Laying the GroundworkBy Tom Barnett | Posted 2012-05-10 Print
The objective was to build a state-of-the-art hospital that would fuse cutting-edge health care with the hospitality and service of the world’s finest hotels.
Laying the Groundwork
Obviously, we had to
get this right from the start. We were fortunate
that the contractor had a
tight timeline and that many of the infrastructure items
we needed to install followed the
build schedule closely. For example, after
construction crews had rough-framed
in a floor of the hospital (meaning the walls were framed), our
teams would begin pulling data cables to each room where the
network closets would eventually be. We
started at the main data center and telco
In all, the team installed
more than 4,400 data pulls and built
25 network closets. We
also installed 231
wireless access point (WAP) antennas that
to resemble ceiling tiles and
constant data and voice coverage, even in elevators.
Once the phone switch was installed, the team pulled 1,507 voice cables and put in just over 1,300 telephones.
We also had to plan for the implementation, configuration and testing of more than 72 applications that are necessary for hospital operations. We were lucky because most of the IT applications were already in use elsewhere in the health system.
Applications in a hospital setting largely
fall into four
categories: revenue cycle
(human resources and financial
) and ancillary applications.
critical chain of data
called the ADT (admission, discharge, transfer)
feed holds most of
these systems together
The ADT feed updates the
status of patients
there is a change, and it contains information such as a patient's name, ID
number and room
is the charge interface, which ensures
that any systems used to perform a billable service in the hospital have
the right patient and send back the correct
To orchestrate all these
systems, we registered
an imaginary patient, Fred Flintstone, in the revenue
cycle system. Then we
worked to ensure that laboratory,
radiology and dietary departments all
received this information, performed services and
sent back billing feeds. Clinical results also had to post back to the
electronic health record, and billable items had to post back
to the patient account.
Using this sequence, we were able to build
the program plan to properly gather specifications and configurations for each
and then test each application.
We had all performed integration testing on a
single application or set of new servers. But testing
something of this
scale and magnitude was new territory. We
needed a tight sequencing plan and an abundance of
The testing had to be planned
in the same way as
the sequencing of the applications. Testing
included the following areas:
registering a patient for
either an appointment or the emergency room, assigning a
bed, ordering diagnostic imaging and lab tests, ordering medications and food,
physician visits, and updating the electronic health
record, followed by patient discharge, accumulation of billable charges, and
finally the creation of the patient billing statement.
For testing purposes, we removed the wait and processing times and were able to simulate the entire process in nine to10 hours.
Once we knew we had everything working exactly as we planned, we were ready to open.
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