Indiana Heart Hospital: Real-Time E.R.By Kim S. Nash | Posted 2005-05-04 Email Print
This "digital hospital" has likely paid for itself in less than two years. And it's radically cutting the time it takes to treat a heart attack.
As you fold down the bedspread, your chest burns. Must be that big lasagna dinner coming back. Thump-bump. You take an antacid and turn in. Thump-bump. Asleep, the tingling in both arms hardly registers. Two hours laterthump-seizeyou bolt awake to a crushing tightness of the chest. A hippo sitting on your ribs. Breathing comes in small puffs and it hurts. Heart attack.
In most cases, the culprit is coronary arteries clogged with cholesterol and fat that struggle to move enough blood to the heart. Not enough blood means not enough oxygen, which destroys heart muscle. Heart disease is the No. 1 killer in the U.S., the American Heart Association says, and in a cardiac crisis, each minute matters.
At the all-digital Indiana Heart Hospital, information technology helps add time to the clock. Here, no doctor scratches illegible prescriptions on paper; he types and sends his orders to the pharmacy. No technician misfiles X-ray film inside a metal cabinet; there is no film and images are digital. No nurse ransacks the medical records room, frantic to find the folder on an emergency room patient; there are no folders or records rooms, because all patient charts are computerized.
Patient information appears immediately at the click of a mouse or touch of a screen. It's "a real-time reality show," says cardiologist Michael Venturini, Indiana Heart's chief medical officer.
Converting health-care facilities to electronic systems makes hospitals better, says Manuel Lowenhaupt, a physician and clinical transformation leader at the Capgemini consulting firm. Doctors and nurses sign in and out of systems before and after interacting with patients, leaving an audit trail and increasing accountability. Having more consistent data to analyze promotes best practices that make hospitals more efficient and patients safer and healthier.
Hospitals are not immune to factors that threaten technology projects in any industry: money and people. Health-care budgets are perennially thin, and doctors, deeply entrenched in their work habits, are the ultimate reluctant users, Lowenhaupt says.
Innovative thinking helped Indiana Heart overcome the obstacles. For starters, the for-profit hospital is 30%-owned by a group of cardiologists who work there, which personalizes their stake in maximizing efficiency. Community Health Network, an Indianapolis hospital group, owns the rest.
In the complex setting of a critical care facilitywhere delays in the chain can killefforts to find a better way to work never end. Doctors and nurses consult almost every day with developers on staff and from GE Healthcare to tweak the software to speed some tasks or rearrange how modules connect.
Centricity, GE's medical software, has been running for two years, says the hospital's chief executive officer, David Veillette, "but we're not done [fine-tuning it] yet."
The U.S. spent $1.8 trillion on health care last year, up about 8% from 2003. Costs are expected to rise at least 7% per year through 2014, according to the Center for Medicare and Medicaid Services in Washington, D.C. The Bush administration wants all health records to go electronic by that year, seeing it as one way to make health care more efficient.
Yet paperwork still plagues this industry. Insurance claims are rejected so often for lack of complete documentation that some hospitals formed "denial management" teams to sort out the problem.
And patients are repeatedly asked the same questions as they are passed from one health-care worker to another to fill out required forms.What's your Social Security number? Are you allergic to any medications?
"If I were a patient, I would question whether these people even talk to each other," says Susan Holbrook-Preston, Indiana Heart's chief operating officer and chief nursing officer. "I would wonder, why isn't there appropriate communication? And if that's missing, what else is wrong?"
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