Situation Analysis:
- Physician satisfaction is very important to the hospital to maintain its referral base. The competing hospital in town implemented a physician portal and local providers desired a more comprehensive solution from Lourdes. In addition, numerous manual workarounds were causing duplication of effort throughout inpatient clinical areas to satisfy the information needs of rounding physicians.
- The hospital had implemented many specialty-specific systems over the years to complement their legacy HIS, and physicians in the community had various ambulatory EMRs. Interoperability of these systems, listed below, had not been achieved:
| Fiji PACS | Ulrich ambulatory EMR |
| ChartMaxx document imaging | Meditech MAGIC laboratory, nursing documentation, pharmacy, radiology |
Approach:
Lourdes Hospital executives set out to quickly deliver a secure, aggregated clinical portal to their physician community to address the competitive issues described above. Lourdes Hospital and CHP set a goal to find a single vendor to fill their three most pressing needs: 1. Provide a competitive clinical portal to the physician community; 2. Aggregate data from ambulatory EMRs and provide results back to those ambulatory EMRs; and 3. Reduce administrative overhead by eliminating the duplicate documentation being performed manually by clinical staff to ensure physicians had the information they needed. Through a vendor selection process, they chose ICA.
Solution ICA Developed for the Client:
ICA recognized that gaining the confidence of the physician population was contingent upon quickly providing a tangible pilot for the deployment of the Lourdes solution. A three-phase implementation process was designed to deliver early and ongoing value to the hospital and its constituents. In phase 1, the infrastructure was put into place to aggregate clinical data from the hospital and physician offices, allowing participating physicians to access a longitudinal patient record through a Web-based portal product. In meeting the first two objectives of the project, Lourdes Hospital was able to strengthen its competitive position by providing more breadth and depth of information at the point of care than the other hospital in the community. Phase 2 will include inpatient flow sheets to accumulate the critical data physicians need to monitor, evaluate and treat their patients. As an added benefit, physicians will be able to access this data from their office, home or any other location with an Internet connection. Successful implementation of this phase will fulfill the third objective of eliminating duplicate manual documentation by nursing staff in the inpatient environment and increasing physician/clinical staff satisfaction. In the third phase, ICA will introduce disease and wellness dashboards to assimilate clinical results so that all physicians having contact with a patient will be aware of any existing medical conditions in order to manage appropriate protocols for delivering higher quality care. This is expected to yield improvements in both physician and patient satisfaction.
Impact of the ICA Solution:
| Previous Environment | ICA Environment |
| Competing hospital in the community was garnering physician loyalty by providing an inpatient patient portal. | A more comprehensive deployment bringing inpatient specialty legacy systems into a unified portal with single sign-on and contextual views of source system images is enhancing the physician experience and winning back loyalty. |
| Physician demand for an ambulatory EMR interface to the hospital HIS system for results retrieval had not been met. | ICA’s solution will integrate ambulatory EMR data in a physician’s data vault with patient matching capabilities and allow this data to be exported to the hospital EMR. |
| Nursing personnel spent hours transferring already entered information onto paper flow sheets and other status views to accommodate physician needs. | Automated inpatient flow sheets will extract information and display it in patient-specific views to accommodate physicians’ data requirements, allowing nurses to focus on clinical patient care. |
Accomplishments to Date:
- Aggregation of all major inpatient clinical systems was available and a pilot of the system was begun within six months from contract signing
- Alerts and reminders are functioning within the pilot project.
- Physicians were trained in one day and immediately began using the physician portal in rounding.
- Clinical leadership has engaged to determine further rollout based on clinical need and key physician acceptance criteria.
Rollout of other capabilities will include:
- Continued addition of physicians and clinical areas.
- Aggregation of additional ambulatory EMR systems and other ancillary systems.
- Deployment of secure clinical messaging to improve clinical communication throughout the community and reduce administrative overhead.
- Deployment of inpatient flow sheets within 60 days.
- Development and deployment of client-specific disease dashboards.
- Deployment of unchecked results
