Based in Allentown, Pennsylvania Lehigh Valley Hospital and Health Network (LVHHN) is a leading academic community-based health care network, specializing in cancer treatment, cardiovascular medicine, mental health, neurosciences, pediatrics, surgery services, level one trauma, women’s health, prenatal care, kidney transplantation, and burn treatment. To say the physicians and nurses at LVHHN are busy would be an understatement. With over 38,000 inpatient admissions, 100,000 emergency room cases, 220,000 outpatient visits, and more than 3,400 babies delivered each year, the staff of 2,800 nurses and 875 active physicians are kept busy treating patients around the clock. As recipients of the National Quality Health Care Award and nationally ranked by US News and World Report for seven years in a row, the physicians and nurses at LVHHN have received frequent recognition for their delivery of superior health care services.

While much of LVHHN’s success can be attributed to the dedication and skill of the physicians and nurses, some of the success can be tied-back to the organization’s innovative use of technology, which is being used to help the staff deliver exceptional customer care. Accordingly, LVHHN has been recognized as a leader in this area, ranking in Hospitals & Health Networks magazine’s 2003 ‘Top 100 Wired Hospitals’ and ‘Top 25 Wireless Hospitals’ listings.

Establishing A Superior Technical Infrastructure

LVHHN’s quest for wireless technological innovation began in 1997 when they launched a pilot one-megabyte wireless network. The network was expanded the following year to a two-megabyte network and the number of wireless access points was increased.

Once a secure and accessible wireless network had been established, the team began developing a wireless clinical system. This system included a computerized physician order entry (CPOE) system, which would enable physicians to enter orders for medications, tests, or procedures into an automated, online order entry system. Once orders were entered, the system would automate the process of order verification, deliver the order to the ancillary department, and charge for the service.

Before the CPOE system, physicians and nurses relied on paper-based charts to track patient vitals and order tests or medications. The charts were stored at the nurse’s station or at the patient’s bedside, where they were manually retrieved and updated. Tracking vital signs and placing orders was a multi-step process that involved physicians, nurses, and the various ancillary departments such as the pharmacy and the lab. Before visiting a patient, physicians would review the chart for the latest information on the patient’s vitals and most recent care. After visiting the patient, they would update the chart and write out orders on the chart, leaving it at the nurse’s station so they could fulfill the order by either conducting the procedure or sending the order to the corresponding ancillary department for fulfillment. Given the number of people involved in the process, delays were inevitable, sometimes taking up to an hour to fulfill an order. The manual system also left room for errors.

Up to the Task: Fujitsu LifeBook P1000 Notebook

Knowing that the physicians would be more likely to adopt the CPOE system if they were able to access it through a mobile device, David Pucklavage, senior clinical analyst of wireless/CPOE at LVHHN began testing various portable devices. The physician’s needs fell into three main categories: weight, battery life, and screen display. The team devised a ‘device triangle’ as a means to demonstrate to the physicians the consequences that changing one part of the triangle would have on the other two parts. Explains Pucklavage, “We knew that weight, battery life, and screen display were the three most important criteria for the mobile device. By using the ‘device triangle’ we were able to show that increasing screen display, for example, would reduce battery life and increase weight.” Using this method, the team eventually chose the Fujitsu LifeBook P1000 notebook. Weighing just two and half pounds, and delivering up to eight hours of battery life, the Fujitsu LifeBook P1000 notebook is the smallest notebook available with a wide-format touch screen. “We tested many different portable devices during our research phase and concluded that the Fujitsu LifeBook P1000 notebook offered the best combination of screen display, battery life and portability,” says Pucklavage.

The physicians were also pleased that the Fujitsu LifeBook P1000 notebook had both touch screen capabilities and a keyboard. “Although the CPOE system is touch screen based, we found the physicians also liked having a keyboard,” says Pucklavage. “One of the reasons we chose the Fujitsu LifeBook P1000 notebook was that it enabled our physicians to enter orders and interact with the notebook in the way they were most comfortable.” The team was also confident that the capabilities and features of the Fujitsu LifeBook P1000 notebook would make the most of LVHHN’s advanced wireless network, and help ensure a seamless connection to the CPOE system.

Building a Patient Safety Net

With the combination of the CPOE system, wired and wireless devices, paper-based charts and orders are becoming a thing of the past. Instead of reviewing written charts at the nurse’s station, the physicians can now monitor patients at their bedside, in their office, or from another facility. The notebooks are so portable and lightweight, the physicians carry them around in their lab coat pocket. The CPOE system and the portability of the Fujitsu LifeBook P1000 notebook have also made it easier for physicians to track patients. The system has been designed so the physicians can pull up their patient lists and scan through vital signs and medications on their entire patient roster—30 to 40 patients—in a matter of minutes. Whereas before, physicians had to manually go through each individual chart, now with the Fujitsu LifeBook P1000 notebook they can get an up-to-the minute view of how their patients are doing in the hospital, at any time and from any place. This has helped the physicians to track their patients more closely from anywhere within the hospital and deliver more individualized, and more efficient, patient care. Explains Pucklavage, “The physicians have become very dependent and protective of their Fujitsu LifeBook P1000 notebooks. They have become almost as important to them as their stethoscope.”

Improving patient safety and care were top goals for the CPOE implementation. The portability of the Fujitsu LifeBook P1000 notebook has enabled the system to deliver immediate and seamless transition of information from physician to nurse to ancillary department. To maximize patient safety, the CPOE system also features automatic error checking, which helps ensure that any medications or procedures ordered are appropriate for the patient. For example, when a physician enters a new medication, the system automatically alerts the physician to any known allergies or drug conflicts. While these safety measures were in place before, because the process was manually performed by pharmacy staff, it would often introduce further delays into the order process. “By enabling real-time, anywhere access to patient information and built-in safety procedures of CPOE, the Fujitsu LifeBook P1000 notebook is allowing us to realize the most important goal of our CPOE solution – patient safety,” says Pucklavage.

As an unexpected benefit, the Fujitsu LifeBook P1000 notebooks are also helping physicians discuss test results and treatment options with patients. Some of the physicians are taking the notebooks with them into patient rooms to, discuss test results, recommended course of treatment, and placing orders in front of the patient, adding to the comfort level of the patient and improving physician/patient interaction.

Casting a Wider Net

The Fujitsu LifeBook P1000 notebooks have been so well received with the physicians, that LVHHN is in the process of replacing the nurse’s old notebook systems with Fujitsu LifeBook E4010D notebooks. The Fujitsu LifeBook E4010D notebooks will be used for patient charting and order entry. The portability of the Fujitsu LifeBook E4010D will enable nurses to easily transport the notebook into each patient’s room, record vital signs, and fulfill orders. By making it easy for the nurses to keep this information up-to-date, the solution also helps ensure the physicians have access to the latest patient information. “We found that the Fujitsu LifeBook E4010D has a larger, better screen display, longer battery life and was much more durable than other products we tested,” explains Pucklavage.

With the help of the Fujitsu LifeBook P1000 and Fujitsu LifeBook E4010D notebooks, LVHHN has established itself as a leader in the use of technology to improve patient care and ensure patient safety. The team’s focus on innovation and safety will, no doubt, continue to earn LVHHN many new accolades in the future.