Date: June 1, 2005
Ivy Holt, Providence Health Systems & Ann Demaree, LifeCom

Good patient care depends on good information at the right moment. Ivy Holt describes how Providence Hospitals moved from paper to wireless bedside patient records and uses knowledge management systems for advice. Ann Demaree recounts the recent introduction of Lifecom’s Shock/Trauma Management System into the chaos and hierarchy of emergency medicine.

#1) WIRELESS TO THE BEDSIDE: The Providence Health System Experience

Ivy Holt, Providence Health Systems
Since the early 1990s, Providence Health Systems has worked to move patient charting on-line and make patient information immediately available. Patient safety is central to this effort as managing paitent information electronically allows for real time communication of patient information. Holt, an RN and director for the project, describes the move from hand-written paper toward wireless bedside entry assisted by knowledge management systems and the many challenges to find the most appropriate form factor to meet the needs of the bedside nurse.

#2) LIFECOM’S SHOCK/TRAUMA MANAGEMENT SYSTEM: Decision-making ‘reminders’ in acute critical patient care

Ann Demareem, Lifecom
Solutions designed to enhance medical decision-making must do far more than store medical records. A solution must identify and present relevant patterns combined with all of the appropriate knowledge needed by a physician in order to make a rapid and accurate decision. Medical decision-making is about recognizing patterns: There are patterns of illness, patterns of behavior, patterns of lifestyle, patterns of therapy, patterns of response, and many others. Medical decision-making requires understanding. It takes more than just seeing a pattern – the meaning and relevance of the pattern must be recognized. Medical decision-making results in action. Physicians must make critical decisions before intervening on behalf of their patients.

Lifecom’s Demerey describes how the Shock/Trauma Managment System was designed to fit smoothly into Emergency Department workflows without adding overhead and how its form, function, and ‘place’ in the medical/social hierarchy was conceived, delivered, and received in practice.