Monday, March 7, 2005

Life Sciences

Clinical information systems key to health care management, patient care

By Phyllis Gotlib

The recent transformation of the hospital intensive care unit started, like many other technological leaps, with an unsolved problem. A shortage of trained critical care specialists meant that hospitals - under pressure to provide cutting-edge care - were seeing costs rise and staff stretched too thin.

By creating tools to solve that problem, innovative companies are revolutionizing the ICU. Clinical information systems (CIS) now routinely help critical care clinicians work smarter and more efficiently, which in turn should enable hospitals to better use their resources to provide significantly better and safer care to patients.

Here's how these new systems work. A CIS automatically captures information from bedside devices. This information is then either monitored on-site or sent to specialists in a remote facility. From a clinician's perspective, these technologies mean less time documenting treatment, less time looking for and deciphering patient information, and less time on redundant communications with other members of the care team.

In sum, that means more time dedicated to directly caring for patients. These systems are intended to serve each member of a critical care team - administrators, nurses, surgeons and other specialists - and can even be customized to suit their work styles.

Equally important, however, is the ability to focus expertise where it's needed. All patient information is available to clinicians in an easy-to-access format that both facilitates decision-making and reduces the probability of treatment errors. The electronic patient record can also be used with user-friendly analysis tools that allow the data to be queried and enable doctors to do advanced research and further improve the quality of care.

Treatment coordination is also greatly enhanced when members of the team have simultaneous access to the very same data and are, literally, on the same page with regard to patient condition.

Since monitoring would no longer be limited to a single site, hospitals can make better use of their specialists. Advanced audio-visual capabilities allow use of a centralized "command center" for real-time access to all ICU patient data. Highly specialized clinicians in a single off-site location can then monitor patients in ICUs in multiple facilities. These off-site "intensivists" work collaboratively with bedside clinicians, accessing the very same data available to the on-site care providers.

If a problem occurs, the specialist monitoring can immediately mobilize on-site staff and even talk directly with the patient. Predefined notifications alert clinicians of adverse changes in patient condition and prioritize these events so that the care is always provided to those patients who need it most. The command center's console may be configured to display these prioritized notifications. The combination of intelligent systems and remote technologies enables hospitals to bring a high level of expertise and specialization to a larger number of patients.

These new ICU technologies are not only increasing patient safety but are saving hospitals money at a time when most other medical costs are rising. New drugs and devices, compliance with increasingly demanding regulations, rising malpractice premiums, and growth in wage rates because of scarcity of skilled workers are all pushing hospital costs higher.

The goal of technology should always be not just to enable hospitals to reduce costs by doing less but rather to do more with the resources they have.

By decreasing administrative costs, manual documentation and therefore potential errors, reducing lengths of stay through more coordinated and appropriate treatment, and better capturing billable services, these technologies have a positive effect on hospitals' bottom lines. Even more important, it can be accomplished within the context of improved patient care and safety.

CIS technology means clinicians can do what they are trained to do, armed with the information and tools they need to do it. And that allows these clinicians to provide the best possible care for their patients.

Phyllis Gotlib is co-founder of and chief executive officer at IMDsoft Ltd., an acute-care technology services company. IMDsoft, which has worldwide headquarters in Israel, has its U.S. headquarters in Needham. Gotlib can be reached at phyllis@imd-soft.com.