How Hackensack University Medical Center used VNA to achieve a unified patient record Colleen Sirhal RN, BSN, CPHIMS
Hackensack, New Jersey (11KM west of NYC) Teaching acute care hospital founded in 1881 Level 2 Trauma Center Magnet hospital since 1995 for nursing, paediatrics and stroke care
Agenda Problem Overview & Expectations Vision Journey Outcome Success
Problem Overview & expectations
EMR Solutions are Encounter Centric EMR Solutions are Encounter Centric Focus on discrete data related to a visit or encounter Limited ability to provide view of complete patient record Less useful in determining the overall health of the patient Past History? Missing Documents? Access to Images?
Traditional Solutions are Image Centric Traditional VNA and PACS solution provide an Imaging or Study Centric view of a patients record Access to other documents and non-dicom imaging is disjointed
Information that may be missing Specialty Area Anesthesia Cardiology Dermatology ED Endocrinology Family Medicine Gastroenterology Hematology ICU Nephrology Neurology Nuclear Med Obstetrics Oncology Ophthalmology Oral Surgery Pathology Pediatrics Pulmonology Radiology Rehabilitative Medicine Rheumatology/Immunology Surgery Urology Angiogram Operative Reports CT Scan EKG Fetal Strips Holter Monitoring Reports Mammogram MRI U/S Renal Scan Digital Path Images Pathology Reports Consults Mole Mapping Wound Images PET PT Videos Glucometer readings PFTs Fluoroscopy CV Cath Procedure Reports SPECT
Healthcare Payer Home Health Physician Office Facilities Management Rehab Medicine Auditing Quality Management Global Consulting Nephrology Health Information Management Urology Neurology Patient Finance Rheumatology/Immunology Cardiology Gastroenterology Clinical Care Accounts Payable Surgery Dermatology Pediatrics Information Technology Hematology Oncology Foundation Accounting Human Resources Oral OB/GYN Surgery Pulmonology Behavioral Health Endocrinology Legal Medical Imaging Ophthalmology Endoscopy Nuclear Med Anesthesiology ICU Admitting/Patient Registration Pathology ED Family Medicine Radiology
Vision
Clinical Content Vision Images- DICOM and NON DICOM Encounter Visit Data Patient Centric workflow
Goals of user experience Single point of access Single sign-on All clinical content in context with the patient All DICOM and non-dicom content available Business continuity services
VNA and enterprise content management (ECM) capabilities are converging as the healthcare enterprise evolves. Source: Gartner Market Guide for Vendor-Neutral Archives, Barry Runyon, August 18, 2015
Clinical Information Solution Strategy Capture Content Universal Scope Capture Mobile registration and image capture OnBase ECM content capture solutions View Content Patient Window Medical Imaging Viewer Share Content Clinical Information Sharing Send/Receive DICOM and non- DICOM content Archive Content OnBase VNA (archiving all non PACS information in OnBase) content from Sunset applications Non-dicom images and apply taxonomy and workflow
Unified Record Strategy
Journey
One Repository - One Code Base - Native Format Ophthalmology OB Ultrasound Cardiology Structured Information DICOM Radiology External DICOM
One Repository - One Code Base - Native Format Wound Care Dermatology Unstructured Information Surgical Videos Consent Forms Scanned Documents
Improving the clinical experience EMR for consistent user experience A 360 degree view of the complete patient record Access to data from the Patient, Visit or Encounter level Views that can be configured to a specific user s needs Organized approach to chronic disease management Useful long term/multi-system involvement (patient care)
Unified Record View
Outcomes
Outcomes and lessons learnt Single integrated interface required no training Agile implementation team Strong clinical leadership, responsive and engaged Ease of use is recognized and valued 6 month data is positive Agfa Radiology (360K new studies/year) Siemens Cardiology PACS (40K new studies/year) Starting with Radiology (in progress July go live) Migrating legacy data to OnBase VNA
Thank you!