In southeastern Michigan, St. Joseph Mercy Oakland, a 443-bed facility that is part of CHE Trinity Health a Catholic-based healthcare system, has laid down an impressive foundation for integration, bringing multiple information systems together.
The emergence of integration at St. Joseph’s came about because of a convergence of events. First and foremost, the hospital announced in 2011 it was building a $150 million, technologically-advanced patient tower. Around the same time, it begun shifting its philosophy to a more private environment for its patients, focused particularly on safety.
“One of the things that the board said to our CEO Jack Weiner is that we had to do something that was different. If we’re investing the money to build this tower, we had to do something that was really going to improve patient safety, quality-of-care, and benefit the patients coming into our facilities,” explains Robert Jones, the director of IT at St. Joseph Mercy Oakland.
Leaders at the hospital recognized that the demands being put upon caregivers were, in Jones’ words, “astronomical.” With the mounting number of tasks that clinicians were being required to do, St. Joseph Mercy Oakland, according to Jones, wanted make sure they were at the bedside—where they need to be for patient care and safety.
St. Joseph Mercy Oakland formed a collaborative team, with both IT and clinical representatives, and tried to determine what kinds of technologies could be implemented to improve a caregiver’s workflow. “We wanted to involve our caregivers in the process as we looked for this technology,” says Jones.
As the team at St. Joseph Mercy Oakland began to search for a system, they determined that integration was going to be vital if they were to improve workflow and patient safety. It was then that idea of the Intelligent Care System began to take shape.
Intelligent Care System 101
The Intelligent Care System, St. Joseph Mercy Oakland’s homegrown integration engine, is comprised of multiple vendor products the hospital uses. This includes a Cerner EMR and connectivity platform, Voalte’s voice over IP computing (VOIP), Hill-Rom’s nurse call and “smart bed” system, real-time location system (RTLS) through CenTrak, GetWellNetwork’s patient education and entertainment system, Sotera’s wireless vital sign monitoring technology, and vital sign analysis interpretation from Visensia.
The Intelligent Care System uses iBus from Cerner as middleware to bring these various technologies together and act as the connectivity architecture. St. Joseph Mercy Oakland takes information from these various systems, sending it through the iBus, and integrates it at the point of care.
As an example, through the iBus, St. Joseph Mercy Oakland is able to send information from its smart bed system to a caregiver’s phone. As Jones tells it, when a patient is a falls risk and they start to get out of bed, an alarm goes off. That bed alarm is sent from the Hill-Rom system, through the middleware, to alert link (from Cerner), which then sends it to the appropriate caregiver. The caregiver, he says, gets that information sent to their iPhone through the Voalte platform.
“So before that patient starts to exit that bed, that nurse [who is not in the room] can say, ‘Mr. Smith, please do not get out of bed. Will you stay in the bed? I’m on my way there.’ So you now you start to minimize and reduce falls related to that,” Jones says.
Not One Single Technology
St. Joseph Mercy has integrated the various vendor systems with the Intelligent Care System in other ways, incorporating nurse call, patient education and RTLS technologies to detect specific performances of its staff as it relates to hand hygiene and infection prevention practices. The hospital is also working on automatically recording and transferring vital sign and other data into the EMR. Ultimately, through this integration, Jones says the possibilities are endless.
“The beauty of it is it’s not one single technology that we have. Having this middleware in place allows us to grow the technology. That was one of our drivers. With this technology, we’re not looking at just today. Technology will change. Technology today will be different where we are a few years from now. We decided to select a platform that will allow us to be able to grow. This technology is not going to become obsolete, it will grow with all of the changes that take place from a technology perspective,” Jones says.
Down the line, Jones and others at St. Joseph Mercy Oakland have ideas for expanding the platform to include other technologies. He says the hospital would like its physicians to connect and share information with each other, regardless of the device they are using. It also would like to get into patient and asset location tracking, and have this kind of technology interact with the nurse call system.
In the immediate future, when that new patient tower opens in May, the Intelligent Care System will be implemented for all 198 beds. Already, Jones says, it has been implemented in 90 beds. It has shown various degrees of success in a short period of time, with increased patient satisfaction and a reduction in falls.
Getting Vendor Alignment
Getting multiple vendors, some of which compete against each other, to play nice was not the easiest of tasks, reveals Jones. He says one of the biggest challenges the hospital faced was simply bringing those vendors to the table and getting them to work together.
“We were told that no one had tried to do what we’ve done. There have been bits and pieces. But no one has taken it to the point of integrating all of these technologies like we have. It was new from our standpoint and it was new from our vendor’s standpoint,” Jones says. “There were no lessons learned that we could use, we had to learn these things ourselves.”
In addition to vendor cooperation, Intelligent Care System represented a paradigm shift for the St. Joseph Mercy Oakland staff. In that sense, Jones says the organization had trouble getting them to change their thinking and buy into the new environment.
With a precedent now in place, Jones and others at St. Joseph Mercy Oakland can offer advice and lessons learned. He says the most important thing to know is that collaboration is essential in order for a project like this to succeed.
“This is not just an IT project. It has to be owned by the business unit. It’s really a clinical project, but it’s a project that touches all phases of your organization. You have to have a team that’s willing to work together, and you can’t become territorial. You can’t work in a silo approach,” Jones says, adding that this philosophy should be shared with vendors as well. “You have to sit down with them very early and share your vision.”