Hospital IT benefiting all patients

Sunday Business Post - Better Business: Healthcare - September 30 2007

New systems enable levels of care to be continually improved, writes Dermot Corrigan

Ireland’s healthcare providers in both public and rapidly growing private sectors are continually investing in IT solutions and infrastructure to help them deliver an improved level of service to patients. The last year has seen a number of landmark projects reaching completion in some of Dublin’s larger hospitals.

"Over the last 12 months or so, our main focus has been on the electronic patient records,” said Martin Buckley, ICT manager at St James’s Hospital in Dublin. “One of our main projects is the addition of the PACS (picture archiving communications system).”

James’s chose a PACS from leading US vendor Cerner Corporation.

“It distributes digital X-rays and imaging for diagnostic results throughout the hospital,” said Buckley. “This has been a major success. Now at every point of care the X-ray image and report from the radiologist are immediately available.”

Across the river, the Mater Misericordiae Hospital has also been investing heavily in new ICT systems, according to its information management services manager Gerard Hurl.

"We are currently rolling out an integrated information system. It has been working quite successfully in a number of specialised areas over the last couple of years and this year we have been given funding to start rolling it out to all the other departments. It is effectively a multimedia system which allows doctors to order tests online and look at results and images on screen."

Buckley said St. James’s had recently partnered with Cisco Systems to install a new 3,000 user voice over internet protocol (VoIP) network to handle their ever increasing ICT requirements.

"The VoIP system is in since June,” he said. “Our old analogue DBX router was 20 years old and in decline. We were faced with an urgent requirement to replace it, so instead of a phased approach, we were obliged to do a full scale changeover.”

"The big benefit is the convergence of voice and data on a single network,” said Buckley. “The investment is future proofed and easily expanded, and it also has less maintenance overheads.”




The Mater IT department also worked with Cisco to improve its communications network recently.

"It was really critical that our network was up to speed, resilient and all the rest,” said Hurl.

In the Mater, approximately 3,000 staff use the ICT system.

"In a hospital like the Mater, as in any of the other large hospitals in the state, every person uses the hospital system, from the financial department to consultants to porters," said Hurl. "We have about 3,000 intelligent devices connected to the network including about 1,500 PCs."

Hurl said the Mater’s ICT department has developed a unique solution to deal with the hospital’s requirements.

"We have the rights to develop this system and have been working on it with the users over the last couple of years," he said. "It is based on one commercial system, and there are other similar systems available, but we have chosen to develop this one."

Hurl said it was important to include the users in the development process.

“The user has to start looking at these systems the way they look at pen and paper, it has to become second nature to them as part of the process of care giving," he said.

Martin Buckley said St. James’s preferred to use different solutions from a variety of different vendors.

"We do very little internal development,” he said. “We would have an information systems team with both medical and IT expertise. Their task is to take the best proven IT systems and fit them to St James's own practices.”

James's EPRS (electronic patient records system) holds information on current and past patients of the hospital, including test results, diagnoses and outcomes.

"The electronic patient record can be comprised of anything up to fifty or sixty components,” said Buckley. “Some of these would be speciality based, for example you have cancer and intensive care modules.”

Buckley said modules were chosen from competing suppliers, meaning that integrating different solutions was a real challenge.

“At the moment we might have 12 to 15 different suppliers,” he said. “From our point of view once the integration works well we can take advantage of competition between different suppliers."

Buckley said further improvement of the hospital’s IT systems was vital to keep improving the level of care it provides.

“The next major piece of information that we are looking to computerise is medication management through electronic prescribing and distribution systems,” he said. “We have this implemented already in the intensive care unit and would like the same facilities across the 900 beds in the hospital.”

Most users currently access the James’s systems internally using stationary PCs. Buckley said this would soon change.

"We are now moving into mobile technology such as mobile laptops and tablets," he said.

Hurl said the Mater was also looking at introducing electronic prescribing systems, as well as developing further its diagnostic imaging systems, physician support systems, teleworking capabilities and wireless patient monitoring.

"We want to make sure we are up to speed and can take advantage of all these technologies, but all of these, of course, are subject to funding,” he said. “With the introduction of the HSE (Health Services Executive) we work within a system and within that context we will be looking to develop. There is no point putting in the investment unless we have organised the processes so we can implement them properly and improve care."