Hospital Adopts New Technology for Mobility, Improved Patient Care
Swedish Medical Center (SMC) is the largest, most comprehensive, nonprofit healthcare provider in the Greater Seattle area. It is comprised of three hospital campuses, a free-standing emergency room, home-care services and a network of about 40 primary-care and specialty clinics. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing specialized treatment in areas such as cardiovascular care, cancer care, neuroscience, orthopedics, high-risk obstetrics, organ transplantation and clinical research.
"The real business driver for making this move was a choice to move to electronic medical records," says Steve Horsley, director of information technology for SMC. "Healthcare organizations are always looking for ways to improve clinical quality, patient safety, and physician satisfaction, all while increasing revenues and decreasing costs. Reducing paper and providing medical information at the point of care is one way to accomplish all of those things." However, electronic medical records (EMR) require a high level of mobility, which in turn, necessitates a robust wireless infrastructure. SMC wanted to deploy a number of Workstations on Wheels (WoWs) to provide point-of-care information, and help eliminate the need to move patients from one location to another.
"This was no small undertaking," says Horsley. "The EMR project required a new data center, approximately 6,000 managed desktops, Workstations on Wheels, and a very robust wireless network."
For help in designing and deploying critical pieces of the new technology, SMC management turned to Cisco® Silver Certified Partner NetXperts, Inc., headquartered east of San Francisco. Laurel Taylor, vice president of sales for NetXperts, had worked with SMC's clinical engineering, telecomm, and IT departments over the years, and the company's relationship with SMC had grown from assisting with a basic paging and medical alert system to re-designing the VoIP infrastructure. In learning about SMC's vision for EMR, NetXperts created an 'Enterprise Communication Strategy,' so that SMC could better understand how to successfully integrate Cisco and other solutions into its existing environment.
NetXperts began by collecting information that would help the company understand SMC's needs and expectations.
"The preparation and planning phases are critical to setting up all of us for success," says Taylor. "In that phase we interviewed SMC's IT department, clinical executives, and personnel from clinical engineering so that we understood clearly the future roadmap." The teams discussed upcoming initiatives such as RFID (radio frequency identification), nurse call integration, wireless voice communications, and how the foundation within the enterprise will serve the business.
"The wireless infrastructure is like a highway, and various cars leverage that highway," says Jason Blick, vice president of engineering for NetXperts. "The cars are what the clinicians and physicians really care about. They care about voice and the ability to communicate with others. They care about workflow. They do not care so much about how it all works; they care that it does work." Through discussions and careful planning, NetXperts gained a full understanding of SMC's goals and standards, and designed the solution around them.
"Healthcare is a big part of NetXperts' business," says Blick. "We have a lot of experience with very prestigious healthcare organizations, and that experience allows us to offer best practices with the greatest confidence."
The NetXperts team recommended a Cisco Controller Based WLAN deployment and an RFID/Location Based Services design that would support Cisco Unified Wireless 7921 Series Phones and other mobile devices that utilized the 802.11 standard. The RFID/Location Based Services design will also enable SMC to track Biomedical equipment including Infusion Pumps and portable Xray devices.
SMC wanted to improve communications between the nursing staff, physicians and patients. The lack of integrated and effective communications solutions was hindering productivity. The nursing staff wanted a solution that was hands-free and intuitive, and that would allow them to locate staff or reach members or groups by providing a command rather than researching phone numbers of staff members and tracking them down.
"The paging workflow was critical for communications but extremely challenging. Further, integration to the Nurse Call System was a crucial requirement that would enable more effective communication with patients," says Taylor.
To meet the many communications needs of the staff, NetXperts recommended a Vocera application to enhance the Cisco Unified Communications solution. The Vocera application enhances users' mobility by taking advantage of the wireless network, so they do not have to carry pagers or cell phones. Additionally, an Emergin Enterprise Service Bus (ESB) deployment would work with the Cisco Unified Communications and Vocera solutions to provide real-time notification of alerts. By combining Cisco Unified Communications with Vocera and Emergin, NetXperts could provide a solution that would allow SMC to deliver point-of-care information to the right person at the right time.
"For a project of this size and scope, it's really critical to choose partners that you trust and who are with you for the long-term," Horsley says. "It's a major investment, and the technology was growing and changing as we went along. Our choice of NetXperts is a big part of the success of this deployment. They understood our goals, knew the specific needs and challenges of a healthcare environment, and designed and deployed a solution that fulfilled our vision."
Currently SMC has deployed over 1400 Cisco 1131 Series Access Points, 500 WoWs and 400 laptops. The WoWs are providing patient information at the point of care which have have enabled clinicians to make better decisions and place rapid orders while working in the fast-paced environment. Communication between the surgical and transport staffs has improved through the use of wireless phones, resulting in a faster turn-around of operating rooms. Patient satisfaction rates are higher in part due to services including free Internet access at all facilities. SMC has already benefitted financially with increases in revenues due to improved service capture at the point of care.
"In the regulated and paper-intensive world of healthcare, getting reimbursed for the services provided are becoming increasingly cumbersome," says Horsley. "Revenues have a potential to increase as you implement these systems, because physician orders are more accurately documented, therefore bills are getting generated quicker and more accurately."
However, Horsley says the most important benefit of this new technology is the quality of SMC's patient care. "We are improving care quality in two ways," he says. "We improve quality at the point of care because we have access to more real-time information along with automated alerts and reminders. We also have access to information for retrospective analysis to improve clinical protocols and drive higher-quality outcomes over time."
The technology in place at SMC provides a foundation for future solutions under consideration, including RFID for patient and asset tracking, Telepresence, Video Bedside Services, TeleMedicine, desktop video conferencing, and disaster recovery. This kind of planning for the future is a key part of NetXperts' business philosophy.
"We want our customers, three years from now, to still say 'wow, what a great job," says Blick. "We want to deploy a solution right the first time, so that as the firm grows and new technology becomes available, there is no need for a major redesign or redeployment. In order to do that, you must have those important business discussions, you must offer best practices, and you must have a lot of experience."
