Workflow Streamlined, Automated

June 1, 2009

An acute care facility implements a back-office solution to deal with repetitive tasks and to maximize its intranet.

Like many hospitals, South County Hospital (SCH) strives to provide high-quality, efficient patient care while maintaining smooth operations. This means the health of the hospital’s business side and information technology (IT) is just as important as the clinical side.

An acute care facility implements a back-office solution to deal with repetitive tasks and to maximize its intranet.

Like many hospitals, South County Hospital (SCH) strives to provide high-quality, efficient patient care while maintaining smooth operations. This means the health of the hospital’s business side and information technology (IT) is just as important as the clinical side.

SCH, located in Wakefield, R.I., is an independent, non-profit, 100-bed acute care hospital offering a comprehensive range of medical and surgical services. The hospital provides southern Rhode Island with a comprehensive range of advanced inpatient, outpatient and home health services. We have more than 100 physicians in our community and 650 full-time equivalent staff.

Overall, our users are not IT people, and they do not necessarily need to learn the technical process of generating and accessing reports. They require quick access to the information they are looking for. Technology should not be their focus, but rather a critical tool to perform their jobs.

In addition to accessing and recommending technology for the hospital, my staff provides IT assistance and training to all users throughout the hospital. We want to establish a partnership in their business operations by delivering technology solutions that complement the department’s business expertise.

Access to Information

The hospital staff and its leadership should be able to find the information they need, when they need it. Technology does not always lend itself to that, depending on which technology is used. For example, e-mail is a great tool for communicating, but it is not always used most effectively or properly. It is perfect as an FYI, but it is not effective for having a meaningful dialogue or for communicating statistics, management reports or policies and procedures to users, staff and management.

SCH’s approach is to publish this information in a way that is accessible to people when they need it, not when someone wants to provide it to you. We use our intranet as the principal medium for storing and organizing content, whether it is policies and procedures, changes in the organization or other tasks. If it is organized and searchable, then people can find it when they need it.

The interfaces built at SCH allow for the transfer of information behind the scenes, without staff intervention. This eliminates redundant data entry and the chance for errors in the transcription process.

Doing More With Less

Processes are different for every single system at the hospital. There are different passwords, different screens and different applications. If someone is new to the organization, navigating them all can be confusing and frustrating. How will the new-hire know what reports are available, or how to access and to produce them? Having report histories available on the intranet page enables managers to become acclimated to the environment, learn what is expected of them and also learn what information is available to them for their work.

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In an effort to organize the back office, SCH’s information systems (IS) staff implemented an automation technology to facilitate and automate many repetitive manual tasks, such as producing daily reports for various departments, preparing downtime reports in case of a system failure and ensuring the accurate transfer of online payments made on the hospital’s Web site onto our hospital information system. By automating workflow, we also maximized the use of our intranet, giving managers online access to payroll and expense reports, and eliminating the hassles that accompany paper-based processes.

By automating the reports, the IS staff can teach the management team or key users how to access the intranet and find the reports in a consistent, logical way. Now all reports, whether they are current, from last year or last month, get archived on SCH’s intranet.

Filling the Gap Between People and Systems

Another project we are undertaking is building interfaces to biomed systems. Organizations that have not built these interfaces usually require staff to write critical patient information on pieces of paper, hand-carry them to the documentation systems department and key in the data.

The interfaces built at SCH, however, allow for the transfer of information behind the scenes, without staff intervention. This eliminates redundant data entry and the chance for errors in the transcription process. Automating the flow of this information increases staff efficiency and effectiveness, improves patient safety and reduces medical errors. It also provides timely access to the information being captured at the bedside and pulls all the data from these various systems’ together for patient records.

Using scripting technology, SCH has established a mechanism for patient access to an online bill payment portal, which allows patients to connect with the patient accounts department and process payments. It is an automated environment where the primary billing system is used to extract patient statement information to post it as a record for the patient when accessing the portal. As payments are received, the Boston WorkStation script retrieves the payments and posts them so they are accurate, updated and timely.

Previously, SCH had a mix of old technology, which was difficult to support in a small environment. When the hospital began installing new systems to address Y2K, the recommendation was to replace those systems with an integrated system designed by one vender that would not require multiple interfaces to work. As a rule, we push for standards and integrated products whenever possible.

By reducing the variety of systems that need to be supported, the hospital became more efficient. In addition, an integrated solution was less expensive to buy, manage and support over time. Staff also could build a foundation with the single product without having to learn a new platform or get used to multiple vendors.

This idea of standardizing is reflected in most of the hospital’s decisions. SCH’s IT/IS staff is not large, so it needs to maximize its effectiveness. Whenever a new technology is introduced, staff tries to establish a best practice for implementing that technology. Copiers and printers are examples of where the hospital standardized on a vendor and the feature set. Now, any employee can use any copier or printer in any part of the hospital.

Boosting Patient/Physician Communication

Another one of SCH’s goals is to improve communication between the providers and the hospital for exchanging patient results, so we are instituting portals in the physicians’ offices that will enable them to enter their requisitions online. They will be able to collect office specimens, label them, and, with the use of 2-D bar-code technology, automate the entry of patient information captured from the physician office system into the hospital registration system.

The physician then gets the results delivered to an electronic in box, closing the loop on the order entry/results reporting cycle. This solution also helps physicians track patient compliance.

Over the last 10 years, the hospital IT staff has moved toward concentrating on clinical systems versus financial systems. Patient safety is the impetus, and technology plays a key role in improving safety in hospitals.

As IT people, we need to partner with our customers, such as nurses, physicians and administrative staff to ensure we are adopting the right technology and implementing it with maximum benefit.

Gary Croteau is assistant VP and CIO at South County Hospital Healthcare System in Wakefield, R.I.

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