Building the Ultimate Healthcare IT Infrastructure

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Database consolidation streamlines the enterprise

Consolidated healthcare IT infrastructure promises to help fix the system—providing clinicians streamlined access to multiple datasets to make timely, informed clinical decisions and removing artificial barriers between departments, physicians and hospitals. “As healthcare evolves and [artificial IT] barriers break down, physicians can respond appropriately, which, in turn, improves patient care and increases patient throughput and capacity,” says Mike Smith, CIO of Lee Memorial Health System in Fort Myers, Fla.

Healthcare IT’s results are impressive. Hospitals deliver better care, faster—and IT helps to saves lives. It’s a fact that patient mortality rates drop 15 percent during hospitalization when computers replace paper, according to a recent study in the Archives of Internal Medicine. Researchers found that healthcare facilities in Texas that used IT-based medical notes and records, test results, CPOE and decision support have fewer patient complications, less mortalities and lower costs.

Beyond patient care, charge capture is more effective with clean, complete claims the first time around. And we can’t forget staff productivity, efficiency, operational workflow, clinical workflow and better quality outcomes measurement.

Cutting-edge organizations with vision and set goals are working toward connecting and consolidating various imaging and clinical databases. The Southwest Ontario Digital Imaging Network in Canada, for example, is deploying a consolidated image database in one of North America’s largest digital image management projects. Ultimately, the project will provide users at 19 hospital corporations and scores of healthcare organizations the ability to share images regardless of the native PACS. Other healthcare organizations are taking a different approach and consolidating clinical datasets in a single source to streamline clinical care. Some are developing a single enterprise image management structure that houses radiology and cardiology datasets and provides an ubiquitous enterprise imaging workstation geared to the clinical needs of the exam.

Images everywhere

Southwest Ontario Digital Imaging Network (SWO) is one of the first steps in an eHealth Canada initiative to create a pan-province longitudinal patient view, making digital images available to physicians across the province, regardless of the native PACS. The project initiated in 2002 as the first of three hospital corporations deployed PACS, with each site selecting a separate vendor. Over the next several years, the project expanded to include additional sites and different PACS.

The network launched phase 2.2 of its project in December 2008. The DI-r (diagnostic imaging repository) is designed to bridge the various PACS throughout the geographic region. SWO invested in GE Healthcare Centricity Enterprise Archive and Centricity OneView—a PACS connector of sorts—a web-based clinical information and workflow management system designed to connect multiple discrete RIS and PACS solutions. The investment was made to complement the local PACS and provide radiologists with the ability to view broader patient information including all orders, patient demographics and results. All physicians in the Grey Bruce site, which consists of one hospital and two health services organizations, access patient images through Centricity Enterprise Archive. Other hubs across Ontario will follow in the next few years.

Planning for the massive centralized project has been complex. When it is complete, seven distinct PACS/RIS will feed into the repository. SWO established a Regional Shared Service organization; decision-makers from regional hospitals and health services corporations met regularly prior to the launch to tackle issues such as patient privacy, equitable cost sharing and appropriate service level agreements. On the IT front, Smart Systems for Health, an Ontario-based non-profit, assessed network readiness, boosted security and increased bandwidth from the hubs to the data center as necessary. 

A few months into the initiative, the DI-r/eHealth project is making an impact on patient care, says Stephane Ouellet, director of Regional Shared Service, Information Management and London Health Sciences Centre. Consider the recent case of a man who presented to a local hospital with symptoms of a massive stroke. A CT at the local hospital confirmed the diagnosis, and the patient was whisked to the regional