Massachusetts General’s POE system offers return on investment that is priceless

It’s a serious problem; one that can cost lives. How does a large hospital keep track of clinicians’ orders when multiple physicians and technicians are treating the same patient? Massachusetts General Hospital, part of Massachusetts-wide Partners HealthCare System, is solving the problem with its Caché-based Provider Order Entry (POE) system, which Partners’ Vice President and CIO John Glaser refers to as “possibly the most formidable tool we have to deliver high-quality care while controlling costs.” The system can reduce costs, especially by eliminating duplicate medications and by recommending less costly therapeutic procedures. More importantly, the system can alert health care providers to potentially life-threatening allergies and drug and food interactions that could pose serious consequences.

Key Benefits

  • Web Technology
  • High Performance
  • Scalability

Massachusetts General’s POE system has its roots at Boston’s Brigham & Women’s Hospital, another facility in Partners HealthCare System. Initially built as a character-based, client/server system, this first POE system delivered noticeable results: A study published by the Journal of American Medical Association (JAMA) showed that serious medication errors decreased by 55 percent after the system was installed at Brigham & Women’s.

Since that first system was deployed, the expectations of the clinical and administrative staffs throughout the Partners system had grown substantially. End users had become aware of the capabilities of information technology and had come to expect only the most sophisticated applications that fully harness the power of technology. So, when Massachusetts General embarked on building its new POE application, a graphical, Windows-based system with multitasking features was the standard to meet.

Caché, the post-relational database, was the cornerstone of the first POE implementation at Brigham & Women’s, providing advanced capabilities such as complex data modeling, scalability, and high-speed performance. For the Massachusetts General implementation, Caché was chosen again for its ability to respond quickly to requests for information and scale to many thousands of users. Additionally, system availability is crucial when an application becomes the backbone of a hospital’s day-to-day practice. Caché’s server shadowing capabilities virtually ensure that POE will always be up and running. Finally, it was crucial that the database chosen to run the system be Web-enabled because Partners’ information systems team is considering a Web front end for the application to give physicians who are offsite the ability to place orders. Caché offers an entire suite of tools to enhance the ease and speed

Possibly the most formidable tool we have to deliver high-quality care

John Glaser, Vice President and CIO
Partners HealthCare Systems

Massachusetts General’s Windows server-based system currently serves 2,400 active users and processes nearly 5,500 orders per day. The system automates the ordering process for medications, lab and diagnostic procedures, food and nutrition, intravenous fluids, and a host of other clinical activities as it screens the orders for duplicate procedures, prescriptions, and for allergies. The POE system also has helped Massachusetts General comply with HIPAA regulations in the areas of confidentiality and security. The system provides not only a highly secure infrastructure with an unprecedented level of access control, but also audit trails that can immediately answer questions relating to the chain of decision in orders for medications or procedures. Additionally, POE ensures that verbal orders are cosigned in a timely manner as mandated by JCAHO regulations.

As with the earlier system at Brigham & Women’s, the dollar savings made possible by Massachusetts General’s Provider Order Entry system will be impressive. Meeting and exceeding federal standards will also contribute to the system’s value, as will the system’s potential for saving lives. Taking all of these benefits together, particularly the increased level of patient care, it is clear that Massachusetts General’s POE application offers a return on investment.