Special report
Research and tabulations by Suzanna Hoppszallern, Jennifer Towne and Alsden Solovy
The challenges have been issued to America’s hospitals and health systems: Improve patient safety. Reduce adverse drug events and other medication-related errors. Enhance efficiency to cut costs.
America’s 100 Most Wired hospitals and health systems are deploying systems to help them achieve these objectives, and typically, they are looking well beyond clinical applications. They’re including supply chain touch-points in their IT budgets to improve clinical and financial performance and efficiency while enhancing quality of care.
Consider that 73 percent of 100 Most Wired hospitals now electronically order supplies once a preset threshold is reached, which helps to avoid critical stock-outs. More than 90 percent perform med/surg product transactions online, which speeds delivery time. And nurses in 68 percent of these facilities are able to receive clinical alerts on-line in real time to assess drug-to-drug interactions, reducing the chances of an adverse drug event.
These are just a few of the supply chain-related findings from this year’s Most Wired Survey, which brought completed responses from 541 hospitals and health systems, representing 1,217 hospitals.
For eight years, Hospitals & Health Networks, our sister publication, has named the 100 Most Wired Hospitals and Health Systems. The list is based on the Most Wired Survey and Benchmarking Study that asks hospitals to report how they use information technology to address five key areas: safety and quality, customer service, business processes, workforce, and public health and safety.
The 2006 survey was made possible through a partnership among H&HN, Accenture, the American Hospital Association, the College of Healthcare Information Management Executives and McKesson Corp.
What follows in this report are statistical results and analysis of the Most Wired Survey data relating to supply chain activities. The data from this year’s poll document many interesting trends regarding on-line transactions with suppliers, the percentage of supplies, pharmaceuticals, equipment and people tracked with bar code technology and more.
This report follows on the heels of last month’s cover story on the 2006 Most Wired Supply Chain Innovator Award, which is jointly sponsored by Materials Management in Health Care, H&HN and the Association for Healthcare Resource & Materials Management.
Improving efficiency and safety in med/surg and pharmaceutical activities
Automating med/surg supply and pharmaceutical supplier activities can have a profound impact on operational efficiency and in many cases, patient safety. The 100 Most Wired hospitals and health systems are demonstrating expansive use of technology in these areas. For example, the Most Wired recipients are exponentially more likely than the Least Wired respondents to perform tasks such as checking product availability, purchase ordering and issuing payment in an automated fashion.
| % key med/surg supplier activities hospitals conduct online (based on $ volume) | % key pharma supplier activities hospitals conduct online (based on $ volume) | ||||
| Most Wired* |
Least Wired* |
Most Wired* |
Least Wired* |
||
| Check Product Availability | |||||
| Manual | 10% | 45% | 6% | 16% | |
| Semi-automated | 35% | 33% | 42% | 55% | |
| Automated | 61% | 12% | 59% | 17% | |
| Purchase Requisition | |||||
| Manual | 7% | 41% | 7% | 25% | |
| Semi-automatic | 33% | 31% | 38% | 48% | |
| Automated | 665 | 18% | 61% | 13% | |
| Purchase Order | |||||
| Manual | 6% | 32% | 7% | 21% | |
| Semi-automatic | 29% | 38% | 35% | 52% | |
| Automated | 71% | 20% | 65% | 16% | |
| Check Order/Status Routing | |||||
| Manual | 12% | 38% | 7% | 18% | |
| Semi-automatic | 33% | 36% | 38% | 51% | |
| Automated | 62% | 14% | 63% | 17% | |
| Receive Order/Check-In | |||||
| Manual | 10% | 36% | 15% | 47% | |
| Semi-automatic | 43% | 40% | 41% | 31% | |
| Automated | 52% | 10% | 46% | 4% | |
| Receive Invoice | |||||
| Manual | 12% | 57% | 21% | 55% | |
| Semi-automatic | 39% | 18% | 36% | 19% | |
| Automated | 51% | 4% | 48% | 7% | |
| Invoice Payment | |||||
| Manual | 14% | 55% | 17% | 54% | |
| Semi-automatic | 39% | 21% | 39% | 21% | |
| Automated | 50% | 4% | 47% | 5% | |
Bar-code technology enjoys widespread adoption in Most Wired facilities
Even though there remains tremendous interest in RFID technology applications, America’s 100 Most Wired hospitals are far more likely to use bar-code systems to aid in equipment, patient and staff tracking as well as keeping tabs on med/surg and blood supplies. In fact, the Most Wired facilities are more than five times more likely than the Least Wired facilities to employ bar coding systems when handling medications. A similar pattern was found when evaluating the percentage of supplies facilities order when a preset threshold is reached, with Most Wired facilities more than four times more likely than Least Wired facilities to employ automated systems to perform replenishment ordering of med/surg supplies.
% supplies electronically ordered when a preset threshold is reached (weighted average)
| Most Wired* | Least Wired* | |
| Med/surg | 73% | 18% |
| Pharmaceutical | 57% | 38% |
% suppliers with which hospitals exchange transactions online (weighted average)
| Most Wired* |
Least Wired* |
|
| Durable equipment | 66% | 26% |
| Med/surg supplies | 91% | 53% |
| Other equipment & supplies | 79% | 38% |
| Pharmaceutical | 96% | 76% |
% supplies, pharmaceuticals, equipment and people tracked with bar code technology (weighted average)
| Most Wired* |
Least Wired* |
|
| Equipment tracking | 59% | 9% |
| Patient tracking (ED) | 44% | 8% |
| Staff tracking | 29% | 5% |
| Bed tracking (to track discharge) | 21% | 1% |
| Blood supply tracking | 92% | 28% |
| Surgical supplies | 63% | 9% |
| Medical supplies (nonsurgical) | 58% | 15% |
| Medication | 74% | 14% |
| Lab/pathology samples | 88% | 31% |
| X-rrays/medical images (radiology, MRI, nuclear medicine |
67% | 15% |
| Forms (procedure/activities) | 61% | 15% |
*Most Wired = Aggregate data for the 100higher scoring respondents.
*Least Wired = Aggregate data for the 100 lowest scoring respondentsSource: 2006 Hospitals & Health Networks' Most Wired Survey and Benchmarking Study
Deploying technology to reduce medication errors and boost efficiency
Ongoing efforts by hospitals and their supply chain partners to reduce medication errors are considered essential to the improvement of patient safety. Various forms of technology, experts argue, can provide a major boost to these safety initiatives and get clinical alerts to nurses faster. So it’s not surprising to find that the Most Wired hospitals and health systems typically far outpaced the Least Wired institutions in all of these areas. For instance, the Most Wired facilities were eight times more likely than the Least Wired respondents to have their nurses perform dose checking online in real time and were more than seven times more likely to access therapeutic overlap alerts online in real time. Meanwhile, physicians at the Most Wired facilities were 18 times more likely than those at the Least Wired hospitals to order medications electronically. Aside from the data found in the tables on this page, the survey also illustrated that the Most Wired hospitals estimate that more than 31 percent of medications are matched to the patient and the order at the time of administration using bar coding or some other form of autoidentification.
Medications ordered electronically
| Most Wired* |
Least Wired* |
|
| Bar coding or RFID of drug to aptient and order at bedside | 8% | 2% |
| Bar coding or RFID of drug, patient, order and nurse at bedside | 23% | 2% |
| Patient and user ID keyed into automated dispensing devide at bedside | 3% | 2% |
| Patient and user ID keyed onto automated dispensing device away from bedside | 37% | 25% |
| User ID keyed into automated dispensing device away fro the bedside | 7% | 9% |
| Medication not electonically matched | 12% | 60% |
% of respondents in each benchmark group who say nurses use clinical alerts online in real time (weighted average)
| Most Wired* |
Least Wired* |
|
| Allergy alerts | 84% | 34% |
| Dose checking | 64% | 8% |
| Dose suggesting | 54% | 3% |
| Drug-diet checking | 50% | 13% |
| Drug-drug interaction | 68% | 18% |
| Duplicate order alerts | 84% | 35% |
| Test prep alerts/guidance | 75% | 21% |
| Test sequencing alerts/guidance | 59% | 12% |
| Therapeutic overlap alerts | 53% | 7% |
Medication orders matched electronically
| Most Wired* |
Least Wired* |
|
| Physicians | 36% | 2% |
| Nurses | 8% | 8% |
| Pharmacists | 52% | 65% |
| Nonclinicians | 3% | 2% |
| Not entered electronically | 1% | 23% |
*Most Wired = Aggregate data for the 100higher scoring respondents.
*Least Wired = Aggregate data for the 100 lowest scoring respondentsSource: 2006 Hospitals & Health Networks' Most Wired Survey and Benchmarking Study
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