The Most Highly Valued Children’s Hospital

Actionable data to improve care
Children’s clinical database supports real-time
alerts for clinicians, and provides a tool by which
the organization understands, communicates and
improves ongoing processes.
The system addresses operations from a reporting
standpoint, meeting the need for both internal
projects as well as external demands, including
regulatory compliance.
The system provides reporting for quality
initiatives, outcome measurements and research
in the generation of new pediatric knowledge,
including real-time disease surveillance and
antimicrobial stewardship.
“With all of our records available electronically, we
have the ability to mine the data to drive toward
significant improvements,” Gessner said. “The
system empowers us to reach outside of our
campus to clinicians caring for these children in
other venues and across time.”
HIMSS Stage 7 and beyond
In 2009, Children’s Hospital of Pittsburgh of
UPMC joined an elite group of 28 hospitals in the
United States recognized for the advanced use
of a comprehensive EMR. Children’s was the first
pediatric facility in the nation to earn the distinction
from HIMSS Analytics, a branch of the Health
Information and Management Systems Society.
Case Study
HIMSS Analytics certified Children’s as a Stage
7 hospital, according to its EMR Adoption Model,
for its adoption of computerized charting, recordkeeping, order-entry and documentation. In the
HIMSS Analytics EMR Adoption Model, stages
range from 0, indicating some clinical automation
exists, to 7. At Stage 7, a hospital is designated
as being fully automated and able to exchange
electronic records with all entities within a
regional health network.
The Most Highly Valued Children’s Hospital
Children’s Hospital of Pittsburgh of UPMC
In addition to the recognition from HIMSS,
Children’s was also one of eight children’s
hospitals to receive The Leapfrog Group’s 2009
Top Children’s Hospital award. To be included in
the list, top pediatric hospitals had to achieve a
quality score of at least 95 through Leapfrog’s
Hospital Recognition Program.
“The Cerner relationship has been pivotal to
accomplishing Children’s goals to improve patient
safety and reduce paper-based clinical processes,”
Dailey said. “By partnering with Cerner, we have
been able to achieve a level of care that goes
beyond many of our colleagues in pediatric care.”
“We look forward to our continued work together,
as we analyze the data available to us and
continuously strive to improve the care of our
patients and workflow of our staff,” Gessner said.
Client at a Glance
Location: Pittsburgh, Pa.
Beds: 296
Cerner solutions:
Electronic medical
record (acute, emergency
department, ICU and
ambulatory), CPOE,
pharmacy, decision support,
nursing, eMAR, prescription
writer, structured
documentation, document
imaging, medical records
publishing, immunizations,
PPID and I-View
From the paper-free care areas to the fireplace-lit
library, Children’s Hospital of Pittsburgh of UPMC
enhances the healing process for its pediatric
patients and their families.
In 2002, Children’s Hospital set out to integrate
clinical workflow and improve the safety and
quality of patient care system-wide with healthcare
information technology. Children’s implemented
19 Cerner solutions and upgraded to the
Cerner Millennium® healthcare computing platform
to create a system they call Children’s eRecord.
Building on the initial focus to integrate workflow,
Children’s leaders expanded the vision to create
the country’s first “paperless” pediatric hospital.
That vision was realized in May 2009, when a
state-of-the-art, completely digital hospital opened.
“The EMR is the cornerstone of our patient safety
and quality care efforts,” said Jacque Dailey,
vice president and chief information officer.
“Computerized provider order entry (CPOE) and
closed loop medication cycle are only beginning
steps to advanced patient care. The opening of
the completely digital hospital, use of iAware in
the intensive care units, warehousing of data
and implementation of a totally integrated record
across all care settings, including ambulatory, has
helped us become a world-class hospital.”
In August 2009, Children’s was recognized with a
“Highest Value Rating” for a U.S. children’s hospital
based upon 2009 KLAS CPOE Digest Research.
KLAS, a research firm specializing in monitoring
and reporting the performance of healthcare
suppliers, also acknowledged Children’s
excellence and leadership in paperless operation.
Children’s KLAS determination was based on a
number of factors. Among them:
< Percentage
of possible physicians using
< Percentage
of possible orders submitted via
CPOE (inpatient and ambulatory)
Key Benefits
safety events have
decreased by 60% and continue to
< Providers
place more than 94% of all orders directly into the system
utomatic documentation throughout
the care process creates 99.4% of the
patient record
< Percentage
of physicians entering notes and
documenting using an electronic medical
record (EMR) (inpatient and ambulatory)
< Sharing
a comprehensive record between
inpatient and ambulatory
< Percentage
of hospital beds where
barcode technology is used for medication
< Percentage
of nurses charting and
documenting electronically (inpatient and
“Cerner is a valued collaborator, and truly shares
our vision of using technology as an enabler for
our clinicians to provide better, safer care for
Cerner Corporation 2800 Rockcreek Parkway, Kansas City, MO 64117 866.221.8877
Cerner Corporation 2800 Rockcreek Parkway, Kansas City, MO 64117 866.221.8877
“We needed a tool to help each clinician orient
quickly to the condition of the patient,” said
Levin. “This was particularly important when
physicians were called to the bedside of a child
with a changing status. We needed to view several
pieces of information simultaneously to fully
understand how the situation was progressing.
CareAware iAware has met that need.”
Information visible within the CareAware iAware
critical care dashboard is in the EMR. The
innovative view allows relevant information to be
compiled so that it promotes rapid interpretation
of and reaction to a patient’s condition.
“The Cerner relationship
has been pivotal to
accomplishing Children’s
goals to improve patient
safety and reduce paperbased clinical processes.
By partnering with Cerner,
we have been able to
achieve a level of care
that goes beyond many
of our colleagues in
pediatric care.”
Jacque Dailey
Vice President
Chief Information Officer
Children’s Hospital of
Pittsburgh of UPMC
ICU physicians use computers at multiple
workstations during their daily rounds, often
making orders as they move through a floor. A
nurse can start processing the electronic orders
while the physician is still on the unit. CareAware
iAware eliminates doctors from having to page
through multiple tabs to pull up X-rays or lab
results in the EMR.
our patients,” said Christopher Gessner,
Children’s president. “Being named the No. 1
hospital in the nation for use of healthcare
IT reflects the incredible dedication exhibited
to improve patient care by our IT teams, our
clinicians, employees and our partners,
particularly at Cerner.”
Completely digital hospital
Children’s is one of the first pediatric hospitals
in the nation built from the ground up to support
an EMR. The 296-bed facility serves 13,000
inpatients and 500,000 outpatients annually.
It features a patient- and family-friendly, quiet
environment supported by technology.
The hospital offers parents overnight, in-room
accommodations, replete with wireless Internet
access and wider cell phone use. To reduce
frequent alarm noise, typical to many pediatric
hospitals, nurses are wirelessly linked to patient
monitors. Data from the monitors automatically
map to the EMR, allowing clinician review without
interrupting the parents at bedside. Nurses also
use wireless medication carts, including barcodeformat positive patient identification (PPID) and
lab label printers, as mobile workstations.
“The eRecord technology and wireless medication
carts help keep nurses at the bedside,” said
Sue Park RN, director, clinical and operational
informatics. “Patient information and medications
are readily available at the nurse’s fingertips.
Medications can be scanned and lab labels
printed at the bedside.”
All Children’s clinicians complete their
documentation online. More than 45,000
PowerNotes™ are entered electronically
each month.
Dr. Jim Levin, chief medical information officer,
lauded the new environment. “It’s what you don’t
see that’s remarkable … the e-record technology
now blends into the background. There are no
chart racks, no clinicians huddled in a noisy
nursing station, and no crowded medication
rooms. This creates a more personal, caring
environment,” Levin said.
The technology is supported by a state-of-theart hospital infrastructure of more than 4,000
computers, including mobile monitor carts;
400-plus miles of cable in the main hospital;
2,000 wireless access points and 100 percent
coverage for most wireless technologies. Support
is provided by desktop technicians who work
directly with the clinicians on the units to ensure
maximum equipment availability, including
preventive maintenance.
Immediate access to information in the ICU
CareAware iAware™ critical care dashboards are at
each bedside in the intensive care units (ICU). The
dashboards provide clinicians immediate access
to view cohesive patient information. The “always
on” display is the same in every room, refreshing
every 5 minutes automatically or more frequently
on user demand, to provide consistent viewing of
information in critical situations.
“Cerner technology enables nurses to download
and confirm information before it flows directly
into the EMR,” said Karen Bondi RN, intensive
care nurse. “This is a real time saver in intensive
care especially, where nurses are sometimes
asked to record vitals every five minutes.”
Integrated eRecord across the continuum
In spring 2009, Children’s relocated their
ambulatory care center to within the hospital.
To integrate workflow between the hospital and
physician offices, 36 specialty physician practices
and ancillary services were phased into using
PowerChart® over two weeks.
“We wanted a system in which a clinician could
see the complete patient’s picture, across venues,
without logging onto different systems,” said
Dr. Steven G. Docimo, vice president of medical
affairs and chief medical officer at Children’s. “We
also wanted families to experience a seamless
transition between their child’s inpatient
admission and their outpatient visit, or vice versa.
Using an integrated record eliminates the need
to ask the patient/family to repeat pertinent
information such as medication history, allergies,
problems and other details important to their care.
“In the emergency department, the operating
rooms, critical care and medical inpatient units,
outpatient suites and ancillary service areas,
Children’s runs on a single, integrated electronic
medical record,” Docimo continued. “This
approach largely eliminates the risks inherent in
handwritten and verbal orders.”