What about Care Planning?

In the world of hospital information technology, automated care planning is as under-appreciated and Computerized Physician Order Entry is over-hyped. Typically care planning software was used outside of the care process to produce documentation for Joint Commission (JCAHO) surveys. This is not the promise of good care planning software.

The care plan should be the plan produced by all disciplines, and led by the physician, that defines the goals of the patient stay and ensures that all of the key interventions take place at the optimal time in order to achieve those goals as quickly as possible (shortest length of stay) with the least amount of resources (lowest cost). The care plan is the hospital’s assembly line. I believe it is the most important element of nursing informatics.

Focusing on medication process automation and Computerized Physician Order Entry (CPOE), to the exclusion of good care planning automation, is like a car company that wants to build really good tires and engines, but does not have a way to build a car in a timely, defect-free manner.

I believe nurses, no – all care givers, need a single dashboard where they can see every intervention (including administering post-operative antibiotics, ambulating patients, assessing skin, patient education, etc,). That dashboard can function as the caregivers worklist presenting the tasks to be completed in the most efficient sequence by the most appropriate member of the care team

Additionally, all of the care plans could be monitored centrally to identify key interventions that have been missed (think population management for inpatients). This would allow interventions of key quality indicators before it is too late, as opposed to the status quo where the quality indicators are available 6 weeks after the patient is discharged and coded.

Why isn’t care planning an element of meaningful use? In my opinion, It holds more promise to manage cost and achieve outcomes than CPOE.