Gear Up for Stage 2 Success at the Point-of-Care

After two years and nearly $2.5 billion in spending under HITECH, many hospitals have made significant progress in deploying technologies to improve quality of care and caregiver efficiency. With the release of Stage 2 guidelines for meaningful use last month, hospital leaders and system providers now have a clearer picture of next steps for achieving the full potential of EMR systems.

While there is still a long way to go, hospitals are ramping up quickly.  In an 18-month period ending in March, the number of hospitals meeting 10 or more Stage 1 criteria doubled to 44 percent, according to Healthcare IT News.

Just over the past year we have seen tremendous gains in the deployment of two key patient safety systems – computerized physician order entry (CPOE) and bar code medication administration (BCMA). For the first time, a majority of U.S. hospitals are using these technologies.

Last year CPOE deployment increased to 61 percent, according to a survey in Pharmacy Purchasing & Products. CPOE use is skyrocketing in all sizes of hospitals, but is most common in large (400+ bed) hospitals. But even in small hospitals with 100 beds or less, CPOE use has increased from just 15 percent in 2009 to 55 percent now.

That’s impressive – especially when you consider that the survey found that just five years ago the primary ordering methods were courier, pneumatic tube and fax. CPOE use is expected to increase to nearly 90 percent within five years while use of old paper-based ordering systems decline sharply.

According to the same survey, BCMA deployment has increased by 29 percent just last year. Today, almost 60 percent of hospitals are using BCMA to improve patient safety by ensuring correct medications, up from just 21 percent five years ago. The number is even higher among large- and mid-sized facilities though even among small hospitals almost half have deployed the technology.

The dramatic progress on BCMA and CPOE lays the foundation for even greater challenges to meet Stage 2 meaningful use requirements, which require much tighter integration between the point of care, pharmacy, lab and radiology. As of mid-year, only 11.5 percent of hospitals had achieved this closed-loop medication administration according to HIMSS Analytics, which means there’s plenty more to be done.

What is the role of point-of-care technologies in meeting Stage 2 challenges? While smart phones and tablets will assuredly play a role, mobile computing workstations and wall-mounted computers will continue to be the primary technology platform.  Mobile workstations can be readily equipped with medication dispensing systems as well as BCMA scanners to support workflows.

However, dispensing alone is not enough as workflows must integrate medication storage and delivery as well. There are no one-size-fits-all solutions, so you need a thoughtful partner who can explore the options to help you tailor the right approach that supports caregivers at the patient bedside.

It’s also important to find a partner who can look beyond point-of-care hardware to support the software issues involved with the move to closed-loop medication administration. For instance, ensuring that workstations can seamlessly integrate with electronic administration records (eMARs) will be critical.

I’ll have some more detailed insights on BCMA in my next post. How is your organization progressing with BCMA and CPOE?  What do you see as your biggest challenges for meeting the stage 2 requirements for meaningful use? Continue the conversation at

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