Risk Management and Measuring Productivity with POAS – Point of Act System

M. Akiyama

doi:10.1055/s-0038-1625429

Methods of Information in Medicine, Table of Contents

Methods Inf Med 2007; 46(06): 686-693
DOI: 10.1055/s-0038-1625429

Original Article

Schattauer GmbH

Risk Management and Measuring Productivity with POAS – Point of Act System

A Medical Information System as ERP (Enterprise Resource Planning) for Hospital Management

Authors

M. Akiyama

¹Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA

¹Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA

Abstract

Summary

Objectives : The concept of our system is not only to manage material flows, but also to provide an integrated management resource, a means of correcting errors in medical treatment, and applications to EBM (evidence-based medicine) through the data mining of medical records.

Methods : Prior to the development of this system, electronic processing systems in hospitals did a poor job of accurately grasping medical practice and medical material flows. With POAS (Point of Act System), hospital managers can solve the so-called, “man, money, material, and information” issues inherent in the costs of healthcare.

Results : The POAS system synchronizes with each department system, from finance and accounting, to pharmacy, to imaging, and allows information exchange. We can manage Man (Business Process), Material (Medical Materials and Medicine), Money (Expenditure for purchase and Receipt), and Information (Medical Records) completely by this system.

Conclusions : Our analysis has shown that this system has a remarkable investment effect-saving over four million dollars per year-through cost savings in logistics and business process efficiencies. In addition, the quality of care has been improved dramatically while error rates have been reduced – nearly to zero in some cases.

Keywords

Point of care systems - hospital information systems - hospital equipment and supplies - hospital financial management - risk management

Full Text

References

References
1. Schmidt DC, Vinoski S. Object Interconnections, columns 1-14. http://www.cs.wustl.edu/~schmidt/report-doc.html
2. Akiyama M. Migration of the Japanese healthcare enterprise from a financial to integrated management: strategy and architecture. Med info 2001; 10 (Pt 1): 715-718.
3. 7PKC Corporation.. A Problem Oriented Approach to the Computerized Patient Record. 1998 http://www.pkc.com
4. Bosak J. Sun Microsystems. XML, Java and the future of the Web. March 10, 1997. http://sunsite.unc.edu/pub/suninfo/standards/xml/why/xmlapps.html
5. Akiyama M. Integration of Medical Information System as ERP (Enterprise Resource Planning) in Medical Field. Proceedings of the Forth ChinaJapan-Korea Joint Symposium on Medical Informatics 2002; 56-59.
6. Akiyama M. Risk Management and Measuring Productivity with POAS - Point of Act System. World Congress of Medical Physics and Biomedical Engineering 2006.. Imaging the Future Medicine Series: IFMBE Proceedings, Vol.14 Kim, Sun I.; Suh, Tae Suk (eds) 2007, pp 321-324. ISBN: 978-3-540-36839-7
7. Bates DW. Using information technology to reduce rates of medication errors in hospitals. BMJ 2000; 320: 788-790.
8. Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM. et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 1998; 280: 1311-1316.
9. Bates DW, Teich J, Lee J, Seger D, Kuperman GJ, Boyle D. et al. The impact of computerized physician order entry on medication error prevention. JAmMed InformAssoc 1999; 6: 313-321.
10. Chester M, Zilz DA. Effects of bar coding on a pharmacy stock replenishment system. Am J Hosp Pharm 1989; 46: 1380-1385.
11. Patterson ES, Cook RI, Render ML. Improving patient safety by identifying side effects from introducing bar coding in medication administration. J Am Med Inform Assoc 2002; 9 (540) 553.
12. Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med 2003; 348: 2526-2534.
13. Weeks WB, Bagian JP. Developing a culture of safety in the Veterans Health Administration. Eff Clin Pract 2000; 6 (270) 276.
14. Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE, Strom BL. Role of computerized physician order entry systems in facilitating medication errors. JAMA 2005; 293: 1197-1203.
15. Kohn LT, Corrigan J, Donaldson MS. To Err Is Human: Building a Safer Health System. Washington DC: National Academy Press; 2000
16. Kaushal R, Bates D. Computerized physician order entrywith clinical decision support systems. In: Shojania KG, Duncan BW, McDonald KM et al. (eds). Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Rockville, Md: Agency for Healthcare Research and Quality; 2001. Evidence Report/Technology Assessment No. 43; AHRQ publication 01-E058
17. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century.. Washington DC: National Academy Press; 2001
18. Bates DW, Kuperman G, Teich JM. Computerized physician order entry and quality of care. Qual Manag Health Care 1994; 2: 18-27.
19. Schiff G, Rucher DT. Computerized prescribing: building the electronic infrastructure for better medication usage. JAMA 1998; 279: 1024-1029.
20. Bates DW, Cullen D, Laird N. et al. Incidence of adverse drug events and potential adverse drug events: implications for prevention. JAMA 1995; 274: 29-34.
21. Bates DW, Cohen M, Leape LL, Overhage JM, Shabot MM, Sheridan T. Reducing the frequency of errors in medicine using information technology. JAmMed InformAssoc 2001; 8: 299-308.
22. Teich JM, Merchia PR, Schmiz JL, Kuperman GJ, Spurr C. Bates DW Effects of computerized physician order entry on prescribing practices. Arch Intern Med 2000; 160: 2741-2747.
23. HealthLeaders looks at hospital CPOE programs [iHealth Web site].. Available at: http://www.ihealthbeat.org/index.cfm? Action=dspItem&itemID=100527
24. Woods DD, Cook RI. Nine steps to move forward from. Error Cogn Technol Work 2002; 4 (137) 144.
25. Berger RG, Kichak JP. Computerized physician order entry: helpful or harmful?. J Am Med Inform Assoc 2004; 11: 100-103.
26. Ash JS, Gorman PN, Seshadri V, Hersh WR. Perspectives on CPOE and patient care. J Am Med Inform Assoc 2004; 11 (207) 216.
27. Ash JS, Berg M, Coiera E. Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J Am Med Inform Assoc 2004; 11: 104-112.
28. Kaushal R, Kaveh S. Bates DW Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. Arch Intern Med 2003; 163: 1409-1416.
29. United States Pharmacopeia.. MEDMARX 5th Anniversary Data Report: A Chartbook of 2003 Findings and Trends 1999-2003. Rockville, Md: United States Pharmacopeia; 2004
30. Woods DD. Behind Human Error: Cognitive Systems, Computers and Hindsight. Dayton, Ohio: Crew Systems Ergonomic Information and Analysis Center, Wright Patterson Air Force Base; 1994
31. Deibel SRA. Brigham and Womens Hospital. Component-based Computing: Perspectives from Healthcare. http://www.arachne.org/
32. Burt CC. 2AB Corporation. Enterprise Architecture Whitepaper: Managed Migration to a Distributed Environment. http://www.2ab.com/ea_wp.html
33. Shojania KG, Duncan BW, McDonald KM, Wachter RM. Safe but sound, patient safety meets evidence-baced medicine. JAMA 2002; 288: 508-513.
34. Kaplan, Norton. The Strategy-Focused Organization: How Balanced Scorecard Companies Thrive in the New Business Environment.. Boston, MA: Harvard Business School Press, 2000