(HealthTech Wire / Interview) - HIMSS Analytics Europe has recognized the University Medical Center Hamburg-Eppendorf (UKE) as Europe’s first clinical centre to achieve “Stage 7” of the Electronic Medical Record Adoption Model (EMRAM). The facility was assisted in this accomplishment by Siemens’ Soarian® Clinicals hospital information system and the Soarian® Health Archive document management and archival system. In a conversation with HealthTech Wire, Dr Peter Gocke, Head of Information Technology at UKE, discussed his experience with a predominantly paperless hospital.
Why is the deployment of integrated IT systems so important in hospitals nowadays?
We came to realize that using paper as an information medium no longer met the speed requirements necessary to keep up with today’s ubiquitous interdisciplinarity. However, after we began replacing paper in selected environments, it became clear that a “two-speed hospital” in which paper and digital documentation coexisted side by side was producing new perils because individual employees were not able to ascertain whether relevant information wasn’t still hidden somewhere on a piece of paper. Armed with this awareness, we decided to attack the problem with a comprehensive digitisation approach. Moreover, if an IT system is to assist in decision-making, all the data has to be available in the system.
Why did you choose Siemens’ Soarian Clinicals?
We examined the market and found that this system fulfilled the greatest number of our requirements. It’s a modern, modular, web-based platform that supports processes and meets our demands for privacy and data security. This last point is very important to us because clearly there are other privacy demands made of a system in which access to all the patients’ data is possible.
How did you actually implement your privacy concept?
The basic principle is that only the employee who needs specific information for the treatment of a particular patient can access it. In order to implement this, we developed the concept of roles and authorisation that can support 8,000 individual users optimally. This requires considerable effort, but practice has shown that it functions well. Identification by a computer increasingly involves a high-tech fingerprint reader with a “live-finger detector”. We’re in the process of making an agreement with the hospital’s staff committee and, when it’s done, we’ll start to phase in the first 2,000 keyboards with the necessary sensors.
Where do you see the real strengths of Soarian Clinicals?
The greatest strength is that information is available where it’s needed, and it’s all within a single system. Furthermore, Soarian Clinicals even provides access to data in subsystems. Another strength is that there’s excellent support for mobile access from home, for example for doctors on call. The UKE provides them with one of our notebooks for which a token generates a one-time password.
From an IT point of view, what we like best is the system’s flexibility when it comes to configuring the user interface. We receive numerous inquiries about the presentation of the data in various scenarios. We’re generally able to accommodate our clinicians, but, of course, we seek to maintain a level of standardisation.
Can you give a couple of examples of treatment processes that you have digitized that are of relevance for everyday healthcare?
A good example was the E. coli food poisoning crisis at the beginning of the year. In a very short time, the UKE had to diagnose a great number of patients quickly and provide proper care for them. Our EHEC specialists agreed on a standardised procedure with colleagues all over Germany. The IT department was requested to generate an appropriate treatment path; it took us only one day, but it definitely doesn’t always go that fast. Nonetheless, it shows that the effort required for such a task is manageable.
Another example is documentation of the standard of care. Here medical intelligence is stored from which specific risk scores are calculated from the care data, for instance regarding the origin of a decubitus. The software then recommends individual preventive measures. In general, workflows are simplified because, with the help of the system, they can be anchored firmly in the treatment process based on recognised standards.
HIMSS Analytics honored the UKE as the first hospital in Europe to achieve Stage 7, the highest level of the EMR Adoption Model. Does the UKE see itself as a completely paper-free hospital?
Strictly speaking, Stage 7 isn’t certification of a completely paper-free hospital; rather, it acknowledges that paper-free systems are in place throughout the facility and that they are in operation. The decisive point is that there is no paper-based information related to treatment that is not also available in digital form. Some paper documents certainly still exist, especially those that patients need to sign, but these are immediately scanned into Soarian.
What is your impression of the audit that preceded the granting of the certification?
It was really quite impressive. First of all, the night before the audit, an in-depth discussion was held with the hospital’s management. Then six auditors spent an entire day making observations and doing interviews. Sometimes they looked in closets and cabinets or behind the counters to see whether there was still some paper lying around. They really worked hard to find weak points.
What do the patients notice in regard to "Stage 7"?
The patients have reacted absolutely positively. They’ve noticed especially that every doctor they meet is already familiar with the details of their case. Comments like “I don’t have your records here” and “We don’t have the results of your tests yet” have disappeared from the dialogue. A patient said that he saw that, all of a sudden, all his results were already at the station by the time he came back from his X-ray exam. This implied that he felt reassured and well cared for, and this makes me extremely happy.
Thank you very much for taking the time to talk with us.
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This is a HealthTech Wire interview in cooperation with the British Journal of Healthcare Computing. © so2say communications. All rights reserved.
Source: HealthTech Wire for UKE