By Todd Peterson, Vice President of Information Technology, Eden Medical Center
My name is Todd Peterson and I’m Vice President of Information Technology at Eden Medical Center. Castro Valley has been my home for the past 26 years, and I’ve worked for Sutter Health for ten years, joining Eden 2 ½ years ago.
My team is responsible for making sure all computer systems are up and fully functioning 24/7; and while computer repair is a significant part of our business, we are responsible for implementing new technologies that are now vital to many aspects of our patients’ care.
One major project underway that will be a cornerstone of the new Sutter Medical Center Castro Valley hospital is Electronic Health Records (EHR), a project conceived when I was still at Sutter. Basically the new hospital is being designed with minimal use of paper. That’s right… no more clipboards and illegible handwriting.
The EHR will facilitate all clinical documentation and reporting; all medical disciplines will be recorded. What does this mean? Our physicians will get a full view of a patient’s care at any given time, from any location, once their patient has been admitted to the hospital. So the patient’s medical history as it relates to diagnostics, drug therapy, procedures, diet, rehabilitation and notes generated by physicians and nurses will all be available online. This also includes previous visits to any Sutter Health-owned facility or physician office.
The EHR will ultimately be integrated with biomedical technology. That means much of the clinical equipment in patient rooms—heart monitors, blood pressure cuffs, IV pumps, and even the beds themselves—will feed information directly into the patient records. With real time monitors of the patient’s vitals, a physician can be alerted if a trend in their medical condition warrants medical attention well before a critical threshold is met. So the EHR will be a documentation system and much more; it will provide clinicians with a wider view of what is happening with a patient at all times so they can quickly take action.
Patient records will also show a correlation of clinical events, a true cause and effect. For example, a physician may order medications in response to laboratory test results. Subsequent laboratory tests can then be correlated to the timing of the medication and will demonstrate the degree of effectiveness. This constant correlation gives the entire care team the information they need to deliver the best care at the right time.
The critical exchange between the doctor who is on call and the nurse on duty will also be enhanced by EHR. Without delay, a physician can access the patient’s record from home, while the nurse views the same information from a workstation in the patient’s room so rather than just rely on a verbal exchange they are both viewing the patient’s record.
One of the key benefits of EHR is patient safety. In the area of medication management, physicians will use computerized order entry to address legibility issues and alert the physician to any contra indications, such as allergies, food or other medications that the patient is on. The process of administering the drug involves the nurse scanning the barcodes on the patient’s wristband and medication bottles. The system will confirm the patient’s name, medication name, correct time, correct dose and proper route (oral, or otherwise).
We will provide full accessibility to patient data. All this information, all images, reports, etc. will be available at the patient’s bedside. Every patient room, alcoves between rooms and nurses’ station will be furnished with a computer workstation so patient records can be accessed throughout the hospital. Physicians will also have wireless devices such as PC tablets to provide the most flexibility and mobility throughout the hospital.
Down the road, our patients who see Sutter Health physicians will be able to see their own clinical results online; they’ll be able to email their doctors and arrange appointments, and more importantly, track their own history and take responsibility for their own health. We may even use EHR to work in concert with our county and state health departments to track health trends in the community.
The prospects for EHR are endless. Our patients and clinicians become real partners in the delivery of care over the long term.
Your input is very important to us. I invite you to ask me any questions about the EHR system by either commenting beneath this post (click on the title of the post, if you are on the blog’s front page, and you’ll see the comment box below), or by emailing me.
Sidney Wanetick, M.D.
My name is Sidney Wanetick. For 26 years, I was in practice as an OB-GYN in Castro Valley, and I delivered more than 3,000 babies at Eden Medical Center.
In 2008, I retired from practice to accept the position of Vice President of Medical Affairs at Eden Medical Center. Today, I serve as the administrative liaison between the medical staff and administration, helping to support our physicians as they provide high quality care to our patients now and as we look to the future of Eden.
In addition to other duties, I am actively involved in assisting our physicians in recruiting new physicians to the community.
I’m very excited about the new Sutter Health hospital that is replacing Eden. Several major benefits stand out. In particular, having all private rooms for patients will make a huge difference, bringing more services to their bedsides and giving them more quality time with their doctors.
From the physician’s standpoint, this is a much better way to take care of patients and have important conversations with family members in private, as well as offer patients the privacy and rest needed for recuperation. The nurses’ stations will have a view of every patient’s room for faster response to patient needs.
The whole atmosphere of the new hospital will feel less institutional and more supportive, soothing and restful.
Today, even though Eden has 176 beds, we are unable to utilize all of these beds. Most rooms are semi-private, with very few private rooms and even a few four-bed wards. Yet, we can’t put men and women together, and we can’t mix patients with infections in with the general patient population. So even though Eden is larger, the Sutter replacement hospital will end up with a much better capacity for utilization of services.
Moreover, we are seeing a steady decline in the number of patients admitted to the hospital for more extended periods of time. When I first started my practice we admitted twice as many patients for surgery as we do today. My patients stayed in the hospital for five days or more! Also, if patients were scheduled for surgery, they would be admitted the night before. Today patients often have surgery and are discharged the same day, or, if they are admitted, the average length of stay is much shorter.
In addition to the 130 acute care beds, we’ll have a 34-bed, multi-purpose Universal Care Unit (UCU), which also supports the shorter hospital stay. Let’s say an Emergency Room patient has been treated and needs to stay for observation, but not necessarily be admitted. He or she can rest comfortably in the UCU. Or, if a patient is recovering from same-day surgery, we could have him assigned to a UCU bed where he’ll get the attention he needs.
There will also be vast improvements in our information technology systems that just aren’t possible at Eden; our current system has reached capacity. With the new electronic medical records system, our clinical staff will have access to lab reports, x-rays, medication, etc., right at their fingertips. Recent studies have demonstrated improved outcomes and fewer errors in centers that have electronic records, and the new hospital will have innovative, secure electronic records and data systems.
I welcome your comments and questions. Please feel free to leave a comment by clicking on the title of this post (if you are on the front page of the blog), and a comment box will appear below.
By Bryan Daylor, Vice President of Ancillary and Support Services at Eden Medical Center
Technology is critical to convenience & efficiency…
As I mentioned in my previous post, our collaborative team has been very focused on how we would use technology, innovation and design to improve work flow and increase efficiency. You may also want to read the previous post by Andrew Flanigan, Senior Planner/Designer with Devenney Group, the architecture firm for Sutter Medical Center Castro Valley.
For example, in our clinical lab today, we have clinical space that is not fully utilized. The lab was originally designed when equipment was much larger and therefore required more space. The current lab was designed as a “decentralized” service, meaning that different sections of the lab, i.e., blood bank, hematology, chemistry, microbiology, pathology were divided into separate areas. We have learned over the years that this concept is outdated, as well as inefficient to operate and impractical to rebuild.
The new “best practice” is to create a centralized service where the work flow is organized and instruments are closely aligned. In this type of design the work flow is much more efficient, and staff has fewer steps between tasks and can be much more expedient in processing specimens. Ultimately this increases turnaround times of critical test results for physicians and patients, and results in a better work environment for the staff. With the advances in technology, one person can do multiple tasks in one area using state-of-the-art instrumentation.
Another mechanism to provide efficiency and convenience for the patient is the new Control Center, located on the first floor close to high activity areas. The Control Center functions similar to an “air traffic control” room. It is staffed with a variety of people representing key functions within the hospital. The area is designed for maximum communication and collaboration among the teams.
There will be multiple computer screens that will provide large visual displays of the various activities and flow of resources—patients, staff and key equipment. Bottlenecks in processing and movement of patients through the care continuum will be readily apparent and the Control Center staff will be able to quickly resolve issues. This will allow us to be much more efficient as we’ll see problems before they occur. The computer monitors will show us bed status: full, vacant, ready for cleaning; patients scheduled and waiting for discharge; expected completion times for surgical procedures; ER patient flow status, etc.
What does this mean for patients? It means less waiting time, more convenience and more time for personal care. For example, the Control Center can monitor patient wait status to ensure no one waits too long for testing. The necessary alerts will be displayed to the staff so they can provide efficient service. If surgical cases are running late, staff will be able to more effectively plan so resources of the OR and other support areas will be efficiently utilized, including communication to other affected physicians, patients and families. We’ll know on a real-time basis if we’re not performing at optimum levels and what the barriers might be. This knowledge will allow us to take the necessary action—e.g., deploy additional resources such as staff or equipment, and return the hospital to optimum performance levels.
Patient-focused clinical flow…
We also looked at clinical flow, from the patient’s perspective. One of our major goals from the beginning has been patient-focused care, creating convenience and comfort for our patients. We have effectively eliminated unnecessary trips within the new hospital for both patients and staff, starting with pre-op registration and diagnostic testing before surgery.
In the new hospital once the patient is registered and accompanied to their suite, clinical staff will come to the room for laboratory and other portable diagnostic testing. The goal is to minimize the amount of travel and disruption for the patient. We are also putting more services at the bedside. Due to the new hospital design of all private inpatient rooms, which are larger than our current rooms, we will be able to deliver more therapies at the bedside. This is an improvement for both patients and staff.
Please email me if you have any questions about the internal layout of the new medical center, or feel free to leave a comment here. We welcome your input!