4-page Case Study - Posted 4/10/2007
Views: 111
Rate This Evidence:
Serbian Surgical Clinic Improves Patient Care with New Information System
The Institute for Cardiovascular Surgery in Serbia needed to access and share patient information quickly to ensure surgeons and other healthcare employees could work more efficiently and make better decisions. Because the clinic stored and retrieved data manually, it encountered inaccuracies and time lapses when obtaining vital information. It decided to implement a Medical Information Management System, developed by a Microsoft® IT Excellence team, together with a team of doctors, nurses, and biochemists. The system is developed entirely on Microsoft technologies, using Microsoft Visual Studio® .NET, the Microsoft .NET Framework, and Microsoft SQL Server™ 2000. The solution has improved the accuracy of transcriptions and reduced administration for doctors by at least 40 per cent. In addition, patient data is consolidated and instantly available across a range of devices.
Situation
The Institute for Cardiovascular Surgery at the Clinical Centre of Serbia opened in 1992. It is composed of four units, specialising in cardiology, vascular surgery, cardiac surgery, and heart electro-stimulation, and is internationally renowned for the number and type of procedures it carries out. Healthcare employees at the clinic perform 30,000 check-ups and nearly 2,000 cardiovascular operations a year—more than any other medical facility in the Balkans. The institute provides 24-hour care for cardiovascular pathology emergency cases, and it is the principal educational centre for cardiovascular study in Serbia. Doctors in the clinic were using Microsoft® Office Word 2003 on individual office computers to input patient information, but the system lacked defined processes or consistency and created silos of information. Each doctor adopted his or her own style of data entry, and most of a patient’s critical information was given to doctors on paper or—even more unreliably—orally. The clinic wanted its information support systems to equal its latest surgical treatments. Accurate patient records that could be accessed, amended, and shared easily would reduce administration and improve working practices, giving doctors more time for patients and providing more reliable information for diagnostic decisions. The initial process-analysis stage took three months. Microsoft Certified Partner IT Excellence worked with surgeons, nurses, biochemists, and other healthcare employees to identify more than 30 different documents created during a patient’s treatment. The institute needed an integrated system to account for and process this information.
Solution
The clinic chose to implement a Microsoft® Medical Information Management System (MIMS). The solution tracks patients’ vital details from the dispensary to hospital care, covering all clinical departments and supportive services. The project began in the first half of 2005, with specialists from the vascular department. The project team consisted of five IT specialists from IT Excellence, four surgeons, three nurses, two pharmacists, two bio-chemists, and one transfusiologist. The project took eight months to complete. Dr. Marko Dragaš, Vascular Surgeon at the Institute, says: “At the start, we were slightly worried about the implementation because many of the medical staff rarely or never used computers. But our fears were not unjustified. The training course lasted two hours for doctors and a day for nurses and other medical staff. The system is simple and clear. Everyone could easily view and recognise which parts involved them from the information displayed on the monitor.” The system is developed entirely on Microsoft technologies. Microsoft SQL Server™ 2000 is the database, with XML Web services on the application server side and Windows® XP on the client side. This is implemented on Windows Server® 2003 with Microsoft Internet Information Service as the Web server.
The patient records tool was designed in line with the following principles:
- Managing high volume—the system design is flexible, catering for a variety of medical expertise. It is easy to customise with any new user requests.
- User-friendly interface—all medical employees can easily identify their work, undertake searches, and access data.
- Compatibility—the use of XML files for standard data representation allows information to be shared with other systems.
All data regarding a patient’s treatment is collected from a range of medical documents. Due to the breadth of information types, a specially designed meta-model has been created that forms the basis for application execution. Combined with the meta-model, the document becomes a powerful instrument that helps users allows quick administration and system updates without the need for coding.
Benefits
The implementation of the solution has reduced the workload for all medical employees in the vascular clinic and, more importantly, helped the institute to improve patient care.
Centralised Patient Records Save Lives
The system provides a clear, quick view of all patients currently at the clinic, with access to an individual patient’s medical history and personal and administrative details. A full medical history—including laboratory analysis, X-rays, outcomes of specialist consultations, surgical history, and discharge records—is displayed on the screen. A patient can easily be located on different clinical wards—be it casualty, intensive care, or a general ward.
Employees can access all data created while the patient undergoes treatment at the clinic. They can also access previous data, such as results from other surgery and discharge lists. This data can be converted into different electronic forms, such as photographs or video. Easy access to medical information enhances the staff’s insight into patients’ condition and reduces the risk of making a mistake on treatment.
Dr. Nenad Jakovljević, Vascular Surgeon at the Institute, says: “We can review a patient’s diagnosis, analysis, and any previous results in one central place to create a complete picture of their overall condition. The system eliminates the need to search through paper-based medical records. With one click of the mouse, we have a concise view of a patient and can easily detect abnormalities. In vascular surgery, a patient’s life often depends on speedy access to this vital information.”
Furthering this point, Dr. Dragaš says: “During an operation, we often need speedy access to laboratory results such as blood gases, electrolytes, metabolites, or coagulation. It’s amazing to have immediate access to the results on computers in the surgical ward. Previously, a laboratory technician ran from the clinic to surgery, carrying the results by hand. Faster access to results can help save the patient’s life.”
Because of the time-saving benefits of the solution, doctors can spend more time with patients. Dr. Lazar Davidović, Institute Manager, says: “The system has revolutionised everyday work. It has standardised all forms of medical documentation, reducing the administrative burden on employees—doctors in particular—by at least 40 per cent.”
Data Exchange Between all Medical Services
Each clinical department and medical service creates patient records. Now, every department has access to all the information needed to diagnose a patient and create a treatment plan.
The system provides an extensive but straightforward single point of reference for all departments and services at the institution. Diagnostic services are no longer isolated. Medical workers can quickly access the relevant information from a patient’s records, formulate a comprehensive interpretation of results, and decide on the most suitable procedure.
Automation Reduces Data-Entry Errors
A patient’s data is consolidated and available across a range of medical and diagnostic devices. Documents and results created in any file format on other systems and devices can be easily added to a patient’s records. Connections with laboratory instruments support efficient analysis, and results can be stored directly on the database for future consultation.
Laboratory analysis requests—conducted every morning for each patient—can be created with speed and ease. By selecting a group or particular analysis, the request can be entered in a few seconds. Milka Golubović, the Institute’s Chief of Staff, says: “The integration of all laboratory equipment and the automation of the laboratory process have reduced the time lapse from sending a blood sample to receiving results from 45 minutes to 10. Human error, such as the incorrect data entry of numeric values, has also been eliminated.”
Reduced Administration Creates More Efficient Working Practices
Medical staff can create templates of medical files—of any document type—to add to a template library. New documents are created by updating an existing template with a specific case. This standardises data entry for each new document. The templates reduce administration time and minimise errors made in the creation of documents.
Miroslav Markovic, Medical Faculty Assistant at the Institute, says: “The system allows us to create a report template for any type of surgery. We just have to fill in the values for that particular surgery. It’s really fast and straightforward. It currently takes only five minutes to write an operative list and three to five minutes to write a discharge list. The system speeds up the administration processes, so we spend less time dealing with paper and have more time to devote to our patients.”
Microsoft Server Product Portfolio
For more information about the Microsoft server product portfolio, go to: www.microsoft.com/servers/default.mspx
Microsoft SQL Server 2005
Microsoft SQL Server 2005 is comprehensive, integrated data management and analysis software that enables organisations to reliably manage mission-critical information and confidently run today’s increasingly complex business applications. By providing high availability, security enhancements, and embedded reporting and data analysis tools, SQL Server 2005 helps companies gain greater insight from their business information and achieve faster results for a competitive advantage. And, because it’s part of Windows Server System, SQL Server 2005 is designed to integrate seamlessly with your other server infrastructure investments. For more information about SQL Server 2005, go to: www.microsoft.com/sqlserver
This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY. Document published April 2007
