Most technologically advance program

[emeddo]

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I really love technology and want to implement it in anyway possible during my residency. I'm one of those people that has a PDA and a tablet PC and am efficient in using both. I am considering getting one of the new UMPCs with 8" screen because I see them as the future of medicine and charting. Anyways, I was wondering if anyone knew of some good residencies that are really interested in using the most up to date technology and computer standards or are looking for residents to help them get there. Wireless internet, digital radiography, telemedicine, e-charting all being things I am looking for. I have talked to some residencies that are really behind the times and don't seem to think about updating so I was hoping there might be some out there that are willing to grow with the future. Thanks!!!

 

[EctopicFetus]

from my experience on the trail last yr lots of places are/were building new eds. as such they will be more technologically advanced. USC+LAC comes to mind. Overall medicine is still in the dark ages as far as technology is concerned as it relates to charting etc..

 

[southerndoc]

Lots of ED's have electronic patient tracking. We have everything but electronic charting at Yale. (i.e., physician computer order entry, electronic archival of ED records, computerized retrieval of labs, discharge summaries, operative notes, etc.) Our new ED medical director is a huge computer guru (creator of eMedicine, medical director for WebMD, creator of eResidency, etc.). I have a good feeling our ED will be completely computerized within two years.

I hear that Beth Israel Deaconess in Boston is one of the leaders in computer technology for hospitals. It's not just their ED, but the entire hospital that is computerized.

 

[Pelivar]

Christiana has to rank pretty high on the list of most technologically savvy places.

We have a fully integrated infrared tracking system for patients, doctors and valuable equipment (I think we were the 3rd ED in the country to have one).

We also have video cameras and mics in our critical care rooms in the ED and in the ICU so the Critical Care attendings can monitor and treat all admitted critical care patients from one room (it's called eCare or eICU, and we are the first ED to implement this specific technology) We also have all the normal stuff like electronic records, radiology, etc.

Pelivar

 

[po' boy]

Vandy has to be on the list. Brand new ED, totally electronic patient record across the whole hospital and all clinics, electronic whiteboard developed in house with seamless ties ins to labs, radiology, EKGs, patient record, etc. Electronic order system. Digital rads. Wireless phones in the ED, given to you at start of shift. Wireless internet across entire hospital campus (bring your own laptop/PDA or use one of the computer on wheels (COWs, also known as Johnny 5's). Ethernet video recording in all trauma bays with review of mentionable traumas at weekly trauma conference. EKGs transmitted by EMS via fax en route to ED, helpful in identifying STEMIs before they hit the door.

It kicks ass, and it makes a difference in patient care, patient flow, efficiency and error reduction. I saw lots of places with similar stuff while i was interviewing but the only other program that seemed to implement most of these things across the board in such a seamless way was Beth Israel Deaconness in Boston.

 

[DrQuinn]

Put the new Georgetown program on your list. One of our strengths is our interest in "medical informatics." In fact, our Azyxxi system (self-created) was recently invested in by Microsoft. All our radiology is self-integrated into it at both our hospital sites (WHC and G'town Hospital). You have to see it to believe how amazing it is. Our residents also do a rotation in medical informatics itself!

Q

 

[docflanny]

Grand Rapids has been keeping up with technology: electronic med records, physician order entry, PACs, laptops everywhere in ED and about 1 laptop for every 2 patients on the floor, wireless in the hospital with downloading of patient info, Rx, X-ray, Meds onto your palm, CT scanner/X-ray within the department, etc. No electronic t-sheet for charting though- we use a combination of dictation/check list for PMH, PSH, ROS, and nml PE. Newly updated portions of the ED: chest pain center, adult, peds modules.

 

[basementbeastie]

Christiana has to rank pretty high on the list of most technologically savvy places.

We have a fully integrated infrared tracking system for patients, doctors and valuable equipment (I think we were the 3rd ED in the country to have one).

We also have video cameras and mics in our critical care rooms in the ED and in the ICU so the Critical Care attendings can monitor and treat all admitted critical care patients from one room (it's called eCare or eICU, and we are the first ED to implement this specific technology) We also have all the normal stuff like electronic records, radiology, etc.

Pelivar

are you getting tracked???😱

 

[beyond all hope]

I bang on stone tablets. I carry Rosen's and Tintinalli in my sherpa's backpack. My level 5 charts are licensed as weapons. Don't get me started on critical care time. We choose residents based on the number of charts they can carry...on their backs.

🙂

 

[NinerNiner999]

Here at Hopkins we have a highly technologic system completely driven by a black inkpen. The only problem is that every now and then, the pen runs out of ink and we have to get a new one. This happens about once per week due to the amount of use our pens recieve, especially during high volumes.

The Joint commission likes to crack down on abbreviations. To avoid this, we all CLEARLY write our orders and are careful to avoid such no-no's as "cc" or misplaced decimals. Our system is so advanced, we the residents develop an intimate relationship with our orders and charts (which are also activated by inkpen and in written prose), so much to the point that at times, our bodies cramp and contort due to over use of our forearms.

Our patient tracking is even more high tech, using the advancement of the magic "white board" and strange markers that erase without leaving a wet residue. Our intimate patient relationship is enhanced by the occasional "run for glory" that takes place when a patient changes rooms and must be updated on the magic board.

At times I am in awe of the amount of technology that is involved in the management of even the simplest patients. Even those patients with minor complaints that require less than one minute of thought benefit from our technology, again improving the intimacy with our patients.

If you want high-tech emergency medicine, Johns Hopkins is the place for you.

 

[SoCuteMD]

Here at Hopkins we have a highly technologic system completely driven by a black inkpen. The only problem is that every now and then, the pen runs out of ink and we have to get a new one. This happens about once per week due to the amount of use our pens recieve, especially during high volumes.

The Joint commission likes to crack down on abbreviations. To avoid this, we all CLEARLY write our orders and are careful to avoid such no-no's as "cc" or misplaced decimals. Our system is so advanced, we the residents develop an intimate relationship with our orders and charts (which are also activated by inkpen and in written prose), so much to the point that at times, our bodies cramp and contort due to over use of our forearms.

Our patient tracking is even more high tech, using the advancement of the magic "white board" and strange markers that erase without leaving a wet residue. Our intimate patient relationship is enhanced by the occasional "run for glory" that takes place when a patient changes rooms and must be updated on the magic board.

At times I am in awe of the amount of technology that is involved in the management of even the simplest patients. Even those patients with minor complaints that require less than one minute of thought benefit from our technology, again improving the intimacy with our patients.

If you want high-tech emergency medicine, Johns Hopkins is the place for you.

 

[basementbeastie]

Here at Hopkins we have a highly technologic system completely driven by a black inkpen. The only problem is that every now and then, the pen runs out of ink and we have to get a new one. This happens about once per week due to the amount of use our pens recieve, especially during high volumes.

The Joint commission likes to crack down on abbreviations. To avoid this, we all CLEARLY write our orders and are careful to avoid such no-no's as "cc" or misplaced decimals. Our system is so advanced, we the residents develop an intimate relationship with our orders and charts (which are also activated by inkpen and in written prose), so much to the point that at times, our bodies cramp and contort due to over use of our forearms.

Our patient tracking is even more high tech, using the advancement of the magic "white board" and strange markers that erase without leaving a wet residue. Our intimate patient relationship is enhanced by the occasional "run for glory" that takes place when a patient changes rooms and must be updated on the magic board.

At times I am in awe of the amount of technology that is involved in the management of even the simplest patients. Even those patients with minor complaints that require less than one minute of thought benefit from our technology, again improving the intimacy with our patients.

If you want high-tech emergency medicine, Johns Hopkins is the place for you.

have you hopkins guys started using that new thingy....i think it is called...."pay-per"?

 

[basementbeastie]

any of you guys spend an *amazing* amount of time either logging on or waiting for the computer to load your page???.....it just kills me....

 

[basementbeastie]

one of my pet peeves is illegible handwritten documentation...👎 👎 👎 👎

 

[Jeff698]

are you getting tracked???😱

Sort of a resident LoJack?

Take care,
Jeff

 

[BKN]

Here at Hopkins we have a highly technologic system completely driven by a black inkpen. The only problem is that every now and then, the pen runs out of ink and we have to get a new one. This happens about once per week due to the amount of use our pens recieve, especially during high volumes.

The Joint commission likes to crack down on abbreviations. To avoid this, we all CLEARLY write our orders and are careful to avoid such no-no's as "cc" or misplaced decimals. Our system is so advanced, we the residents develop an intimate relationship with our orders and charts (which are also activated by inkpen and in written prose), so much to the point that at times, our bodies cramp and contort due to over use of our forearms.

Our patient tracking is even more high tech, using the advancement of the magic "white board" and strange markers that erase without leaving a wet residue. Our intimate patient relationship is enhanced by the occasional "run for glory" that takes place when a patient changes rooms and must be updated on the magic board.

At times I am in awe of the amount of technology that is involved in the management of even the simplest patients. Even those patients with minor complaints that require less than one minute of thought benefit from our technology, again improving the intimacy with our patients.

If you want high-tech emergency medicine, Johns Hopkins is the place for you.

It sounds like nothing has changed since the 70's. I guess it shouldn't surprise me, I couldn't get a sump NG tube back then since Halsted used a single lumen red rubber.😎

 

[NinerNiner999]

Well, at least we have the sump tubing now. Everything is kept "neatly" in the pyxis for "easy" access. As you might remember, the critical care rooms are pretty tight. Imagine them as they were, but with three GIANT pyxis machines added in. Ahhh, the good life...

 

[SoCuteMD]

Christiana has to rank pretty high on the list of most technologically savvy places.

We have a fully integrated infrared tracking system for patients, doctors and valuable equipment (I think we were the 3rd ED in the country to have one).

We also have video cameras and mics in our critical care rooms in the ED and in the ICU so the Critical Care attendings can monitor and treat all admitted critical care patients from one room (it's called eCare or eICU, and we are the first ED to implement this specific technology) We also have all the normal stuff like electronic records, radiology, etc.

Pelivar

So, in other words, you can't hide at the back of the trauma bay to wolf down your energy bar/fruit/chinese food?

J/K - that's really cool!!

I think that Sentara Norfolk General has a similar eICU - but not connected to their ED.

 

[la gringa]

we need electronic tracking for all moveable items.... people will steal ANYTHING!

 

[Pelivar]

They can't find me if I wear my tinfoil hat.

We just added the capability to track doctors, but nobody has busted me hiding yet. The nurses refused to be tracked for obvious reasons.

So far it has worked out great and I love that all the tracking is passive and we do not have to input any info. Another plus is that we have trackers on the tonopens, ultrasound machines, etc, so you can find them hidden in the corner of the ED.

 

[BKN]

Well, at least we have the sump tubing now. Everything is kept "neatly" in the pyxis for "easy" access. As you might remember, the critical care rooms are pretty tight. Imagine them as they were, but with three GIANT pyxis machines added in. Ahhh, the good life...

Actually, I've never seen the ED you're in. My senior year ('79) I was involved in the planning of a new ED in the Basement of Harriet Lane. Is that the one you're in now?

I trained in 25 barely connected rooms on the first floor of Halsted. Built in the early 50s, horrible design. Are they still trying to asassinate folks with trocars to put in chest tubes?

And yes, I'm familiar with the Pyxis issue.😡

 

[NinerNiner999]

Actually, I've never seen the ED you're in. My senior year ('79) I was involved in the planning of a new ED in the Basement of Harriet Lane. Is that the one you're in now?

I trained in 25 barely connected rooms on the first floor of Halsted. Built in the early 50s, horrible design. Are they still trying to asassinate folks with trocars to put in chest tubes?

And yes, I'm familiar with the Pyxis issue.😡

Yep, we are still in the basement of Harriet Lane Clinic (which is now the pediatric UCC, Harriet Lane has its own free-standing clinic, and the peds ED is in its place). Ironically, they are breaking ground for the new ED/critical care tower where the Broadway garage used to be (they tore it down last year).

Haven't seen any trocars for CT yet, but I've seen many more thoracotomies than I thought I would.

 

[BKN]

Yep, we are still in the basement of Harriet Lane Clinic (which is now the pediatric UCC, Harriet Lane has its own free-standing clinic, and the peds ED is in its place). Ironically, they are breaking ground for the new ED/critical care tower where the Broadway garage used to be (they tore it down last year).

Haven't seen any trocars for CT yet, but I've seen many more thoracotomies than I thought I would.

Well the broadway garage used to generate my patients hit over the head with a lead pipe. Glad it's gone. Did a psych faculty, his secretary and a 2nd year IM residnet on three successive nights.

 

[NinerNiner999]

Well the broadway garage used to generate my patients hit over the head with a lead pipe. Glad it's gone. Did a psych faculty, his secretary and a 2nd year IM residnet on three successive nights.

Yeah - not much has really changed....

 

[Chrismander]

They can't find me if I wear my tinfoil hat.

We just added the capability to track doctors, but nobody has busted me hiding yet. The nurses refused to be tracked for obvious reasons.

So far it has worked out great and I love that all the tracking is passive and we do not have to input any info. Another plus is that we have trackers on the tonopens, ultrasound machines, etc, so you can find them hidden in the corner of the ED.

I'm curious cause i've heard of this IR tracking thing before. how does it work for people? do you have to wear a bracelet or is it built into your ID badge or something? or do they just tattoo you on the first day?

 

[peksi]

Actually there is a removable badge, however compliance is good, and this has greatly streamlined care in our large, busy ED. Residents, nurses and consultants are directed to the computer to view who is the attending, resident, or nurse for the patient. Triggers for radiology, labs, time to physician, nurse etc are available as well as active length of stay in the ED are identified. Our hospital bedboard is linked into this as well, no more "calling someone" for a bed on admission, a click of the mouse and the request is registered.

Triage sees which rooms have patients up for discharge in realtime, so they can be ready to fill the vacancy, much as the hotel and airline industry does.

I actually like the system a great deal, the refresh time is very 3 seconds, and I think our patients, attendings, residents and staff have embraced the technology. It's not perfect, but it works very well.

We are awaiting their eventual upgrade to RF, as IR must be in a "line of sight" for the sensors. As Pelivar has stated, we all really like the system, and sign out is very easy,😎, as you can update the patient's status, issues to be addressed etc. right on the computer.

That being said we have full hospital computer access from home as well, this has been beneficial in following up on patients you've seen...if your into that kind of thing!🙄

Defintitly a good thing for our ED.

Paul

 

[Hard24Get]

I.....REALLY...want....to....rotate.....there!!!! After hearing all this I might become sick if my away application is not accepted!

Actually there is a removable badge, however compliance is good, and this has greatly streamlined care in our large, busy ED. Residents, nurses and consultants are directed to the computer to view who is the attending, resident, or nurse for the patient. Triggers for radiology, labs, time to physician, nurse etc are available as well as active length of stay in the ED are identified. Our hospital bedboard is linked into this as well, no more "calling someone" for a bed on admission, a click of the mouse and the request is registered.

Triage sees which rooms have patients up for discharge in realtime, so they can be ready to fill the vacancy, much as the hotel and airline industry does.

I actually like the system a great deal, the refresh time is very 3 seconds, and I think our patients, attendings, residents and staff have embraced the technology. It's not perfect, but it works very well.

We are awaiting their eventual upgrade to RF, as IR must be in a "line of sight" for the sensors. As Pelivar has stated, we all really like the system, and sign out is very easy,😎, as you can update the patient's status, issues to be addressed etc. right on the computer.

That being said we have full hospital computer access from home as well, this has been beneficial in following up on patients you've seen...if your into that kind of thing!🙄

Defintitly a good thing for our ED.

Paul