Computer system ensures OH never overlooked

OH clients are spotted and tracked automatically

Because she previously managed the emergency department (ED) at Borgess Medical Center in Kalamazoo, MI, Karen Fulton, RN, MSN, CNA, knew it was unrealistic to expect ED staff to ask patients if they were affiliated with any of the hospital’s occupational health clients and then track down the appropriate employer information.

"That can be a lot to demand in the chaos of an ED," she says.

But when she took over as program coordinator for corporate health with CorpFit, the hospital’s occupational health program, she knew it was crucial to make sure occupational health patients received the proper treatment and follow-up no matter when or where they showed up for treatment. Fulton decided the solution was to design a computer system that required little human intervention to get the occupational health patients on the proper track.

That was more than two years ago, and Fulton says the computer system used by the hospital has greatly improved the way occupational health patients are treated at the hospital’s emergency department, immediate care clinic, and at an affiliated hospital across town.

"It’s beautiful the way the computer system works automatically to make sure everyone has the right information to work with," Fulton says. "And the great part is that it just happens. No one has to ask for the information. The computer knows to automatically print out the information that makes sure our patients are handled the right way."

No expense, little start-up time

The computer system sounds like an occupational health manager’s dream come true. This is partly because the 426-bed tertiary care hospital already had a powerful mainframe computer system in place. When Fulton was trying to solve the occupational health/emergency department problem, she got together with a computer programmer at the hospital and brainstormed about how a computer system might be used to solve the problem. They came up with the idea of programming the computer to recognize a patient’s employer as an occupational health client of the hospital. Within six weeks, the system was up and running.

The system costs nothing at all because the hospital’s mainframe computer was in place and all the hospital’s sites and departments already had terminals.

When a patient shows up for care at any Borgess facility or department, the registration clerk enters the person’s name in the computer system and prints out the patient’s chart. With the added feature Fulton helped develop, the computer also determines if the employer listed is connected with the hospital’s occupational health program. If so, the computer also prints a special occupational health data sheet and adds the CorpFit occupational health logo to the chart’s cover page. The logo serves as a visual reminder that the chart contains the occupational health data sheet. (See sample data sheet on p. 53.)

"The data sheet might note that the patient needs a drug or alcohol screen in certain situations, or has to be able to lift 50 pounds before being returned to work," Fulton explains. "It also includes all the details about the company, contact information, and what special hazards might be found in the workplace. So theoretically, the patient should not get out of our facility without getting all the care he [or she] needs."

The automatic nature of the computer system is its strong point, Fulton says. Not even the registration clerk has to take note of the employer’s connection to the occupational health program and tell the computer to print the data sheet. When the employer’s name is entered routinely, the computer takes it from there and prints the data sheet along with the rest of the chart on the same printer.

"The less you have to rely on someone noticing something and remembering to do something, the less you will ever have people slip through the system," Fulton says. "Now we very rarely miss drug screens or other things that are necessary, and that was fairly frequent before."

Computer ensures documents are sent

The hospital’s computer system also helps ensure employers get the right information promptly after an occupational health patient’s visit. When the patient’s chart is sent to medical records for routine filing after treatment, the computer again takes notice of the occupational health affiliation. The computer alerts medical records staff that the patient’s employer is a CorpFit client, and that certain documents must be immediately faxed to the employer.

With a few keystrokes, the medical records employee uses the computer to fax the employer four documents from the patient’s chart: face sheet, discharge instructions, physician’s dictation, and employee work status. Employers receive the documents within 24 hours of the patient’s visit.

Fulton reports that employers love the reliability of both aspects of the computer system. She periodically surveys employers with a brief survey card. (See sample survey card, p. 54.)

"They love it, and so do we," she says. "It’s a system that gets the job done while also taking a lot of pressure off people to try to remember every single thing."