In October 2015, three-hospital Southcoast Health serving southeastern Massachusetts and Rhode Island went live with an enterprise acute/ambulatory Epic electronic health records system. With the new system, the organization wanted to get away from manual anesthesia documentation, which takes time and the attention of clinicians in the operating rooms.
The goal was to automate documentation and translate messages from a range of anesthesia machines of different types to readable language that the Epic system could accept, says Scott LaRosa, director of clinical systems.
Southcoast Health searched for a connectivity vendor that could integrate with anesthesia machines and selected the BedComm medical device data integration technology of Excel Medical.
“The Excel product helped us integrate the patient data from the anesthesia machines through the physiological monitors and into the Epic environment,” says Dan Bazinet, director of clinical engineering and technology. “The technology gives our anesthesia staff the time and ability to focus fully on the patient during surgery versus on documentation or other interruptions.”
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Building automated anesthesia documentation was so complex that certain staff members were assigned to do it—others could not step in, LaRosa says. If a team member could not attend a meeting, the meeting was cut short or cancelled.
Over the years, Southcoast Health had acquired about 60 anesthesia machines, including a small contingent of really old machines that needed to be integrated and tested. All of these different machines gave different readings, and the build continues today. In large part, team members continue to upgrade and have not gone back to their original departments.
Despite the complexity, the build has been successful because team members make sure all personnel engaged in the process are still there to test every parameter on every device. “That was the longest part of the project, but also the largest benefit of the project,” notes LaRosa.
In time, Southcoast Health had automated its OR documentation system, but anesthesiologists initially were not ready to immediately jump on board. To get their comfort levels raised, the organization did shadow charting for a month with each anesthesiologist doing manual charting, but on one procedure they also used the automated tool in a mock environment, LaRosa explains. “The key to success was a strong anesthesia champion who was responsible for communication with the anesthesia staff.”
When Epic proposed its plan for anesthesia integration, it was overwhelming to Southcoast Health staff, LaRosa recalls. The way to move forward was to make sure that integration was the priority and that everyone met Epic’s timelines. “It is doable, and the plan absolutely works,” he adds. “This is not an area where you can have disruption and disagreements with vendors. You need to lay out accountability and who is responsible for ensuring tasks are completed.”
Epic’s team included former clinical engineering personnel who remain on the team today to assist with future upgrades and other related Epic build-out or integration processes.
Excel Medical’s other BedComm products support collecting and integrating vital signs monitoring data and delivering it to the EHR across a hospital’s wireless network, digitizing cardiac rhythm strips and alarm documentation across the enterprise and into the EHR, and enabling clinician access via the EHR to patient monitoring waveforms, vital signs and alarms.
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