Unwiring the Healthcare Industry

By: Jose Allan Tan

Visit any hospital in Asia and you will see physicians walking along corridors of white anesthetized rooms visiting patients while holding flipcharts, scribbling observations and recommendations. Attending nurses move to and from their station answering calls, paging physicians and following up on patient medication.

Most departments from administration, finance, purchasing, nurse stations, resident physicians and laboratories have computers networked together to allow authorized staff to view documents online.

Advances in technology and business processes have reached the point where real benefits can be achieved through the convergence of computing and communications. It's no longer the realm of science fiction and healthcare institutions with very deep pockets, healthcare providers of different sizes, even those specializing in niche areas of healthcare provision, have discovered the payback of computing and the hard benefits of going wireless.

Lead by example

Case in point: St. Vincent's Hospital, a 338-bed acute care facility in Birmingham, Alabama, USA, is running a ten-year old campaign to elevate care standards by improving the quality, timeliness and accessibility of clinical information.

"As we deliver clinical information faster, to locations that are more appropriate and necessary, then we enable our physicians to make better decisions faster and earlier," explains CIO Tim Stettheimer. "That has direct and immediate effect on the quality of care and the clinical outcomes that depend on it."

St. Vincent's careful construction of a fully integrated and wirelessly accessible care information system environment reveals several important characteristics of successful solutions:

Tight integration between clinical care applications and a shared data repository, enabling automatic, real-time data aggregation.

A robust, easily managed wireless environment that provides appropriate levels of security for sensitive patient data.

An open standards-based enterprise hardware platform that supports mission-critical reliability, flexible scalability and affordable cost of ownership across a complete range of servers, workstations, desktops, notebooks, tablet and multi-function handheld computing devices.

As real-life example show, by properly integrating some of the latest in information technology, healthcare providers can experience significant transformation in the way they provide services to their customers. Transformations that directly benefit both the hospital's bottom line and the people the organization has sworn to serve - the patients.

Wireless technology has reached the point where users can now access information and communicate to colleagues within the organization securely and effortlessly. What's more, the infrastructure requirement does not require significant investment on the part of the organization. Most of today's notebooks and personal digital assistants (PDAs) come built-in with wireless technology.

Mobile Point-of-Care (POC) is a rapidly evolving segment of hardware, software and service solutions all focused on extending enterprise services and data to mobile care providers and their patients. Most of these solutions can combine new application logic with a trio of enabling technologies: high-speed wireless LANs; XML data integration; and handheld wireless client devices. These can all help bring patient data, decision support and administrative services to mobile points of care. These will also improve clinical outcomes by making patient information and diagnostic data instantly available to mobile care providers.

Mobile applications

Some of the applications already being utilized as a number of healthcare facilities include:

An online clinical decision support suite that combines expert diagnostic, treatment and prescription support tools with clinical management software, all accessible over handheld PDAs.

Electronic prescription systems that can automate order entry, preparation, delivery and check patient records for drug allergies and interactions have the potential to save lives by eliminating most prescribing and transcription errors. These systems allow providers with handheld devices to match bar-coded medication with bar-coded patient and physician IDs, establishing an accurate and fully documented "medication information supply chain."

An automated supply tracking and inventory control solution using wireless handheld scanners and enterprise database software.

An automated, remote patient monitoring and charting solution that links Bluetooth*- enabled medical devices and monitoring equipment with department and care center systems by way of an integrated wireless LAN relay device located in each patient room. Management systems can't solve these problems unless their services and data are readily accessible at every point where providers and patients interact.

A wireless LAN-based Voice over Internet Protocol (VoIP) telephone system that lets nurses and physicians communicate easily using tiny, wearable voice-activated "badges."

A wireless Picture Archiving and Communication System (PACS) that serves up diagnostic-quality radiological images to WLAN-enabled devices.

The future

While many hospitals are just beginning the process of integration and access engineering that leads to point-of-care solutions, others are looking further down the road. St. Vincent's Stettheimer envisions mobile technologies that will manage the onslaught of information more intelligently and proactively to help overloaded clinicians focus their attention for maximum productivity.

He thinks that mobile devices will soon track the user's physical position, and will present information filtered for location context. A physician on rounds, for example, might have patient information updated automatically as he moves from room to room.

In Asia, hospitals like Bumrungrad Hospital in Thailand, Singapore General Hospital and Medical City in the Philippines are paving the way for other hospitals in the region to follow suite. The question to ask is not "if" but "how fast" can hospitals transform their organization and thereby reap the rewards of operational efficiency and improve patient care.

Success Stories

Representatives from different departments at various healthcare institutions worldwide discuss how information technology improves the business of providing patient care services. Click here to watch a video.

Medical Associates Clinic, Dubuque, Iowa, USA

A 140-provider multi-specialty group practice producing over 500,000 patient visits annually through a network of 14 clinics and 22 outreach offices. Like most successful medical groups, Medical Associates Clinic (MAC) strives to maintain the balance between growing administrative workloads and a high standard of patient care. Processes like prescription management drain the time and attention of nurses and physicians. MAC deployed McKesson's Horizon Ambulatory Care, a Web-based clinical automation solution that provides comprehensive support for care delivery in an ambulatory setting. Now the group's clinicians can access records, document encounters and initiate orders directly from wireless-enabled Tablet PCs. Prescriptions are automatically checked for possible interactions and electronically faxed to the patient's pharmacy, improving accuracy and patient satisfaction.

Schneider Children's Medical Center, Israel

The Schneider Children's Medical Center of Israel (SCMCI) is a 224-bed acute care facility located in Petach Tikva. SCMCI implemented an online clinical data warehouse based on Ness Technologies dbMotion platform. The new system consolidates medical information from various departmental systems and provides secure, role-based access to authorized and authenticated users. Caregivers access the system using notebook PCs and other mobile devices with integrated wireless connectivity. Now clinicians can view their patients' entire medical history in real time, directly at the point of care. The immediate availability of comprehensive patient records reduces the administrative costs and delays related to data acquisition, accelerating diagnosis and treatment. It lets caregivers spend more time focused on the patient, and helps improve the quality of the care interaction.

University of Jena Hospital, Germany

At the University of Jena Hospital (UJH) clinical complex in Theuringen, Germany, a mobile point-of-care solution trial has demonstrated simplified work processes with significant reductions in nursing workloads. The pilot was designed to test lightweight, mobile alternatives to the hospital's existing infrastructure of fixed PCs for patient data input and retrieval. By eliminating trips to the central ward PC to enter and access patient data, administrative workloads were reduced by up to two hours per nurse per day, allowing substantial reallocation of nursing time to direct patient care.

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