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A recent HIMSS Analytics white paper reported that while most of the 825 hospitals in its study used vital signs monitors, less than 7 percent were interfacing the devices with their electronic medical records (EMRs). This means that many time-consuming and error-prone processes are still in place because existing technology is not being leveraged to its fullest potential.
Technology can drive tremendous value, especially when considering the manual processes it frequently replaces. But even while the industry touts the patient care, workflow and patient safety benefits that technology can deliver, it's time for hospitals to do more than simply deploy disparate solutions that solve discrete needs.
Some will argue that integration is easier said than done and that it simply adds to the list of hospitals' challenges, with community and rural hospitals having the steepest hill to climb thanks to limited information technology (IT) staff and budgets. But by banding together and sharing best practices and learning experiences, hospitals can go a long way. I know this to be true because at Stillwater Medical Center -- a 119-bed, not-for-profit, public trust acute care general hospital serving patients throughout north central Oklahoma -- we quickly experienced the results that integration delivers. Our comprehensive approach, from a thorough vendor search to clinical staff involvement, contributed to our success.
 Unlocking the Potential
While planning for patient monitoring equipment upgrades in our ICU, we took a serious look at current processes and how new technology could bring efficiency and add to the patient care experience. Evaluating clinical workflow gave us astonishing visibility into the extra steps and time taken to simply document patient vital signs. Nurses are inherently busy, but when they have to manually record a patient's vital signs every 15 minutes and then re-enter that information into the EMR, their day is quickly consumed by clerical duties. Nurses need to focus on patients not paperwork, so we set out to find a solution that would automate how vital sign data was captured and recorded, with integration and automation being the key pieces to the puzzle.
Collaboration Is the Key
Before embarking on any IT project, hospital executives should tap their pool of collective resources to gather information, seek recommendations and most important, learn from other's experiences. This can include talking with industry peers and/or seeking third-party recommendations from user groups and professional associations. A common goal is meeting meaningful use criteria, so meaningful use should be part of every conversation and be appropriately weighted in decision making.
Throughout our investigative process, we not only worked with our vital signs monitor vendor, but we reached out to other hospitals using the same hospital information system (HIS). We promptly recognized that customization capabilities would greatly improve the likelihood of success, so we searched for a vendor that was willing and able to customize their interface for our clinical and IT environments rather than offer a one-size-fits-all solution designed for very large providers. We also sought a vendor that would work with us to develop a patient-matching strategy for our vital signs interface, so we could ensure that the captured monitoring results are matched to the correct HIS record.
Our multidisciplinary team mentality and approach made the biggest difference and contributed the most to our success. From the planning and selection process through implementation and training, we involved healthcare leadership from both the clinical and IT sides to address each detail and identify what was needed for a fully functional interface. Each team member brought a unique perspective, which helped us minimize any missteps, and most important, address how end users would leverage the integrated solution. For example, our chief nursing officer (CNO) kept what's best for patients and clinical staff top of mind, which helped guide decisions relating to functionality and ease of use.
Integration: Better Efficiency and Care
Before we integrated our ICU vital signs monitors with our HIS, nurses were writing vital sign results on a flow sheet every 15 minutes, printing out monitor data and then manually entering details into the HIS. This made it very difficult to "paint the picture" of the patient's record, as well as see how they were corresponding to treatment. In addition, physicians didn't have real-time access to patient vital signs results, and all of the manual steps and duplicate efforts slowed processes, as well as increased the likelihood for mistakes.
Now that our vital signs monitors communicate directly with the HIS, processes are more fluid and efficient. Once a patient is admitted to the ICU, registration leverages the admissions/discharge/transfer (ADT) interface to pull data from the emergency department (ED) monitoring system, which prevents any loss of critical information gathered in the ED. Once in ICU, patient vital signs results are automatically captured and recorded, which has not only improved clinical workflow, but has also increased quality of care. Clinicians have real-time access to patient information, even outside of the ICU, and this enables them to make more informed decisions, spot trends and prescribe corresponding treatments.
Continuing to Bridge the Gap
People become clinicians to provide the best patient care possible. Technology can greatly contribute to this goal, but we must bridge the gap between the two. Identifying synergies and continuing to make data useful and accessible gives clinicians even more tools with which to provide exceptional care. In addition, it helps eradicate ineffective, time-consuming and potentially error-prone processes, while implementing practices that are in patients' best interest. When it comes to integration, there's still much hospitals must do but even greater benefits to be gained.
Chris Roark is the CIO at Stillwater Medical Center, based in Stillwater, OK. He can be reached at CRoark@Stillwater-Medical.org.
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