“Journey Map allows anyone, not only medical attendants, to understand the condition of patients within just 10 seconds. It helps doctors understand the patient’s condition from multiple perspectives for a patient-first medical service. Plus, integration
with UC improves cooperation between hospital personnel. The medical service is better than ever, not least because medical personnel can now contact medical attendants and/or nurses immediately via UC whenever they have a question about the patient’s condition
as summarized in Journey Map”
National University Bundang Hospital CIO and Professor Hee Hwang
In April 2013, Seoul National University Bundang Hospital began running BESTCare 2.0, a next-generation hospital system. BESTCare 2.0 achieved a string of considerable ‘firsts’, drawing attention from professionals in the healthcare IT field. One notable first
is that BESTCare 2.0 provides all the information from many different systems like EMR and PACS on a single WPF-based UI. Moreover, it became the first system in the history of the medical IT field to have UC features. The integration of BESTCare 2.0 with
UC fully integrates systems and enables users to be connected with others as required – while still staying on the current screen. In other words, it removes the hassle of having to open a UC window. Another great feature is that it displays the reachable
UC profile of medical attendants, doctors and nurses, whenever the user scrolls over them on the screen, while still delivering all the services available in BESTCare 2.0. Seoul National University Bundang Hospital has now achieved a considerable milestone
in the renewal of hospital information systems with the successful integration of UC into its next-generation hospital system for greater information-sharing and smoother work flow. As patient-oriented medical communications start to become the norm at hospitals,
rather than the exception, hospital personnel no longer need to waste time physically searching out the attending physician and his/her contact number. This is critical in the high-pressure environment of a medical emergency when simply, quickly and effectively
being able to communicate almost instantaneously with the staff member they need can save lives. For instance, when doctors are out of office for a seminar/conference, they can still send and track important messages about patient care.
Communication is paramount in the medical service industry. At hospitals, it is important to quickly and accurately deliver messages between hospital personnel while still providing in-depth guidance to doctors as required for the purpose of medical treatment.
In this regard, hospital personnel must ultimately be reachable at all times of day, 24/7, 365 days of the year. This is the reason why the ‘pager’, a wireless telecommunication device, has long been a ubiquitous sight at hospitals. However, smartphones are
rapidly replacing the latter as the mobile device of choice.
The smartphone is a comprehensive communication device, enabling voice calls and instant messaging. It has completely changed the way hospital personnel communicate within hospitals. Yet, it has never before been able to improve work efficiency. While smartphones
have replaced pagers, one thing hasn’t changed - the process of delivering the actual message to the medical attendant in the event of an emergency and/or when needed. It is necessary to find the medical staff member required. If this is not physically possible,
a call must be made on the correct number. This is the typical found in a modern-day hospital. Seoul National University Bundang Hospital, known as a leader in IT innovation, is different. It is gradually changing the way hospital staff work in line with the
BYOD trend where smartphones represent UC in the healthcare field.
It was the development of BESTCare 2.0, the next-generation hospital information system launched in April 2013, which presented Seoul National University Bundang Hospital with the opportunity to integrate UC into its medical service. While actively engaged
on its next-generation system project, Seoul National University Bundang Hospital decided to integrate UC into a hospital-wide information system. This was the first attempt to do so not only in Korea, but globally as well. Though the hospital information
system and communications were two separate domains, Seoul National University Bundang Hospital saw that there was greater mileage in tying them together to meet the needs of hospital personnel.
In the course of developing the next-generation hospital information system, Seoul National University Bundang Hospital paid keen attention to the feedback it was receiving from users. In 2003, when the old hospital information system was developed, the majority
of medical staff had scant experience of utilizing IT systems in their work, meaning they had difficulty in identifying, let alone articulating, their needs. Ultimately and perhaps unsurprisingly, user needs were not defined clearly enough to describe how
the system should be implemented. Over the course of 10 years’ professional experience using the IT system in the field, medical personnel became well-versed in precisely what technological help they needed to improve their work efficiency. Seoul National
University Bundang Hospital made sure to address both their needs and wants. The concept underpinning BESTCare 2.0 reflects the needs and requests of users.
The key to this concept was none other than ‘user experience’. Ultimately, the system must be an environment that users want to work in. For this to happen the system must be developed in such a way that it reflects the actual work flow. There lies the reason
why UC was integrated into the system. When you look at the day-to-day routine work of hospital personnel, the one constant is the stream of constant communications. The daily schedule of most medical workers is filled with checking patients and discussing
their conditions. In this regard, it would be nonsense to view tools for communication outside the context of the hospital information system, particularly since UX is the key value of BESTCare 2.0.
The UC integration principle that Seoul National University Bundang Hospital established corresponds to the intended purpose of BESTCare 2.0 development – to implement UC through deep integration with the actual work of hospital personnel. While it may sound
simple enough as an idea, developers when initially presented with the request were stumped, not least because integrating UC into the hospital information system remains somewhat of an abstract concept. To help flesh out developers’ understanding of the concept
involved, Seoul National University Bundang Hospital got on board as many hospital personnel as possible for the design, development and implementation of BESTCare 2.0. About 30 doctors joined different task force teams in each field and put their heads together
with developers to define the specific functional requirements of the system. This provided the basis of the design of the UI and UC prototypes.
The UC taskforce, in particular, defined what messages are delivered between doctors and nurses and how they work together. What the team found was that doctors usually query records, orders and test results, whereas nurses check nursing orders, nursing records
and clinical observations. Though doctors and nurses check different records, the team found one common denominator– all the records they check are about patients. Such patient information, which appears on the screen, is recorded and managed by someone in
the hospital. The implication was that communicating with the person who records and manages the given patient information is essential to implementing medical communications in line with the actual work flow within the hospital. In other words, the taskforce
team discovered what could be thought of as information channels allowing hospital personnel to communicate based on their work and the information they record.
Suppose that a doctor had a question with what was on the medical record query screen. If UC was not integrated into the system, he would have to look for the contact number of the person involved and make a phone call or else open up a separate UC window to
talk with that person. In this case, three different windows would have to be running at the same time - one to show the medical record, one to check the contact number and another to communicate with the person involved. The UC task force simplified this
through the use of a UC profile window through which the person needed can be reached by scrolling the mouse over his/her name on screen. The overall goal of UC integration was to help users check whether the person involved is in his/her office and, if so,
to allow them to decide which communication channel (whether chat, mobile, extension number, Lync call, memo, e-mail or SMS) to use in order to communicate with him/her.
The UC task force shaped the core concept for the integration of UC into the next-generation hospital system and shared its work with developers and designers. From then on, rapid progress was made. In BESTCare 2.0, all the screen layouts were implemented based
on WPF. This was to display the information sent from different systems like EMR and PACS within a single WPF-based UI. Here, UC was also integrated into this WPF-based UI. Lync Server provides SDK for WPF. This means it was relatively straightforward to integrate
UC into a WPF-based desktop application to help implement media, animation and 2D/3D graphics with ease.
Meanwhile, the UC task force distributed the Lync client mobile app for smartphone users to make Lync Server into a single communication channel. This allowed users to chat and make calls to other UC users in the hospital using their smartphone, just as they
did in the UC environment.
Patient-oriented medical communications
Seoul National University Bundang Hospital is now experiencing the benefits of the improvements in speed and efficiency that UC has delivered in terms of its decision-making process for personnel on the move. Efficiency here essentially means finding an
accurate medical solution more quickly through active communication. With the increased efficiency it has achieved in terms of its communications, Seoul National University Bundang Hospital was able to strengthen the competitiveness of its patient-oriented
A notable example of innovation in patient-oriented medical information via UC is Patient Journey Map, which provides all the records about a patient, including treatment received and results of tests taken. Journey Map is the pinnacle of UX innovation in
BESTCare 2.0, and it is also integrated with UC. “With Journey Map, anyone, not only medical attendant, can now understand the condition of patients in just 10 seconds. It helps doctors understand the patient’s condition from multiple a more thoroughly patient-oriented
medical service. ntegration with UC cooperation between hospital personnel. The medical service is better than ever, not least because medical personnel can now contact medical attendants and/or nurses immediately via UC whenever they have a question about
the patient’s condition as summarized in Journey Map”, said Seoul National University Bundang Hospital CIO and Professor Hee Hwang .
Faster and more accurate medical service
There are several things that UC system integration rendered obsolete. Typical examples are wireless phones and a list of emergency contacts placed on the nurses’ desk. Nurses when on their rounds typically observe and record every single change in patient
condition. After this, the nurses then have to inform medical attendants. he medical attendantsmake the order as needed. Given such clear-cut routines, UC ensures that communications are convenient on a day-to-day basis and, in the event of an emergency, it
gives the option of instant results.
For example, suppose a nurse was on her daily ward rounds and found that one patient’s vital signs were abnormal. In case, how would she choose to contact the medical attendant? If she knows the contact number of the medical attendant, she can call him/her
using a wireless phone or smartphone. hat if she not know the medical attendant’s number? She to rush into the nursing room, look through the list of contact numbers placed on the desk and then reach the medical attendant on the extension or cell phone. Doing
so wastes vital time in which the patient’s condition may worsen. In the event of an emergency, every second counts and with the help of UC, nurses now do not need to look for whom they need to reach. After integration of UC into the system, a USB phone was
connected to the laptop placed on the medical cart, allowing nurses to reach the doctor whose name appears on the EMR information window whenever they need to do so and without having to rush into the nursing room, saving vital time.
“Communication between hospital personnel is about patients most of the time and, in this regard, their primary duty is to communicate with each other. UC is especially useful as a means of reaching the doctors involved whenever needed, particularly in an
emergency. Even when they are on a business trip for a conference and/or seminar, doctors can still check on patients and make an appropriate medical order at anytime and anywhere, using UC”, said Professor Lee Kihyuk.
First step to safe BYOD
The use of personal devices for business purpose is common in hospitals. most commonly used is the smartphone. As it is so easy, familiar and convenient to use, hospital personnel often make a call or send a message using their own smartphone at work. However,
using such personal devices in medical communications poses potential problems from a medical information security standpoint. However, Seoul National University Bundang Hospital is not troubled by such problems. This is because the Lync client allows hospital
personnel to make a call and send SMS from PC to PC, PC to smartphone and smartphone to smartphone, regardless of whether they are in the office or outside. Such seamless communications are of course rooted in robust security protocols. In this regard, Lync
Server provides essential security features including secure connection and data encryption, meaning it complies with healthcare related regulations to prevent possible leakage of sensitive information through communications shared between hospital personnel.
For example, Lync Server supports TLS and/or MTSL-based encryption to ensure that communications inside and outside of the hospital remain secure. In addition, the desktop client stores and records communication-related information with the purpose of complying
with the regulations governing communications in hospitals.
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