Situation Analysis:
- Bassett Healthcare System is a physician-owned, rural health care system comprising five hospitals, 23 community health centers, 14 school-based health centers and more than 300 providers. It delivers primary, specialty and acute care throughout a nine-county area covering over 5,000 square miles in upstate New York.
- With medical assets dispersed over an area the size of Delaware, communication and medical-record portability issues made it difficult for Bassett Healthcare to provide consistent, evidence-based care throughout their entire network.
- The installed base of legacy systems at Bassett Healthcare includes:
| Endosoft endoscopy | Microsoft Active Directory |
| IDX scheduling | MUSE/WITT/Xcelera cardiology |
| Varian oncology | Quest Outreach lab |
| McKesson document imaging | SIS surgery |
| McKesson PACS | Spheris transcription |
| Meditech Client Server abstracting, admission,dietary, lab, pharmacy |
Approach:
Recognizing their need to resolve the issues stated above, Bassett Healthcare formed a multi-disciplinary work group consisting of physicians, executives and technical staff to formulate a solution. The committee focused on two key requirements of the solution: “Make Quality Easy” and “Be Physician Focused”. They also identified three key factors critical to ensuring provider adoption:
- System must be intuitive and not disrupt the workflow or thought processes of the provider
- System benefits must be greater than the effort to implement change
- System must be flexible and customizable
Once these parameters were established, a solution selection committee was formed to examine possible technology solutions, evaluate demonstrations of the systems and conduct site visits. The committee ultimately selected ICA to provide a solution meeting their needs.
Solution ICA Developed for the Client:
The solution ICA designed for Bassett Healthcare provides “consolidated web-based access to all clinical data.” ICA”s solution allows Bassett to protect its investments in specialized clinical systems and provide data to clinicians in a concise aggregated format. This format allows the provider to view data “when and where they need it” in the format they want to view it. In addition, ICA”s solution augments Bassett”s existing systems to provide patient management, results management, care team messaging and alerting capabilities.
ICA”s solution is also being used to bridge the migration from Meditech to McKesson Horizon without disrupting the workflow and productivity of providers. The bridging work is done in background mode, so Bassett Healthcare providers can view data from the ICA desktop in a format familiar to them.
Impact of the ICA Solution:
| Previous Environment | ICA Environment |
| Lack of complete information available to physicians from all clinical settings and geographic locations was causing inconsistencies in the care received. | Comprehensive medical information viewable by every clinician within the entire enterprise regardless of the clinical setting or geographic location improves the ability to provide uniformity in practice patterns. |
| Lack of complete data caused duplication of diagnostic tests and exams, inhibited the ability to view patient compliance with preventive or chronic disease protocols, etc. | All members of the geographically dispersed health care team will have a comprehensive view of all diagnostic test and exam results to reduce duplication, as well as a view of immunizations, preventive maintenance exams, vital signs and other indicators to determine if patient compliance is appropriate. |
| Communication among clinical resources across the broad spectrum of settings and locations was inadequate and inefficient. | Secure messaging enables health care providers to communicate in a secure fashion and attach clinical documentation, as well as save information to the patient”s chart for future reference. |
| Patient either had to carry a copied portion of their medical record or repeat information already provided when referred to another location, specialty or diagnostic center. | Medical record viewable through a single portal eliminates the need for patient to be responsible for relaying information to providers at different settings or locations |
Accomplishments to Date:
- Implementation of Phase 1 began in 2007 and Bassett was able to roll out the entire enterprise within eight weeks.
- Within two months of Phase 1 go-live, 95 percent of Bassett providers were trained and using the system with no interruption in productivity in any clinical setting.
- Specialists in the Bassett enterprise now can review patient records remotely and provide clinical guidance to their colleagues, adhering to the original goal of delivering evidence-based care
- Within months of operation, ambulatory providers spontaneously began to provide outpatient care without record pulls because of the availability of all clinical data within a single source, easy to use application.
- Alerts and reminders are assisting clinicians in being timely in follow-ups, improving patient compliance with medical treatment plans.
- Deployment of the Medical School module is allowing medical students to track case requirements, as well as record assessments, treatment plans and diagnostic evaluations and forward them to preceptors for review, with links to the full medical record, for evaluation of their work and approval for future activities.
- Secure Messaging rollout to all health centers and clinics allows communication among health care providers along with the ability to save information to the patient’s chart and attach clinical documentation for future reference.
Rollout of other capabilities will include:
- Formatted clinical forms and notes
- Custom clinical flow sheet views for the inpatient setting
- Disease management dashboards across the enterprise
- Unchecked Results – allows viewing of actionable information early, while ensuring all results are reviewed
All this additional functionality will move Bassett closer to their original goal of providing evidence-based care allowing for proactive changes to the patient treatment plan as the physician sees fit.