Laying the Groundwork

By Tom Barnett Print this article 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 distribution room. 

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 were designed to resemble ceiling tiles and provide 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 (billing), clinical, business (human resources and financial ) and ancillary applications.

A 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 when there is a change, and it contains information such as a patient's name, ID number and room

Another key element 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 billable items.

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 system 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 checklists.

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.

This article was originally published on 2012-05-10
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