 “When the founders of our hospital envisioned the future, they saw a
community in which local people received sophisticated healthcare services without having to travel out of the area,” says Sam Downing, President/CEO of Salinas Valley Memorial Healthcare System. “From the beginning, they recognized the importance of technology and helped create a strategic focus that would make us a leader in medical technology today. Through the dedication of a skilled team of Information Technology professionals, we continue to make their vision a reality.”
Information Technology (IT) is the connective tissue that unites the efforts of everyone involved in our complex, geographically spread-out Healthcare System. It helps improve patient satisfaction, streamline patient care, increase efficiency, reduce costs and maintain confidentiality.
“A secure, integrated IT system enables immediate access to information when it’s needed, from any location,” says David Perrott, MD, Medical Director, Salinas Valley Memorial. “It also has a significant impact on patient safety and confidentiality. Our IT infrastructure includes checks and balances, guidelines and prompts that make it difficult to misinterpret information, such as prescription and test orders or diet restrictions. And it monitors and limits access to confidential information.”
Prior to 1992, the IT Department at Salinas Valley Memorial had a staff of three and basically installed and maintained departmental applications. “Today, a staff of 39 IT professionals oversees nearly 100 servers, and maintains and repairs systems and equipment spread across hospital departments, affiliates and physician offices,” says Audrey Parks, Director of Information Technology. The department also manages dozens of applications, maintains a 24-hour Help Desk and plans for the strategic expansion and maximum use of current systems. “It’s a tremendous job,” says Parks.
As the framework for the IT infrastructure was crafted, Sam Downing understood that physicians would be key users, not only within the hospital, but from their offices and other locations. In the early 1990s during the vendor review and selection process, Tony Smith, MD served as a liaison between the medical staff and the hospital. After the systems were in place, he worked one-on-one with physicians, helping them learn to use the new technology. Later, this role was formalized and James “Bill” Dickey, MD, a general surgeon with a passion for IT, became Salinas Valley Memorial’s Director of Clinical Informatics.
“I’ve long had a fascination with Information Technology and the ways in which it supports high-quality patient care,” says Dr. Dickey. While in medical school at the University of Florida near Kennedy Space Center, he realized that the computer was central to all that was happening at NASA and could envision how it would streamline the delivery of healthcare. When he discovered Salinas Valley Memorial through a fellow physician, Dr. Dickey was intrigued with how the organization embraced Information Technology as integral to healthcare. “Sam Downing has been instrumental in creating an environment where we can be innovative in using technology,” he says. “And I like the fact that we’ve done things in a pragmatic, strategic fashion. He and John Fletcher, Senior Vice President/ Finance, have been fun to work with because we discuss overall strategy of the IT department and what the future could look like.”
From the registration process to patient care, Information Technology touches every aspect of healthcare. It improves access to information and increases accuracy and convenience. “With electronic charting, vital information about each patient is legible and in the system the second it’s entered,” says Judy Snyder, RN, C, MS, Director of Education and Patient Care Systems. “Anyone who is authorized to care for a patient can check the data. It makes sharing of information much easier and we can run reports to see how we are doing. Integrated IT systems not only support care at the hospital, but also at affiliates throughout the Healthcare System.”
When Mike McMillan, CEO of Doctors On Duty (DOD) joined the organization in 1996, DOD used four separate IT systems for its nine clinics. DOD converted to a single system, one that communicated with the hospital’s information network. “Today, our 13 locations in Monterey, Santa Cruz and Santa Clara counties use a single, secure, integrated system that enables us to access a patient’s information at any of our offices,” says McMillan. “And when a patient registers at the hospital, that information is accessible to authorized users throughout our Healthcare System. Patients typically register once and the demographic and health insurance information is simply updated as needed.”
Physicians can use a portable device to securely access medical records as well as diagnostic images including Computer Tomography (CT), Magnetic Resonance Imaging (MRI) and ultrasound. This allows physicians to consult with nursing staff about a specific patient from any area in the hospital or from a remote location. It also enables transmission and real-time conferencing with specialists at Stanford University Medical Center and other medical facilities.
 Virtual registration is now available in some departments. For example, when a patient who is not registered comes to the Cardiac Fitness Center for the first time, an admitting clerk registers that patient using computers and two-way live video. “It is so much nicer for our patients not to have to make a second stop in Admitting to enroll in Cardiac Rehab,” says Julia Kuwada, MS, Director of the Cardiac Fitness Center. “The Regional Heart Program has electronic medical records so that we can access appropriate patient information from all of the many departments involved.”
“Prior to implementation of our integrated IT systems, everything in the department was done manually,” says Ken Goebel, Senior Administrative Director of Nutrition and Environmental Services.
Currently almost a dozen separate systems are used to manage the millions of details that go into coordinating special events and running nutrition (food and clinical), audiovisual, laundry and housekeeping services.
For example, Picis’ MedDIETARY program automated food services. Patient diet orders now tally automatically and tray tickets are accurately printed. The program generates production sheets and recipe guides for cooks, giving them the necessary information to prepare the food. BedTRACKING is another example of technology replacing a manual system for greater efficiency. An electronic “white board” has replaced the manual “white board”. In conjunction with a telephony system, the admitting staff now immediately know which rooms are available. Transporters can transport a patient to wherever a doctor, nurse or admitting clerk may request. With this system, Environmental Services staff are automatically paged whenever a room needs to be cleaned. Once a patient is admitted, the hospital is able to track that patient throughout his/her stay throughout the hospital.
“These systems provide a wide variety of services for patients, visitors, physicians, volunteers, vendors and staff. They have increased efficiency a hundredfold,” says Goebel.
Security is another area that has reaped benefits from the IT system. “A communications network links security staff and systems throughout the organization,” says Michelle Keith, Administrative Director, Plant Operations, Safety and Security. “Electronically-read badges limit access to certain areas of the hospital to authorized individuals. With technology today, our engineering department can monitor warning systems for fire and other hazards which instantly communicate information. This allows us to react immediately.”
Maintaining a sophisticated Information Technology system requires professional, round-the-clock support. The Help Desk, established in 1993, has six full-time computer operators and is staffed 24-hours-a-day, every day. In addition to employees and medical staff throughout the Healthcare System, support is also provided to affiliates and physicians’ offices. “Overall, the Help Desk fields an average of 325 calls per week and provides support for more than 3,300 users,” says Raquel Mojica, Computer Operator Supervisor.
“The connective tissue of IT has become a way of life throughout our Healthcare System, and we rely on it,” says Sam Downing. “In addition to the myriad advantages the integrated IT system affords today, it promises even more benefits for tomorrow. In the next issue of Lifeline, we’ll explore the developments already underway.” |
Part two: Today