Technology Helps for Health Care Data

Hospital pharmacists know thatthe ability to stay on top ofchanges in patient health andmedications is vital to ensuring positivepatient outcomes. Various health informationsystems can assist by providingtools and services to help gather, retrieve,classify, and manage health caredata accurately and efficiently.

One example of this technology isbioMérieux's Stellara Clinical Interventionand Patient Monitoring software. It isdesigned to integrate microbiology results(identification/susceptibility/resistance)from bioMérieux's BacT/Alert 3Dand Vitek 2 systems with the patient therapyprofiles, as well as other laboratoryresults, directly to the pharmacist and clinician.Having this real-time informationallows clinicians to quickly match bacteriato the most effective treatments, avoidingpossible errors in dispensing and reducingcostly adverse drug events (ADEs).

Mike Broyles, BS, PharmD, is the directorof Pharmacy, Laboratory, and ImagingServices at Randolph County MedicalCenter, a rural community hospital inPocahontas, Ark. His hospital's pharmacywas using bioMérieux's TheraTrac 2 systemfor years before it upgraded to theStellara system in October 2004, and heand his staff noticed the difference rightaway. He said, "The Stellara system atRandolph is a significant advance. Stellarahas 120 programmed alerts (92were preprogrammed and we customizedthe rest) that are driven from thelab, the pharmacy, and [microbiology]."Dr. Broyles said one of the main improvementswas the ability to access everythingvia a Web browser or on the hospital'swireless network. This providesseamless connectivity in the hospital,from home, or when traveling. Additionally,a PDA [personal digital assistant] canbe used on the hospital network forimproved efficiency and convenience."Now [all our reports] can be exported toExcel, if you want to do other things withthem, such as graphing," he said. Dr.Broyles also reported that, between Januaryand July 2006, his hospital avertedat least 60 significant (moderate-tosevere)interactions, and the hospitalsaved about $115,000 as a result of thisand other clinical interventions.

J. Kelly Martin, PharmD, manager ofpharmaceutical services at FranciscanHealth System (FHS) in Tacoma, Wash,said that the Stellara system was ideal forFHS because of its flexibility in performancelevels, or "Étages," to fit the needs ofany size hospital. Each level builds on theone before it to upgrade the system asthe hospital grows. The addition of Étage4 completes the bioMérieux suite ofIntelligent Patient Therapy SoftwareSystems. One year after completing astudy that compared Stellara with theTheraTrac 2 system that was formerlyused, Dr. Martin reported that Stellaracontinues to prove its worth. Total interventionsjumped from 27,667 in the periodbetween January and June 2005 to35,222 from January to June 2006. In thesame time frames, the total number ofADEs prevented throughout FHS leapedfrom 1167 to 2573, and the hospitals' total financial savings due to interventionsrose from just over $3 million to justover $5.5 million. He remembers thatbefore they installed an automated clinicalintervention and patient monitoringsystem, the hospitals had to rely on manualdata entry to keep tabs on patientsand their medications. "In a 300-bed hospital,information gets missed [that way]," he said. Having a computerized systemsuch as Stellara "helps us do it faster, in amore organized fashion."

Dr. Martin recalled an instance wherehaving the system in place helped apatient who, upon admission, seemed tohave no issues with her drug regimen."The patient was taking metformin,which is contraindicated in patients withserum creatinine levels above the upperlimit of normal, and upon admission herlevels were fine," he said. "During herstay in the hospital, however, her kidneyfunction deteriorated enough to wherethe [metformin] could have caused anADE." The pharmacist on duty got thealert from the system that her levels hadrisen and was able to intervene beforelactic acidosis occurred.

Dr. Martin uses his PDA when he is onthe road to monitor patient progress,while Dr. Broyles prefers his desktopmodel, which "has more real estate," ashe puts it. Both pharmacists agree thatthe addition of the Stellara system totheir hospital pharmacy has given themand their staffs more peace of mind,knowing that they are protecting theirpatients with state-of-the-art technology.