El Camino Hospital’s new computerized record system has been off to a rocky start since its launch in March.
Its first few months at El Camino have seen a state investigation, pharmacy errors, dissatisfaction among physicians and nurses, and the departure of the hospital’s chief information officer.
At the Wednesday night meeting, after the Voice went to press, the hospital board addressed some of these issues by discussing a contract with an outside pharmacy management company, and providing funding for upgrades to new system.
ECHO, which stands for El Camino Hospital Online, is the new system that replaced a medical information system that had been in place since 1971. Doctors and nurses must use it daily in the hospital to place orders for medicines and tests, and to track patient records.
Eclipsys Corporation created the ECHO software, which cost El Camino $8 million. The transition has been riddled with errors, however, causing the hospital to bring in an outside pharmacy management company, Cardinal Health.
“We’ve had some issues in the pharmacy, which is one of the reasons Cardinal Health was brought in,” said hospital spokesman Jon Friedenberg, adding, “Issues that predated ECHO made the ECHO implementation that much more challenging.”
Meanwhile, the Centers for Medicare and Medicaid Services, or CMS, received a complaint that prompted a state Department of Health Services survey on May 19 to investigate.
“The condition found [to be] unmet was pharmaceutical services,” said Mary Frances Colvin, nurse consultant for CMS.
Friedenberg said pharmacy problems were related to “medication order verification and audit,” but that the new computer system was not entirely to blame for lost pharmacy order records.
The Voice has requested full survey results from CMS, which were not available by press time. El Camino Hospital submitted the required plan of correction to CMS on June 21, and because the survey revealed problematic findings, Health Services will conduct a follow-up investigation by early August.
Some argue that dissatisfaction with ECHO can be chalked up to doctors and nurses experiencing an adjustment period while learning the new technology. But others say both the errors and general unhappiness could have been prevented with more training before ECHO’s launch.
“The problem was that the pharmacy could have used more preparation for the introduction of ECHO,” said Edward Bough, a cardiologist and El Camino’s board president, adding that he too would have preferred more training with the system before it launched.
Prior to ECHO’s introduction earlier this year, physicians were told through a December hospital newsletter that the new computer system would allow them to “be able to do the same functions from the old system, but in a much easier and more intuitive way.”
This was not the case for many at El Camino, who found the new system to be unwieldy and not user-friendly, and voiced their grievances through a grass-roots survey of doctor and nurses.
“When I go over [to the hospital], I can’t even find my patient in the computer system,” said Larry Epstein, an internist at El Camino. “It’s not intuitive.”
At the Wednesday night meeting, the board was scheduled to vote on an additional $2 million in upgrades to make ECHO more user-friendly for physicians, among other improvements, according to Friedenberg.
Also at that meeting, the board was to vote on whether to allow interim CEO Marla Gularte to negotiate a three-year contract with Cardinal Health.
New system, no CIO
On May 23, Bough met with Gularte and Eclipsys representatives to discuss issues related to the state investigation of the pharmacy, as well as physician and nurse dissatisfaction with the new computer system.“I wanted to be certain that the Eclipsys hierarchy appreciated the scope of the problem, the extent of our unhappiness, and the need for them to put substantial resources into the solution,” Bough wrote in a letter to physicians in late May.
He added, “In fairness to Eclipsys, a significant part of the problem was also the relative lack of resources which Mark Zielazinski and El Camino had devoted to the actual implentation of ECHO.”
Zielazinksi, El Camino Hospital’s chief information officer (putting him in charge of information techology), launched ECHO in March, then left at the end of April to become chief operating officer at Sensitron, Inc. in San Mateo. Former CEO Lee Domanico serves on the advisory board of Sensitron, which brought a new wireless data transmitter called CareTrends to the hospital in 2004.
Originally hired to work for El Camino by Domanico — who left in January to head Legacy Health System in Portland, Ore. — Zielazinski followed in his boss’ footsteps and left four months after Domanico.
“I was tied pretty tightly to him,” he said. “It just seemed to me to be the appropriate time, given where Sensitron was, to go off and try something like this.”
But leaving shortly after ECHO’s launch, Zielazinski left problems with the new computer system for other hospital employees to resolve.
“Do I have to commit my whole life to stay at El Camino?” he asked. “In my opinion, it’s never a convenient time to leave an organization.”
Zielazinski said he is helping with the transition to ECHO despite already starting his new job at Sensitron. Diana Russell, vice president of patient care services, has taken over his responsibilities regarding ECHO on an interim basis.
E-mail Molly Tanenbaum at mtanenbaum@mv-voice.com
