Clinical SWAT team helps hospital go all-digital

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ORLANDO—Multidisciplinary collaboration was the key ingredient for the successful creation of an all digital hospital, according to Tanya Townsend, MSMI, director, Information Technology and Larry Hegland, MD, chief medical officer, St. Clare’s Hospital, Ministry Health Care, during a 2008 HIMSS conference presentation which highlighted the hospital’s efforts.

“We wanted to optimize information flows by eliminating duplication and providing ‘any place, any time’ access to information,” Townsend said. “We saw no need for patients to have to repeat themselves across the campus.”

Townsend said the goal was to create an all digital hospital that was completely chartless and filmless, on one network, and provide wireless access everywhere. “We no longer had a safety net since we no longer had medical record file rooms and film storage rooms,” she added.

The only question for administrators was “How exactly were we going to achieve an all digital environment?” Townsend said the hospital collaborated with Marshfield Clinic to do an initial assessment of how to go chartless, looking for gaps in workflow that needed attention.

“One of the keys to our success was the creation of a collaborative environment to get things done,” Hegland said. Getting things done meant creating a culture of collaboration that first defined the desired culture, and then began building that culture through an active recruitment process and physician participation—all which was done digitally.

“The implementation of complex and new initiatives, technologies, and processes is dependent on how well those using it will embrace, champion and lead it,” Hegland added.

To this end, he said a multidisciplinary team comprised of physicians, nurses, administrators and IT staff performed an objective review. The team’s recommendations were structured into a proposed action plan, centered around acceptance, training, support and super-users. “We gave a voice to the people in the trenches,” he said.

Townsend concluded that through this collaborative effort, the team at Saint Clare’s was able to see key IT clinical successes, beginning with access to patient records in real time, across the patient care continuum, from any location with internet access.

Creating an all-digital hospital with virtually no paper also avoids the problems of dual systems, she added. With telemedicine capability in the emergency department, Townsend said the hospital also has closed the loop on medication, and therefore, patient safety.

Both Townsend and Hegland proposed that opportunities to improve still remain. Ongoing training and education is needed to master EMR systems for existing and incoming employees, they said. There also is a need for IT generalists to support the entire applications and the need for department super-users that will be given opportunities for advanced IT training and time for support.