For insight into the effort it takes to develop an information system for the operating room, look to Vanderbilt University Medical Center.
After searching unsuccessfully in the mid-1990s for a commercial system to automate its OR, the Nashville-based academic facility decided to build its own. The multi-million dollar effort recently came to market fruition, as Vanderbilt licensed its VPIMS (for Vanderbilt Perioperative Information Management System) to Birmingham, Ala.-based Acuitec in Feb. 2008.
Paul St. Jacques, M.D., a Vanderbilt anesthesiologist, describes the system as a soup-to-nuts suite of applications designed to support medical documentation, patient tracking, and report generation. The director of perioperative informatics, St. Jacques says that Vanderbilt completed the complex build over the course of years. A pre-operative module came early on, with a nursing and anesthesia documentation component following in 2001.
In 2005, Vanderbilt completed a wireless network application for remote monitoring of OR patients. The application, which runs on handheld computers, integrates information from the OR as well as views from live video cameras. The system is programmed to dispatch alerts to the attending anesthesiologist in case vital signs drop. VPIMS incorporates both vital signs and waveforms from various clinical monitors.
St. Jacques, who practices medicine half time, says the homegrown system enables him to be more productive and mindful of patient conditions. While working, St. Jacques may be responsible for up to four ORs at once. A resident or advanced nurse is present, but it is still critical for the supervising physician to keep tabs on things, he says. I like to pop into the OR just as the OR nurse is getting ready to page me, he says. According to St. Jacques, many current OR information systems lack adequate anesthesiology documentation modules, which was a factor in why Vanderbilt decided to market the technology commercially.
That does not mean he takes the value of the technology for granted. Two studies of Vanderbilts VPIMS and remote monitoring module are underway. The research projects are supported by a $1.2 million grant from the U.S. Dept. of Defense. About a dozen anesthesiologists are participating, St. Jacques says.
The Feature Story in Septembers issue of Health Data Management examines I.T. tools in the OR. To access the story, click here.
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