Public Hospital Rolls Out Low-Cost Point-of-Care Technology for Evidence-based Medicine from Performance Clinical Systems

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Alameda County Medical Center adds SmartOrders to patient admission and transfer processes as an innovative approach for improving clinical performance, quality, and outcomes

We needed to find an effective solution to accelerate and manage the expansion of evidence-based medicine in our clinical workflows. With SmartOrders we've been able to quickly onboard residents and I’ve been impressed by how warmly it’s been received.

In response to the important need to bring real-time computerized clinical decision support to its practicing physicians, Alameda County Medical Center (ACMC) has launched SmartOrders™ from Performance Clinical Systems™, allowing doctors to improve the quality and safety of the care they deliver. The program was quickly implemented for a majority of physicians in the general admitting service and will soon expand to include clinical workflows for hospital discharges and transitions of care.

SmartOrders is a decision support and clinical content management system that utilizes a powerfully simple web-based technology, creating breakthrough capabilities at a radically low price point. Performance Clinical's "intelligent checklist" platform enables physicians to easily cull only relevant, patient-specific orders from hundreds of evidence-based order sets with just a few mouse clicks. ACMC saw dramatic improvements in compliance for many required elements, including codes status documentation and quality measures.

SmartOrders builds on current enterprise legacy applications to leverage a hybrid system of database-driven technology and paper output, enabling ACMC to replace either hand-written or cumbersome pre-printed orders. SmartOrders’ flexibility enabled ACMC to launch the program in under 60 days with minimal disruption to existing clinical workflows.

“Improving the quality, safety and consistency of care through evidence-based medicine is a key priority for our organization. Implementing new technologies in our care delivery processes is fundamental for doing this practically and efficiently,” said Sang-ick Chang, M.D., ACMC’s chief medical officer. “SmartOrders is elegant in its simplicity and serves as an excellent transformational platform for introducing our physicians to new decision support tools required to achieve our core goals,” he added.
ACMC’s Highland Campus is a 236-bed California Safety Net hospital and regional trauma center. Located in a dense urban area, it serves a highly diverse patient population with nearly 12,000 annual inpatient admissions.

"When I came to ACMC this spring, SmartOrders was selected as a priority project to affect change quickly and drive consistency in our care delivery processes," said Howard Landa, M.D., chief medical information officer at ACMC. "We needed to find an effective solution to accelerate and manage the expansion of evidence-based medicine in our clinical workflows. With SmartOrders we've been able to quickly onboard residents and I’ve been impressed by how warmly it’s been received.”

SmartOrders was designed by physicians and engineered to be both intuitive and efficient. As a result, training takes less than an hour and user adoption rates are high because the technology doesn't force physicians into mastering unfamiliar workflows and processes.

"We're very familiar with the challenges posed to public hospitals like ACMC as care management demands escalate," noted Performance Clinical's chairman and co-founder, Jeremy Nobel, M.D., MPH. "We have developed a very low-cost, high impact way to introduce reference-based clinical content— such as guidelines for safe and effective hospital admissions and discharges—into specific workflows to assist clinicians in making the best choices for their patients. We also manage other important documentation, including patient care instructions, advanced directives, and protocols of various types, by providing decision support, performance analytics, and shared views for ‘interactive checklists’ among multiple stakeholders. We believe these advanced capabilities, brought to clinical users seamlessly in a web-enabled platform, represent a real breakthrough for any hospital looking to maximize bang-for-buck in clinical information technology."

About Highland Hospital/Alameda County Medical Center (
Alameda County Medical Center is a health system of hospitals and clinics that work to maintain and improve the health of all Alameda County residents, regardless of ability to pay. ACMC is a public entity governed by trustees who are appointed by Alameda County supervisors. Highland Hospital opened its doors to the community in 1927, and has always provided an assured source of care for all Alameda County residents, regardless of ability to pay. With the opening of the Koret Foundation Critical Care and Clinical Center in 2004, ACMC offers a modern, attractive and well-equipped facility for emergency care, outpatient visits, surgery and other services. Highland is a licensed 236-bed acute care hospital in Oakland, which fulfills a number of unique roles in the community.

About Performance Clinical Systems (
Performance Clinical Systems is a healthcare technology company based in San Francisco, California and Boston, Massachusetts. Its core applications, SmartOrders and SmartTransitions™, inject precision and consistency to evidence-based medicine, provide dynamic decision support directly at the point of care, while simultaneously gathering essential data for advanced analytics and quality improvement. The company’s solutions are attractive to key stakeholders because they are quickly embraced by end-users, deployed rapidly (within weeks, not months), are a fraction the cost of enterprise-wide HIT systems, and contribute significantly to a hospital’s ability to meet evolving demands and requirements in today’s healthcare environment.

SmartOrders and SmartTransitions, with their Intelligent Checklist Management, modular configuration and browser-based interface, are powerful in their simplicity, highly scalable, support virtually any content source, and work within virtually any technical infrastructure.

Performance Clinical's customers include individual hospitals, health systems and health plans and is privately held.


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