Medical Device Link.

Originally Published MX September/October 2004

COVER STORY

When people think of healthcare delivery, they tend to focus on the doctor-patient relationship as the critical nexus for the provision and receipt of care. But the business flow of healthcare is actually much more complex, encompassing a large number of varied and interdependent processes.

The task of coordinating such varied processes can be a healthcare provider's nightmare—and it isn't always done successfully. Under optimal conditions, for instance, it might take 5 minutes to perform a CT scan, 5 minutes to read it, and 10 minutes to transcribe the report. But successfully managing workflow is a challenge for most institutions. For example, typical turnaround time from physician order to receipt of a CT report can be anywhere from 8 to 26 hours.

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Enter the concept of the integrated digital healthcare enterprise.

This rapidly emerging concept is all about thinking bigger, implementing efficient workflow processes that handle communications and data exchange between healthcare providers and their patients, suppliers, and payers. By connecting and improving an institution's workflow cycles, providers can better manage resources and reduce the time to initiation of treatment.

The concept relies on the integration of innovative information technologies (IT) and medical technologies. When implemented, such integrated systems can transform a healthcare organization into a filmless, paperless, patient-centric high-performance delivery system (see Figure). Integrated technologies and workflow management solutions help improve quality of care through easier scheduling, shorter wait times, faster diagnoses, and up-to-the-second information access for clinicians. In addition, fully integrated clinical and financial information systems enable improved cash flow.

The Nebraska Heart Institute Heart Hospital (NHH; Lincoln, NE) is a new facility that is rapidly realizing its vision of becoming a leading integrated digital heart hospital. When NHH opened its doors, in May 2003, it was nearly paperless, already making the facility one of the most progressive in the nation. But administrators credit the hospital's growing success in managing its clinical workflow to its partnership with Siemens Medical Solutions (Erlangen, Germany), which integrated the hospital's unique care delivery model with Siemens IT solutions, medical modalities, and networking technologies. As a result, the facility has achieved measurably greater workflow efficiencies than originally anticipated and has exceeded all expectations for patient care.

One of the tangible benefits realized by NHH is a much lower length of stay (LOS) than originally projected for the hospital. NHH initially expected to operate at an average LOS of 4.3 days; but through December 2003 the hospital's actual average LOS was 2.5 days. The hospital is also handling more patients than originally expected. Administrators had projected that the hospital would handle 766 discharges between its May opening and the end of 2003, but actual patient throughput nearly doubled to more than 1300 discharges—all with the same number of staff as originally projected. And while operational efficiency and profitability are critical to the longevity of a facility, patient satisfaction levels are also high, with more than 97% indicating they would return for treatment.

Smooth, seamless, integrated, quality healthcare may be an ambitious goal. But a number of healthcare institutions are already beginning to realize the vision of the digital, integrated healthcare enterprise in large and small ways. Their successes today promise even greater achievements for the future.

Illustration courtesy SIEMENS MEDICAL SOLUTIONS

Copyright ©2004 MX