HIS Project 1 Surgical Information Systems 3/22/00 Tanaz Dutia Debby Keller Emily Zajano

Objective: To evaluate surgical information systems from a clinical vantage point Expected results: Drastically improved effective resource use in the surgical environment -Decreased costs -Increased satisfaction of providers& patients -Improved quality of care

Outline  Description of problem Highlight the problems of not having unified information systems in surgical units  Analysis of Requirements Determine what a complete information system should address  Evaluate Surgical Information Systems  Gaps in SIS and solutions  Conclusion/Lead in to project 2

Description of Problem  OR is the highest cost center and revenue generator.  Pressure to cut costs leads to information systems solutions.  Could save 30-40% by using an IS that captures all data – both clinical and administrative.

Problems with Previous IS Solutions  No standardization of data elements.  Data elements had different meanings to different services.  Database development and maintenance was dependent on user’s knowledge.  When the developer/maintainer left, the hospital was left with difficult task.  Need complete software packages to address all data produced and needed in OR.

Why Use an SIS?  Manage schedule of surgical cases to maximize resource utilization  Capture all clinical data at point of care  Eliminate redundancies in data entry  Generate real time clinical reports (as needed or automatically scheduled)  Staff spends less time on non-clinical paperwork and more time on patient care

Analysis of Requirements  A source of standardized and comprehensive content and format the transmission of procedure-related risk and complications;  Captures and archives clinician behavior relating to use, modification and disclosure of standardized knowledge sources;  Provides just-in-time access to procedural descriptions information relating to risks and complications.  Captures, archives and makes available to the clinician patient use of procedure-related knowledge resources.

Surgical Data Flow Diagram Surgical Service OR Coord. Nursing Anesthesia OR Operating Room Anesthesia Data Entry Nursing Data Entry Surgical Service Data Entry

How an SIS Manages the Flow Surgical Service OR Coord. Nursing Anesthesia OR Operating Room Anesthesia Data Entry Nursing Data Entry Surgical Service Data Entry Streamlined into One!

Analysis of Requirements Mandatory Functions  Scheduling Patient Care Plans  Recovery Room  Pharmacy  Clinical Data  Patient Assessment  Medical Records  Pre/Intra Operative Data Management  Resource Use  Surgeon Preference Case Card  OR logs  Anesthesia  Staff Records  Infection Control  Case Costing

Evaluation of Vendor  Surgical Information Systems (SIS).  Why SIS is our vendor of choice:  System captures all clinical, financial, administrative, and archival data needed to manage surgical services and comply with JCAHO quality monitoring requirements.

Function of SIS  Manage your schedule of surgical cases. maximize resource utilization.  Captures all clinical data at the point of care.  Integrates into existing HIS. saves time in working with existing systems and saves money for future IS scalability.  Eliminate redundancies in data entry; information need only be entered once, and will then appear throughout the system wherever appropriate.  Generates real time clinical reports (as needed or automatically scheduled).

Vendor’s Tools  Used by SIS to deliver these solutions and streamline the operating suite.  Patient scheduling data management.  Nurse anesthesia interoperate management.  Anesthesia interoperate management.  Reporting modules.

Patient Scheduling Data Management  The system is integrated with pre-admission, pre- operative, intra-and post-operative modules.  Block scheduling accommodates specialty block definition, practice block definition, and surgeon block definition. Utilize integrated preference cards and pick lists.  Access room, materials, personnel and equipment availability. Facilitate real time conflict checking.  Graphical User Interface (GUI) format.

Preoperative Nursing Data Management  Records info on patient history, medication names, handicaps, patient valuables, and a recall feature for patients who have had previous procedures.  Preoperative data is stored for anesthesia and intraoperative providers to review.

Intraoperative Anesthesia Data Management  The patient interview is verified and released to other providers throughout the hospital.  Simultaneously monitor up to 125 vital signs from as many as 25 patient monitoring platforms.  Non-physiological data including the administration of drugs, anesthetic events, patient demographics, event timing, and involved staff is recorded quickly and easily using a GUI.  Voice response, touch screens, light pens, or bar coding are available for SIS users.

Screenshot: SIS Anesthesia IntraOp Module

Gaps in SIS & Solutions  EDI v. XML  Price  Age of Vendor  Solutions to problems

Looking Ahead to a Clinical DSS  We conclude that surgical information systems can help save costly time and money, as well as increasing the quality of care.  Inclusion of surgical DSS will intensify the savings and satisfaction in the surgical environment.  Computer-based decision-aids are hardly used.  Successful implementation of decision-aids in the clinical environment must integrate the future users.