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MEDHOST - Emergency Department Information System (EDIS) Demonstration by Peter Anderson MD Fountain Valley Emergency Department

Peter Anderson MD, director of Fountain Valley Emergency Department demonstrated the MEDHOST - Emergency Department Information System (EDIS) Version 4.1. MEDHOST EDIS is clinical system developed for an emergency department which facilitates the point of care for patients brought into the emergency department, either through walk-in or ushered in by the paramedics. This information system is used to track the patients status in the emergency department, starting from the point of admission, to treatment and discharge. The workflow for the point of care in the emergency department is shown below.
Actors Interaction Process Flow Walk-in Paramedics Information EDIS Use

Rgistration Clerk Patient

Registration

Names, Gender, Date of Birth, etc

Patient Registration

Nurse - Patient

Triage

Patient Chief Complaint & Vital Signs

Nurse Charting

Registration Clerk Physician Nurse - Patient

Emergency Room

Names, Gender Date of Birth, Chief Complaint & Vital Signs

Patient Registration, Nurse Charting, Ordering

Physician Patient

Physicians Diagnosis

Detailed Diagnosis Lab/Xray & Meds Ordering

Physician Documentation, Ordering

Technician Patient Physician Nurse - Patient

Labs

Labs or Xray Results

Reports

Observation Room

Patients Status

Locator

Admit

Transfer

Discharge

The best 5 features of the MEDHOST EDIS as demonstrated are: (i) The Locator (ii) Condition Assessment Screen (iii) Ordering (iv) Results (v) Multiple Access (i) The Locator

The locator screen of the MEDHOST emergency department information system (EDIS) (Fig.1.) is a status dashboard which shows the customized floorplan and bed locator of the emergency department (ED). The visual display is a central and indispensable tool for communication and information management in the ED. The locator board keeps track of patient information and provides an up-to-date view of the overall operation of the ED. The status board provides information on the doctors on duty, location of patients and their status, as well as, indicating the time when the patient was last seen by the doctor. The computerized patient records and orders entry system enhances staff communication and workflow management through automated notifications, risk alerts, and visual cues.

Login name

Doctors on duty

John Daviss patients

Stan Uptons patients

Fig. 1 Locator Screen

The main dashboard screen facilitates information display and ease of navigation by providing a condensed and high level a summary view of ED information that is constantly changing. (ii) Condition Assessment Screen

The EDIS facilitates communication, support collaboration and serve as the single point of entry for obtaining more detailed point-of-care information for clinical and operation of information needs of staff members within and outside the ED managing the care of the patient. In the ED treatment area clinicians to rely on the MEDHOST EDIS system components for communicating, documenting, and retrieved in patient care information. The EDIS provides visual display of the patients status which acts as a reminder or tracker for physician and nurses on assessing the condition of the patients. The nurses or physicians consistently update the status of the patient through the charting aspect of the EDIS after an activity has been conducted with patient. All these activities are tracked by time. This information provides comprehensive reporting on the patients conditions and status chronologically, and it is a vital point of reference for all physicians and nurses attending to the patient. A snapshot of the nurse chart is shown below.

The EDIS allows physician to keep track of the patient's workup plan, such as pending studies, and comments, which helps with continuity of care when there is shift change. An increasing number of patients, some of which complex medical problems visits the emergency department with severe medical conditions that require swift decision-making, however clinical decision making is frequently hampered by the limited ability to access and share information at the point-of-care. The EDIS using the ER-Connect makes it possible for other health care entities such as hospitals and community clinics to share information to enable continuity of care. The

access to information at the point-of-care would make treating elderly patients more efficient, and would also reduce prescription abuse by patients with addictive disorders. (iii) Ordering

The EDIS is interfaced with the hospital information system for labs, radiology, and prescription ordering. Radiology and lab tests are requested electronically with a click of the mouse, and results are displayed the moment they become available. The EDIS requisition system replaces a paper-based transport system that uses tubes. Users have reported that it easier to understand what the attending physician order, because the requisitions with EDIS are more legible. (iv) Results

The EDIS enables direct access to detailed laboratory results, imaging exams, and medication treatment plans. For example it provides information on radiology exam status, radiology reports and status of individual test. The emergency department is vulnerable to medical errors due to frequent interruptions and the urgent need for timely results, the EDIS makes it possible for diagnostic results to be available in real time. (v) Multiple Access

The ED staff members can access the status board from workstations throughout the department to view, add, delete or update clinical information. The main screen balances the need to display large amounts of data in a desirable level of detail with the need for a comprehensive overview to prevent information overload. Access to detailed information and other applications is achieved with friendly mouse or touch screen interface navigation and user manipulation. The patient's electronic medical records are later archives on the Tenet mainframe P-Bar system for later access in case of repeat visits.