Clipboards and pens are a common data collection tool in today’s hospitals—and increasingly insufficient to meet the fast-growing data needs of accrediting bodies, payers, government agencies, and the hospitals themselves. Sutter Health has found
an answer: Mi-Forms mobile e-forms technology running on Windows 7 slates. Data collection is 36 percent faster and is used to improve treatments, saving lives.
Hospitals are caught in a data collection crisis, according to Richard E. Shaw, who ought to know.
Dr. Shaw is Director of Clinical Informatics and Reporting, as well as Research Director, Division of Cardiology, at the California Pacific Medical Center, part of Sutter Health, a network of doctors and hospitals that serves more than 100 cities throughout
Shaw’s own institution exemplified his concerns. At Sutter Health, electronic forms from national registries were downloaded, printed, attached to clipboards, and used to capture data on patients and procedures. Employees rekeyed the data into databases
or websites for validation which, ironically, could introduce errors.
Capturing the data at the point of care would have increased accuracy and timeliness, making the data more useful for analysis and improvements in care, but too often was impractical under treatment conditions.
Sutter tried handheld mobile devices for data capture, but the screens were too small for the amounts of data involved. Tablets such as Androids and iPads lacked input mechanisms that were as fast and familiar as pen and paper, limiting their adoption at
Sutter Health, especially by clinicians averse to extensive data collection.
Sutter continued its search for a better data collection mechanism until it found Mi-Forms, a mobile enterprise application platform from Mi-Co, a member of the Microsoft Partner Network with Gold ISV competency. Sutter runs the Mi-Forms solution on
Windows 7 slates (tablets running the Windows 7 operating system) from Motion Computing, and supports it on the back end with applications built on Microsoft SQL Server 2008 R2 database management software running on the Windows Server 2008 R2 operating system.
||We wanted an ink-capture solution, and that meant using Microsoft technology. Because Microsoft was already one of our corporate standards, it was easy and cost-effective to add Mi-Forms to our infrastructure.
| Kyle Smith
Director of Clinical Data Integration, Sutter Health
“We built Mi-Forms on Windows in part because the ink capture is so refined,” says Gautham Pandiyan, Director of Sales & Marketing at Mi-Co. “For intensive data collection needs, especially away from a desktop PC, handwriting and ink capture are the way to
Leaders at Sutter agreed. “We wanted an ink-capture solution, and that meant using Microsoft technology,” says Kyle Smith, Director of Clinical Data Integration at Sutter Health. “Because Microsoft is one of our corporate standards, it was easy and cost-effective
to add Mi-Forms to our infrastructure.”
Smith and his colleagues use Mi-Forms to design forms that look exactly like their paper counterparts—until data collectors use them. Then, the intelligence that Sutter builds into the forms hides or displays entire sets or pages of questions based on the
collector’s initial entries. Fields that need responses based on an answer to an earlier question are highlighted; those that become irrelevant are dimmed. Data collectors can move easily and rapidly through the forms using built-in navigation. “It’s like
zapping your paper form right into the database,” says Shaw.
Sutter uses a SQL Server database as a back-end repository to store the clinical data that is captured as the clinician is on the move. SQL Server provides further data validation tools that help to ensure 100 percent data accuracy, and the SQL Server Reporting
Services technology that runs key performance indicators and delivers data tailored to the user’s role and permissions.
Sutter applied the Mi-Forms solution to specific data collection needs: heart failure patient care risk assessments, rapid analysis of cardiac surgery metrics, real-time stroke patient data collection, and data collection for accreditation organizations
and national registries.
Sutter Health uses Mi-Forms on Windows 7 slates to make data collection and analysis faster and more accurate.
Success Spurred by Familiar Forms and Input
The solution is likely to be a success not only at Sutter Health but also elsewhere in the healthcare environment, according to Shaw. “Combine the feel of the paper-and pen approach with sophisticated and immediate feedback for data accuracy, and you
have a compelling solution to the problem of intensive data collection,” he says.
Data Input Time Reduced by 36 Percent
Patients with acute coronary syndrome (ACS) need care that gives them the best treatment in the timeliest manner. It takes a lot of data to tune an ACS program so that patients are diagnosed and treated quickly.
Shaw and his colleagues conducted a pilot test to see if clinical data collectors could gather ACS patient data with the same level of accuracy that they could using a standard database or web-based application. The results showed that, using Windows 7 slates
and Mi-Forms, they completed the data collection process with greater accuracy, and 36 percent, 19 minutes, faster.
“The people you are asking to collect this data are highly trained and often are running a variety of disease management programs simultaneously,” says Shaw. “The time saved really counts in giving them rapid feedback on the quality of care.”
Time for Data Extraction Reduced from Weeks to Minutes
Cardiac surgeons at Sutter Health review performance metrics in search of quality improvements every week—but, prior to the tablet PC solution, the data they used and extracted from paper files was often five to seven weeks old. Using the Windows 7
slates and Mi-Forms solution, the time for data extraction was reduced to 26 minutes. “Now, you can have data from last week at the quality meetings, as opposed to the last quarter,” says Smith.
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