A range of the latest medical and information technologies are intended to improve care and patient experience at a just-opened outpatient cancer surgery facility in New York.
Memorial Sloan Kettering Medical Center in January 2016 opened its new Josie Robertson Surgery Center, equipping clinicians with precise tools for surgeries and IT that supports patients in the care delivery process.
The specialized outpatient facility treats patients who can receive treatment with generally short stays, although some inpatient beds are available for those who need a little more time to recover from procedures.
With the opening came a range of advanced technologies and information systems. For example, it has four daVinci Surgical Systems that enable robotic surgeries. These procedures generally involve performing surgery through small incisions, using a vision system that gives surgeons a three-dimensional, high magnification and high-resolution view inside the body.
The surgeon operates robotic hands, known as “wristed instruments,” that can bend and rotate better than human hands and with smaller and more precise movements, says Vincent Laudone, MD, a surgeon at the facility.
The new surgery center uses real-time location system (RTLS) technology to track just about everything, including patients and family members before and after surgery. The system, for instance, enables medical teams to track patient locations and how well they’re able to regain movement after surgery.
Hospital executives say the center selected Versus as the RTLS vendor because of its tight integration with the electronic health record and medical devices and being able to automatically track vital signs of patients.
RTLS also is used to support inventory control, asset management, and patient and staff flow. The system notifies a surgeon or anesthesiologist that the patient is in the pre-op room and then is enroute to the operating room, and tracks when patients and clinicians enter and leave various procedure locations.
Because all staff and every patient and family member wears an RTLS badge, there is no overhead paging in the waiting areas, says Brett Simon, MD, director of the surgery center. “We don’t call the patient and family on the overhead, but track them and bring them to see the doctor. Patients can move around and not miss a thing.”
The biggest benefit to patient care that RTLS supports is getting patients out of surgery on time and then tracking their ability to regain mobility after surgery, according to Simon. “RTLS can measure how much patients are walking, (enabling us to) analyze data to predict who might not be ready to go home. We’re just at the early stages of trying to understand what added value there is.”
Josie Robertson Surgery Center also has multiple information technology options for patients.
This includes “Skype-type” technology on a tablet computer in each patient room as a patient or family communication device. The tablet also has controls to change the television channel or the temperature in the room, and to open or close the shades.
One challenge of the tablets, Simon notes, is ensuring patient privacy. When a patient is discharged, the tablet has to be wiped of browsing history and all personal information that it captured. It took six months to find the right tablet security vendor; AirWatch eventually got the nod.
A patient portal supports secure messaging, access to lab results and the distribution of information to patients on what to expect with an upcoming surgery, as well as driving directions and where to park.
The surgery center supports mobile apps from Health Loop that focus on patient engagement by providing reminders and answering questions. The app also can send patient information a little bit at a time as the date for surgery nears, giving a series of tips over several days, which Simon believes are more easily absorbed than handing patients a stack of information. The tips include checklists, pre-op tests coming up, reminders to bring a medication list, and explanations of what will happen during the whole process of preparing for the surgery and what comes afterward.
Implementing the app program hasn’t been easy, and the surgery center is now getting ready for its first pilot test. “We’re trying to determine the pace and information that patients want,” Simon explains. “We have patients helping design it.”
A secure video conferencing system from Cisco Jabber also is installed as sometimes physician schedules do not permit them to make morning rounds after a procedure and the patient wants to go home, so the morning visit can be done virtually.
With all the various systems being used, none of the installs has been easy, according to Simon. “Everything is more work than we thought because medical data systems are not that great talking to each other.”
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