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Starting from Scratch
March 1, 2008
The opening of a new, non-replacement hospital is a relatively rare event that provides insights on what information technologies are most appealing when truly starting with a blank slate.
Adventist Bolingbrook (Ill.) Medical Center, which opened in west suburban Chicago on Jan. 14, is the first new hospital in the state since the early 1980s. Not surprisingly, the 138-bed hospital, one of 37 owned by Adventist Health System, is highly automated, using technologies ranging from robots to deliver sterile instruments to high definition cameras in an operating room.
The new facility is taking advantage of Adventist’s national strategy of standardizing its software and hardware, including the mandated use of the Millennium suite of applications from Cerner Corp., Kansas City, Mo. Because Adventist’s four-hospital regional I.T. office for Chicago has a staff of 42, the new facility has only four I.T. specialists on-site, says Russell Soliman, Midwest region director for the health system’s information services unit.
The community hospital, which cost $152 million to construct, spent $5.8 million on I.T., or roughly 3.8%. The I.T. investment was minimized, in part, because the hospital pays an annual fee to access many of the applications acquired through Adventist’s national office, Soliman says.
Accessing data
Physicians and nurses have several hardware choices when accessing the Cerner applications and others. For example, nurses in the emergency department and certain other areas rely on computers mounted on mobile carts from Infologix Inc., Hartboro, Pa., and Ergotron Inc., St. Paul, Minn.
Most clinicians, however, use desktop workstations from Dell Inc., Round Rock, Texas, or wireless Toughbook laptop computers from Panasonic Corp., Secaucus, N.J. The entire hospital relies on wireless networks using technology from Cisco Systems Inc., San Jose, Calif.
Karsten Randolph, CFO of the new hospital, visited six other Adventist facilities to discern the hardware preferences of caregivers.
“None of the nurses we talked to felt comfortable documenting in a patient’s room,” he notes. And many found carts cumbersome to work with in certain areas.
For data entry, most clinicians point-and-click when using the Cerner applications and others, although some specialists, including radiologists and pathologists, still dictate notes for transcription.
In the short-term, the hospital will move to speech recognition from Burlington, Mass.-based Dictaphone Healthcare Solutions, a division of Nuance Communications Inc., for certain specialists. Soliman predicts that speech recognition could be the preferred method of data entry for all clinicians in the long run.
The hospital will implement computerized physician order entry later this year as part of the regional rollout of Cerner technology. Also on the “to do” list is “finding better ways to use the Cerner applications,” Soliman says.
“They are too cumbersome for some of our nurses. We need to simplify them.”
The new hospital is the first Adventist facility in the Chicago region to offer a patient portal as well as on-site kiosk, both of which enable patients to fill out registration forms, review accounts, make appointments and more. The portal uses technology from Galvanon Inc., Maitland, Fla.
Physicians can use another portal to access clinical data, including test results. The Chicago Adventist hospitals had been using hardware tokens for network security, but dropped them because they proved too cumbersome.
The hospitals will switch to other security options, perhaps biometrics, later this year, Soliman says. Among the many other technologies in use at the new facility are HD cameras in the OR for laproscopic procedures, wireless fetal monitors in labor/delivery/recovery rooms and flat-panel televisions in patient rooms.
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