Remote Control

June 24, 2011
Increasingly, healthcare providers are turning to information technology for solutions in their quest to deliver better care at lower costs.

Increasingly, healthcare providers are turning to information technology for solutions in their quest to deliver better care at lower costs.

Portal technology - coupled with integrated messaging and file management capabilities - is one of the most effective and affordable ways to equip physicians with on-the-spot access to important patient information and open new channels for expanded and cost-effective communication with patients.

Hays Medical Center, Hays, Kan., has adopted these technologies to improve service to patients in our 150-bed hospital system as well as to several smaller, remote hospitals to which we provide IT services. These include financial and clinical data management, as well as Web/e-mail services. Hays - the regional referral center for northwestern Kansas - serves more than 120,000 citizens.

Balancing act
As Hays' service area has expanded, so, too, has the need to strike a balance between leveraging current IT investments and providing state-of-the-art services. Physicians - particularly those in rural areas - often require remote, real-time access to e-mail, files, and other productivity tools. Hays' staff had routinely sent confidential files via cable modems behind a firewall, which physicians could then access at home or on the road.

Our IT department spent a great deal of time making the staff's home computers secure, as we had to ensure that hospital and patient records were kept confidential to achieve compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Providing doctors and administrators with access to records from home computers was a difficult and costly process.

We wanted to create an integrated messaging and file management system that could deliver expanded services, improved reliability and scalability to meet our future needs. The new system also had to be cost effective. Beyond providing users with secure access to files, e-mail and calendaring from remote locations via a secure portal, we wanted our new integrated messaging system to feature search capabilities for both file and e-mail archives.

In addition, our administrative and IT teams were eager to reduce IT development, hardware, and management costs. As such, we carefully considered migrating to a Java environment and consolidating the organization's hardware infrastructure.

Hays originally considered building a homegrown solution. After assessing our already-stretched in-house development resources and need for extensive functionality, the IT team decided to look for a commercial solution. We selected Oracle Collaboration Suite - an integrated messaging, scheduling, and file management system from Redwood Shores, Calif.-based Oracle - that allows Hays physicians and authorized staff access to critical patient information via portal technology, powered by Oracle Application Server.

An obstetrician, for example, can log into the portal from home to view a patient's fetal monitor, access files to compare results, and use the calendar function to confirm the patient's next appointment. Doctors used to have to be in the facility standing next to the machine to see the read-out. Now they can view it in real-time, online. At the same time, the doctor can check e-mail, calendars, and data files.

Through the portal With our new integrated messaging system, staff members use a standard Web browser to access the portal. Once logged in, users can navigate the organization's file systems regardless of their location or the time of day. We think this capability improves productivity, delivers critical information to care providers when they need it, and lowers frustration levels.

The Oracle-based files system stores master documents on a secure server and allows multiple users to collaborate on the same version of the document. A document automatically locks when a user is updating it, although others can still see the document in read-only mode.

The system also features single sign-on technology, which allows remote users to log in only once to securely access information available on Hays' Web site. The single sign-on approach simplifies user management, reduces security threats, and eliminates the cost of password resets.

External users navigate the Hays Web site to obtain basic information on the organization and its healthservices; authorized personnel and physicians use the same site to securely access selected records and documents. The system and its inherent security features also help Hays ensure compliance with HIPAA privacy requirements.

To designate access privileges, the new communication system features a search function that enables Hays to designate which parts of the system each user is allowed to search. For example, prior to the new implementation, our IT group ran searches on sensitive materials for the company's attorneys. Our attorneys now have direct access privilege to pertinent content - streamlining searches while maintaining the security of sensitive information.

Oracle Collaboration Suite also helps to expedite our medical transcription process. Transcriptionists working remotely can securely upload documents to the Hays server. The Hays staff can then pull the medical documentation into a patient's electronic medical record and forward it to the appropriate physicians for electronic signature. These documents are then available enterprise-wide, enhancing the timeliness and quality of Hays' patient care. This process also reduces the need to route paper documents - a process that can be cumbersome, expensive and present security risks.

By consolidating 10 servers to three and eliminating the need to maintain remote PC systems, the hospital saves $125,000 annually on licensing and maintenance fees. We also migrated to Java and open standards, which allowed us to consolidate and streamline our IT resource and development requirements.

Today, our IT team can deploy applications right from the development tool, which shortens development lifecycles and accelerates time to market. The Java migration also allowed our organization to consolidate four IT support positions into two, saving the medical center an additional $60,000 annually.

Further, the system is built on Linux, allowing for cost-effective scaling when needed and allowing us to keep server licensing costs down.

Hays turned to Enterprise Business Solutions (EBS), Lenexa, Kan., to implement its new system and train Hays employees in best practices. The learning curve has shortened significantly since we have standardized our IT training processes. In addition, we are using Oracle-based Web conferencing to train care providers on advanced messaging and file management functionality. Physicians can log on at their convenience to complete training modules, without disrupting their time for patient care.

Phase change
We are entering a new phase in our messaging portal implementation, which will allow patients to register, make appointments, communicate with doctors and request prescription refills online.

Hays is also working to replace manual reporting and tabulation of patient census data through the use of self-service technology. We plan to automate our daily administrative report, a crucial tool that details the number of patients in beds and scheduled surgeries.

Beyond expanding staff access to the portal, we are evaluating the benefits of extending its Web-based system and services beyond the medical center to other remote hospitals that Hays utilizes for several of its outpatient services (such as a sleep disorder clinic). The new IT system allows Hays the ability to securely transfer raw study information between the hospitals, opening the door for new revenue.

Establishing integrated messaging and document management capabilities via a secure portal can empower healthcare providers to reap the benefits of information technology. By opening the door to expanded communication - between physicians and with patients - Hays Medical Center is leveraging its new IT system to deliver better care at lower costs.

Scott Rohleder is director of information technology at Hays Medical Center, Hays, Kan.

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