Hospital pharmacists know that the ability to stay on top of changes in patient health and medications is vital to ensuring positive patient outcomes. Various health information systems can assist by providing tools and services to help gather, retrieve, classify, and manage health care data accurately and efficiently.
One example of this technology is bioMérieux's Stellara Clinical Intervention and Patient Monitoring software. It is designed to integrate microbiology results (identification/susceptibility/resistance) from bioMérieux's BacT/Alert 3D and Vitek 2 systems with the patient therapy profiles, as well as other laboratory results, directly to the pharmacist and clinician. Having this real-time information allows clinicians to quickly match bacteria to the most effective treatments, avoiding possible errors in dispensing and reducing costly adverse drug events (ADEs).
Mike Broyles, BS, PharmD, is the director of Pharmacy, Laboratory, and Imaging Services at Randolph County Medical Center, a rural community hospital in Pocahontas, Ark. His hospital's pharmacy was using bioMérieux's TheraTrac 2 system for years before it upgraded to the Stellara system in October 2004, and he and his staff noticed the difference right away. He said, "The Stellara system at Randolph is a significant advance. Stellara has 120 programmed alerts (92 were preprogrammed and we customized the rest) that are driven from the lab, the pharmacy, and [microbiology]." Dr. Broyles said one of the main improvements was the ability to access everything via a Web browser or on the hospital's wireless network. This provides seamless connectivity in the hospital, from home, or when traveling. Additionally, a PDA [personal digital assistant] can be used on the hospital network for improved efficiency and convenience. "Now [all our reports] can be exported to Excel, if you want to do other things with them, such as graphing," he said. Dr. Broyles also reported that, between January and July 2006, his hospital averted at least 60 significant (moderate-tosevere) interactions, and the hospital saved about $115,000 as a result of this and other clinical interventions.
J. Kelly Martin, PharmD, manager of pharmaceutical services at Franciscan Health System (FHS) in Tacoma, Wash, said that the Stellara system was ideal for FHS because of its flexibility in performance levels, or "Étages," to fit the needs of any size hospital. Each level builds on the one before it to upgrade the system as the hospital grows. The addition of Étage 4 completes the bioMérieux suite of Intelligent Patient Therapy Software Systems. One year after completing a study that compared Stellara with the TheraTrac 2 system that was formerly used, Dr. Martin reported that Stellara continues to prove its worth. Total interventions jumped from 27,667 in the period between January and June 2005 to 35,222 from January to June 2006. In the same time frames, the total number of ADEs prevented throughout FHS leaped from 1167 to 2573, and the hospitals' total financial savings due to interventions rose from just over $3 million to just over $5.5 million. He remembers that before they installed an automated clinical intervention and patient monitoring system, the hospitals had to rely on manual data entry to keep tabs on patients and their medications. "In a 300-bed hospital, information gets missed [that way]," he said. Having a computerized system such as Stellara "helps us do it faster, in a more organized fashion."
Dr. Martin recalled an instance where having the system in place helped a patient who, upon admission, seemed to have no issues with her drug regimen. "The patient was taking metformin, which is contraindicated in patients with serum creatinine levels above the upper limit of normal, and upon admission her levels were fine," he said. "During her stay in the hospital, however, her kidney function deteriorated enough to where the [metformin] could have caused an ADE." The pharmacist on duty got the alert from the system that her levels had risen and was able to intervene before lactic acidosis occurred.
Dr. Martin uses his PDA when he is on the road to monitor patient progress, while Dr. Broyles prefers his desktop model, which "has more real estate," as he puts it. Both pharmacists agree that the addition of the Stellara system to their hospital pharmacy has given them and their staffs more peace of mind, knowing that they are protecting their patients with state-of-the-art technology.