February/March 2002

Medical Staff Bulletin

Message from Dr. Peter N. Herbert,
YNHH Chief of Staff

Several recent publications from the Institute of Medicine have stressed the importance of information technology in ensuring patient safety and improving care efficiency, effectiveness and timeliness. YNHH established virtually universal computerized physician order entry (CPOE) in 1992. A decade later, we are among only 5 percent of the nation's hospitals with CPOE. Our TS 7000 system, despite some rough edges, has served us remarkably well.

On Feb. 25, Mr. Zaccagnino announced a new strategic information partnership between YNHH and Eclipsys Corporation. Eclipsys currently supports our CCSS-CPOE and data retrieval systems. Over the next two to three years, CCSS will be significantly upgraded, using a new Eclipsys product, Sunrise Clinical Manager (SCM). This will greatly improve the CPOE process and permit real-time, knowledge-based analysis of all orders. SCM also provides synchronous alerts based on clinical algorithms and best practices and offers wireless connectivity and enhanced, web-based communications. SCM was selected after an exhaustive two-year assessment led by Medical Staff members. It has recently been ranked first in several independent industry surveys because of demonstrated functionality and proven technical infrastructure.

We are currently recruiting Medical Staff members from all clinical departments to participate in the SCM implementation. The design of the user interface, the selection of rules and alert thresholds, and the utilization of clinical algorithms will be critically dependent on a heavy infusion of medical logic. If you have personal interest in participating in this work, please let me know.

Extended patient retrieval guide

Physicians can now look up archived patient information through a new retrieval pathway in CCSS that provides access to ambulatory as well as inpatient data on all patient visits dating back to February 1997. If you select "Search all visits," the pathway allows you to retrieve information from a specific visit or from all visits.

If your sign-on screen is a patient list, select "Other" at the bottom right of the screen instead of selecting a patient. On the next screen is the new selection. If your sign-on screen is not a patient list, a new selection, "Search all visits," was added there. This retrieval allows you to see dates of inpatient admissions and outpatient, DI and ED visits. You can also retrieve orders and results related to those visits (including Lab and DI). Only data captured in CCSS is available.

National Doctor's Day

Yale-New Haven Hospital will celebrate National Doctors Day on Thursday, March 28, 7 - 8:30 a.m. Please stop by the Doctor's Lounge (first floor West Pavilion, next to Medical Records) for breakfast and an informal gathering.

Medical Staff Bylaws & Rules and Regulations

At its January 24 meeting, the Medical Committee of the Board of Trustees approved several changes to the Medical Staff Bylaws & Rules and Regulations. Medical Staff members may contact the Department of Physician Services at (203) 688-2615 for a revised copy.

Anticipating new Medical Staff members?

Is your practice bringing on any new associates this summer? Now is the time to start processing their applications for Medical Staff membership. New physicians should contact the Department of Physician Services at (203) 688-2615 to request an application.

HIPAA applies to hospitals and physicians

Ten important privacy essentials for physicians to remember as their organizations start implementing requirements of the Health Insurance Portability and Accountability Act (HIPAA). [Courtesy, attorneys Amy Fehn and Abby Pendleton, Wachler & Associates, Royal Oak, MI]

1. Do not send patients mass mailings without first checking the HIPAA "marketing" restrictions.
2. Maintain and enforce strict disciplinary policies for breaches of confidentiality.
3. Train employees on privacy policies and give updates/reminders.
4. Be careful with confidential information in trashcans and recycle bins; use a shredder if necessary.
5. Avoid placing patient information in view of other patients or family members.
6. Limit the amount of access employees have to information they don't need to perform their jobs.
7. Use caution when sending faxes containing patient information (faxes can be seen from both ends).
8. Protect medical records after hours (e.g., evening shift cleaning, maintenance or other staff).
9. Emphasize the need to maintain confidentiality of passwords. Don't share passwords or post them on computer monitors.
10. Keep conversations confidential; discourage hallway, elevator, public discussions or gossip.

Radiation Therapy update

The Department of Radiation Therapy resumed operations on January 18, following major renovation after the Dec. 19 flood, reported in the last issue of the Medical Staff Bulletin. Two treatment units are fully operational and the third unit is being replaced and equipped with state of the art technology. During the upcoming weeks, we will continue to improve our facility with the implementation of new equipment. The commitment put forth to achieve such an aggressive timetable is a testament to everyone associated with our recovery effort. We would like to thank everyone affected by this mishap for their patience and understanding during this interruption in service. We look forward to providing enhanced services to both our patients and colleagues. Please let us know if we can assist you in any way. You may call the department at (203) 688-4344.

Urgent day of admission radiology studies

Patients no longer need to be admitted through or held in the Emergency Department to obtain urgent studies in Diagnostic Imaging. A timing selection termed "urgent admission" is now available in CCSS. The Radiology Information System (IDXRad) will prioritize these CCSS orders, similar to ED-initiative orders, and cases will be scheduled immediately upon receipt. This expedited ordering pathway can only be used within four hours of admission.

Annual tuberculin skin testing

Consistent with CDC guidelines, Medical Staff members who have negative tuberculin tests must be retested on an annual basis, and should maintain their own record of the result. Medical Staff with positive tuberculin tests who have had a single chest radiograph showing no active disease following the skin test, and who have made a decision regarding tuberculosis prophylaxis, require only symptomatic monitoring for active disease, and are exempt from yearly tuberculin testing.

Members of the Medical Staff were sent a notice in February requesting them to indicate either that a tuberculin test has been completed within the past year, or that annual tuberculin testing is not indicated due to a past positive result. The completed forms needed to be faxed to (203) 688-5343 in Physician Services by March 15. Please keep results of your annual PPD testing in your office file containing copy of your recredentialing application.

Tuberculin skin testing may be done at YNHH Occupational Health Services (OHS), at the Yale Health Plan, or at any physician's office. Tuberculin testing at YNHH-OHS (Grace Building 130) is done free of charge Monday-Friday from 7:30 a.m. - 4:30 p.m. Testing at the Yale Health Plan is free for university-employed staff.

Refer items for the next issue of Medical Staff Bulletin via phone, fax, E-mail or mail to:
Peter N. Herbert, MD
1063 Clinic Building
P: (203) 688-2604, F: (203) 688-7152
herbertpn@ynhh.org
or
Katie Krauss
Marketing & Communications
GB 443
P: (203) 688-2492, F: (203) 688-2491
krauss@ynhh.org

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Last revised: April 13, 2004 (cfs)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.