March 11, 2001
A Web-based clinical messaging system has tangible and intangible benefits - A Case Study
March, 2001 - Healthcare Informatics
To make clinical data available between its affiliates and its 520 physicians via the Internet, Bethesda Healthcare System, South Florida, recently launched a clinical messaging system using the latest Web technology. The 362-bed private community hospital, outpatient multispecialty center and several ancillary facilities designed the system to quickly and cost-effectively automate workflow, improve communication and collaboration, build physician loyalty and enhance patient care throughout the network.
The first step was to replace the DOS platform that had been in use for the past seven years, because its store-and-forward system was not capable of supporting today's technology. Before Bethesda's team of specialists from information systems and business development departments began researching the marketplace for an Internet solution, they assessed the needs of Bethesda's physicians, hospitals and specialty care centers.
After an 18-month investigation, four serious contenders were singled out. Each gave several demonstrations to groups of physicians and the hospital's executive staff. In February 2000, Bethesda selected Axolotl to launch its Elysium Clinical Messaging system.
Choosing and using
The product had to be easy to use and deliver immediate results, says Joy Rodak, Bethesda's vice president of corporate strategy. Even more important was data security, and the system incorporates IBM's secure Domino messaging platform.
System implementation was divided into two phases. The fist, immediate connection, includes the 210 physicians using the DOS-based system. The second phase, scheduled for October 2000, was implementation of the product among the remaining 310 medical professionals who had not been using the old system. Due to the concentrated efforts of everyone involved, installation went smoothly and rapidly. Originally scheduled to take 90 days, phase one was completed three weeks ahead of schedule.
Bethesda understood that the success of any automation project would depend heavily on user acceptance, so it implemented a comprehensive education program to ensure that all staff would feel confident using the system and to help overcome hesitancy regarding Internet use. Training classes, which began during installation, continue to be held four days a week-early in the day and over the lunch period. Users typically need only one or two training sessions to operate the system, but they are welcome to return to classes anytime.
Saving and improvements
Feedback on the initial benefits has been extremely positive. One employee reports saving more than two hours per day on printing, sorting and filing data for eight physicians. With the system's auto trace feature, data are organized so they can be selected and printed according to patient or physician. Physicians like the icons that flag critical or abnormal values. Lab reports were a nightmare with the DOS system. A typical lab panel contains 20 separate tests. The old system printed out hard copies of partial results as they became available. Elysium queues up the individual results until the panel is compete and send the consolidated results in a single report.
Another advantage is that physicians can access clinical information anytime, anywhere, evaluating from home or the office the necessity of a hospital visit to check the status of their patients.
The product's use of standard tools permits easy customization of features to fit the organization's needs. Bethesda's Web programmers were able to write the scripts to automate the standard forms. Instead of filling out forms by hand and faxing them to the appropriate office, physicians can click on a link within the messaging system to go to the Bethesda Automated Forms page. They select a form from the reports available on the list and fill it out using customized drop-down menus and highlighted buttons. The information is converted into an email message and sent to the desired department via Bethesda's internal email system.
In addition to the measurable results, some intangible benefits are anticipated, such as enhanced relationships between Bethesda and its affiliated physicians. "Bethesda initiated the investment in technology to help the physicians and to help patients," says Bethesda CEO Robert B. Hill. "It's a win-win situation for everyone."
Lisa L. Kronhaus is director of public relations, Bethesda Healthcare System, Boynton Beach, Fla.