EHR Interfaces Central to Valley Health System's New ‘Smart Hospital’

March 22, 2023
CIO Eric Carey describes how all the new technologies to be deployed at New Jersey hospital interface with the Meditech Expanse EHR

As New Jersey-based Valley Health System prepares to move into a new hospital building in early 2024, it is redesigning dozens of processes and patient engagement features. Valley Health vice president of information systems and CIO Eric Carey recently spoke with Healthcare Innovation about how all the new technology in the “smart hospital” interface with the Meditech Expanse EHR.

The new 400-bed hospital being built in Paramus, N.J., has a strong focus on patient engagement and activation. Each patient room includes a large interactive footwall monitor that will allow patients to see their own medical record information, care team members, and diagnostic images (where available). Monitors will also enable patients to control their lighting, window shades, and room temperature.

“We took all of our team members and leaders and documented everything about how we operate today, then we said to them, ‘If you could just start from scratch, what would it look like?’ And that's what we're building,” Carey said. “Basically, other than saying hello to your co-workers in the morning, every single thing that our team is going to do at that new facility is new. At least half of the technologies will be new.”

Valley Health worked with a vendor on an enclosed PC case built into the wall that can be swiveled to face the patient and the 75-inch monitor screen at the same time. That's a game changer, Carey said, because doctors often struggle when trying to share things on small computer screens with patients. “We're talking about a full-blown, high-resolution image that really will also pull the family members in as well. Valley is very focused on patient and family-centered care.”

Each room will have electronic door signs with uniform icons, with data coming from the medical record. When a nurse or clinician documents something, it posts there in real time, Carey said.

Patients will also be able to use their monitors to leverage information from Valley’s real-time location system (RTLS), such as identifying who enters their room (including their name, title, and photo). The RTLS will be integrated with Meditech to provide patient location when they are not in the patient room. By leveraging the Meditech scheduling system for the interventional platform operating rooms, Valley can implement power utilization reduction by lowering airflow exchanges when rooms are empty, he added. Smart beds and new artificial intelligence video surveillance systems will identify fall risk behavior based on patient movements, and will enhance staff response times, he added.

By tracking the location of nurses and physicians in relation to patients, clinicians will partner with the health system analytics team to gain a better understanding of how the number of patient-to-provider interactions impact patient outcomes, he said.

I asked Carey about the integrations required to make these systems work with the EHR.

“We have a middleware model at Valley. Our development staff works with the vendors to pull and push data in and out of all the systems that are connected to try to optimize it,” he said. “In order for this to work in a near-real-time mode, we have to have this middleware that optimizes all of this data flying back and forth. You have to pick the master record — the single source of truth that populates everything else. We have to connect Meditech to all these other downstream systems and Meditech will absorb the pertinent data and put it into the medical record.”

I also asked Carey if some of the things Valley is doing might be firsts for Meditech as well.

“They have other customers who've done parts of this, but we are definitely doing things they've never done before,” he explained. “And that's part of the excitement for us, because it is a game-changer for them as well. I think that over the next two years, every new hospital will start to adopt more of this technology. We're right on that cusp of the first wave of people starting to do this. As with anything in healthcare, once someone gets wind of it, everybody starts following very quickly.”

Valley Health even wants details about room condition such as lighting and temperature adjustments the patient makes to flow into Meditech. “We want the current data to be flowing back into the EMR so the nurses can check in the EMR and see what the room conditions are,” Carey said. “If you think of the EMR as your master control panel, we want to keep working with Meditech to get as many of these parameters and settings into the Meditech patient record, so that when a nurse is down in the nursing station, and they want to have a conversation with the patient about what's going on in the room, wouldn't it be nice if they also know what the current room temperature is and what the conditions are, so they can see that the patient is still cold, yet the rooms is pretty hot right now. So maybe there's another problem.”

Even the food ordering system, which Valley is switching to a hotel room service-type ordering system, has interfaces to the EHR, because it has to track any patient dietary restrictions.

How will they pilot the different features and give the clinician some experience with it before the new hospital opens?

“We have developed proof-of-concept units in the current hospital and where it's not cost-prohibitive, we are standing up new systems there,” he explained. “Just to give you an idea of the scale and scope of new systems, we're changing our nurse call system, our telemetry, our physiological monitoring system. We're changing the way Meditech works in a lot of ways. We have a pair of innovation nursing units where we're deploying all of these things in a small scale; then we're cycling staff through there so they can so they can get a feel for it,” he said.

“When we get ready for training, we're doing full day-in-a-life simulations at the new hospital. Every single staff person will spend at least a day, typically two to three days, in the new hospital actually pretending to care for patients. We have to do that because you can't just expect everything to work day one, right? There'll be enough challenges. As I said, everything's net new. So that's how we get over that. We have tons of pilots going on.”