Improving Community Care
Community hospitals embrace advanced network applications to enhance patient care, operational efficiency.
iQ Magazine , Second Quarter 2006
by Vicki Powers
At first glance, Citizens Memorial Healthcare looks like a typical rural hospital. Located in Bolivar, Missouri, it employs approximately 1,500 people, has a charter to serve its community, has very real budget limitations, and needs to make the most of its limited resources to improve patient care, manage rising costs, and operate efficiently.
Look more closely and you'll see its forward-looking approach to technology. Before it began upgrading its technology, Citizens Memorial had an antiquated combination of disparate information systems. Today, with a standards-based, medical-grade IP network, it supports electronic health records (EHR) to operate in a 100% paperless environment. Mobile caregivers and support staff gain access to patient information where and when they need it, thanks to a wireless LAN.
In 2005, Citizens Memorial became the first rural hospital to earn the Nicholas E. Davies Award of Excellence, presented by the Healthcare Information and Management Systems Society (HIMSS) for advanced clinical applications in hospitals and clinics.
Balancing Costs and Benefits
Hospitals and clinics increasingly rely on networked healthcare technologies. Even smaller hospitals with limited budgets are realizing that network-based technologies can enhance care and staff productivity while helping to reduce operating costs. Advanced clinical solutions available today include the following:
- Mobile nurse-call communications utilizing wireless IP phones
- Active radio-frequency identification (RFID) services to track equipment and other assets
- Imaging and patient-monitoring applications
All of these technologies enable caregivers to increase productivity and responsiveness.
At Citizens Memorial, the goal was to provide caregivers with information whenever and wherever they needed it. "The new technology was definitely to solve a business issue," Citizens Memorial CIO Denni McColm says.
Today, an IP backbone from Cisco plus 50 servers supports a wired and wireless network that connects 33 buildings. An external consultant helped Citizens Memorial select clinical and administrative applications from Meditech and a practice-management solution from LSS Data Systems.
Experts were heavily involved early in the process, enabling the hospital's 11-person IT group to take over after the installation. A basic timeline:
The project's cost ($3.4 million for software and $1.58 million for hardware) initially seemed high because Citizens Memorial had never made significant investments in technology. But as the business benefits continue to add up, the value is clear:
- 2002 and 2003: Deployed financial, billing, nursing, and core clinical applications
- 2004: Finished scanning all paper documents into the system
- 2005: Implemented real-time nursing documentation and online medication-administration applications; in the emergency department, a patient-tracking application greatly improves communication and workflow
- The hospital now processes 70% of claims without human touch.
- Net patient revenues have increased 23%.
- Medical-records filming costs, which ranged from $48,000 to $60,000 each year, have been eliminated.
- At the physician clinics, the average time it takes to receive payment dropped from more than 80 days to fewer than 50.
Most important is the direct benefit to patients. Care providers now have effective access to information when they need it, resulting in enhanced care.
Reducing Medical Errors
Healthcare organizations that invest in IT and deploy advanced clinical applications should realize considerable cost savings over the next 5 years as a result of fewer medical errors, according to Dave Garets of HIMSS Analytics, a provider of healthcare information and analysis.
"The average cost when you have a medication error is around $4,400," Garets says. "When you make a mistake, people get sicker or have a violent reaction and have to stay in the hospital longer. IT will be one of the most effective tools for reducing the cost of healthcare."
Citizens Memorial Healthcare CIO Denni McColm says that once a day on average, a physician in the Citizens Memorial system gets an alert that a drug-drug or drug-allergy interaction may occur and changes an order to prevent it. "If even one-tenth or one-hundredth of them would have been an adverse drug event, we're talking some big dollars," McColm says.
Monitoring Patients Effectively
Central DuPage Hospital near Chicago, recently invested in an enabling technology complementing the patient-monitoring system for its 38-bed cardiology unit. Cisco collaborated with Philips Medical Systems, a patient-monitoring solution provider, and technology integration company Emergin, to use the hospital's existing Cisco Medical-Grade Network infrastructure.
Central DuPage replaced nurses' cell phones with wireless IP phones integrated with a central call-management program. Telemetry information (a patient's electrocardiogram data) is now output as digitized data on the network. The system automatically delivers alerts to mobile clinicians within 3 seconds (compared with 15 to 20 seconds previously), allowing nurses to respond before situations escalate.
The system also reduces the cost of data and voice communications. The hospital estimates that the IP telephone system will save $1.68 million over 5 years.
Increasing Operational Efficiency
Employees at Rockford Memorial Hospital, a 396-bed facility in Illinois, spent hours each day trying to locate specific equipment for routine maintenance. Gary Bayston, the hospital's biomedical engineering manager, conducted research to learn the full situation.
His research revealed many challenges:
- Missing or unavailable equipment led to excess equipment leases and purchases.
- Patient care was delayed when equipment wasn't ready for use.
- Workers spent excessive time searching for equipment.
- Management inefficiency affected personnel, bed, and systems capacity.
Overall, he found that tracking the hospital's 9,000 pieces of equipment cost $1.5 million per year in lost productivity alone. For example, his group might spend 7 hours to find a piece of equipment and just 1 hour to perform the maintenance. Likewise, Bayston found that care providers spent 25% to 30% of their time looking for equipment and often purchased extra equipment.
Rockford Memorial selected PanGo Networks' Locator, an asset-tracking solution that uses the hospital's existing wireless LAN. PanGo Locator uses RFID tags, letting staff know the exact location of any piece of equipment at any time.
Today, it tracks 600 assets using RFID and plans to add 1,000 per year. Rockford is considering tags for everything from food-service carts to biomedical equipment; possibly even people, such as staff, Alzheimer's patients, and infants.