-set reviews had been com-
They also can review the clinical evidence supporting pleted within the regional healthcare system. A total of
their decision in the process. 255 individual physicians are involved in the review pro-
Requests to review order sets specifi c to each clinician’s cess, plus 195 individual nurses, pharmacists and allied
specialty also ensured their timely feedback. Input from health providers conducting several thousand reviews.
ancillary departments was obtained as appropriate. Follow- Aurora experienced a fi ve- to 10-fold increase in the
ing a two-week online review period, a multidisciplinary number of clinicians who became involved in standard-
core team reviewed the comments, and was empowered to izing the order sets.

make decisions regarding the fi nal form of the order set. “With ZynxOrder, clinician consensus was reached
“Physicians were not only given CPOE templates that quickly with a high level of participation from clinicians,”
were evidence-based, but could also easily reference the says Gorczynski. “Data was easily collected, reconciled
clinical studies directly,” Smith explains. “The studies and deployed into the fi nal order set. Virtual teams were

were archived in an electronic library of printable docu- created, such as a system-wide group of obstetricians
ments that could be easily accessed so physicians could or ED physicians; they were connected directly with

examine the study results directly.” specialty-specifi c order templates to review, relevant to

In a paper system, links to clinical studies and research their patient population.”
evidence are not available, but with ZynxOrder integrated Aurora also found there was an increase in evidence-
into a PowerChart CPOE system, peer-reviewed research based, clinically reviewed order sets, with immediate
became easily accessible via the Aurora libraries Web site. updates across the system to the order sets that refl ected
This enabled physicians to review and download materials the best practices and the latest research.
quickly, a high priority given physicians’ work fl ow. “We had committed to leveraging evidence-based
medicine in 2004,” offers Smith, “so when the HITECH
Nelson Publishing
Physicians as active stakeholders guidelines for meaningful use were published, the inclu-
Aurora also found that the use of common subsets sion of evidence-based medicine was easily received by
2500 Tamiami Tr N
of orders that apply across multiple conditions – nested senior leadership, care management and information
Nokomis, FL 34275
order sets – became easier. For example, a standardized technology. By ensuring that standardized order sets
approach to the tiered use of several medications for the were accessible across the system with an easy-to-use
treatment of nausea was created. It was then applied solution, physicians and providers had access to the latest
uniformly in a modular fashion to many order sets. clinically supported best practices for improved care for
“We provided teaching and training in order sets so their patients.” HMT HEALTH MANAGEMENT TECHNOLOGY February 2010 39
HHMT1002 Zynx FINAL.indd 39MT1002 Zynx FINAL.indd 39 11/25/2010 2:22:06 PM/25/2010 2:22:06 PM
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