Linking Affiliates Electronically
A Web-based clinical messaging system has
tangible and intangible benefits - A Case Study
By: Lisa L. Kronhaus, Director of Public Relations
Bethesda Healthcare System
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.
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