Transcript Somerset Medical Center

Somerset Medical Center
Inet and BMDI
Design and
Implementation
Dennis Dacquel, RN
Somerset Medical Center





Non-Profit Community Minor Teaching Hospital
355 Licensed bed
261 maintained / 240 average census
Annual Statistics
– 40,000+ Emergency visits
– 30,000+ Inpatient Visits
– 250,000+ Outpatient procedures
– 1420 FTEs (1800 people)
– 540 Independent Staff Doctors
Average LOS = 4.9 – 5.1 days
2
Somerset Medical Center
Strategies
Top 100
Community
Teaching
Hospitals
Leapfrog
Certification
e-Health
3
4
Clinical Systems Vision:
Nursing Process Automation & Redesign






Standards of Care
Documentation
Charge automation
Order Processing & Results Charting
Care Delivery Task Management
Medication Management
GOAL: MORE TIME FOR PATIENT CARE
5
Phase II: Add the Intelligence
Phase I: Replace the Core
M1 M2
M3
M4
M5
M6
M7
M8
M9
M10
M11 M12………………………………… M24
Hospital-wide Integration at Somerset
Ancillary Departments: Lab, Rx, Radiology, OR
Patient Care / Physician
Workflow Redesign
Scheduling, EMPI, Registration
Order Sets/Pathways
Orders, Documentation
ICU Integration
Clinical Data Repository
M.A.R.
Chart Tracking & Deficiency
CPOE
Patient Safety Initiatives
E-Sign
6
Critical Care Pavilion





ICU(8 beds)
CCU(12 beds)
IMCU(8 beds)
85 Critical Care RNs
1 Intensivist, 1 PA, 1 NP
7
Timeline Summary
April
May
Inet Project Timeline Summary 2003
June
July
August
September October
November
Design Phase
Technical Team
Testing
Education
Go-live
8
Clinical Systems
Steering
Committee
Care Provider
Clinical Content Cmte
Chair: Sys Admin,
Medical Informatics, MD
Care Provider
Clinical
Content
Committee
Physicians
SMC Project
Executive
SMC Mgr,
Clinical Infromatics
SMC Process
Facilitator
Dir, Performance
Management
SMC
Departments
(As needed)
Patient Access
Management
Team
Project
Organization
SMC Implementation
& Process Design
Project Teams
Patient Care
Delivery
Team
Records
Management
Team
eBusiness
Technology
Team
9
Inet Project Team
SMC IS staff
Critical Care Clinician Specialist
Critical Care Manager
Critical Care Director
Critical Care Staff
Cerner Inet/Documentation Resource
Cerner BMDI resource
10
Design and Build
Design Sessions
Multiple ‘wish-list’ meetings
 Ensuring wish-list items are JCAHO
compliant.
 Form design
 BMDI data acquisition requirements

12
Inet Build
Inet OCDs
 Upload Event Codes
 Upload Event Sets
 Create DTAs
 Turn on the Flowsheets

13
14
15
16
17
18
19
20
21
22
23
24
Technical Design

Local Model
- ‘fat client’ PC with direct multiple serial
connections to bedside devices for every bed
- reference database needs to be copied to
every PC
- troubleshooting
- maintenance
- hardware
25
Technical Design

Centralized Gateway Model
- ‘thin’ clients
- 1 BMDI gateway to capture data for all
bedside devices via TCPIP network
- 1 Cerner reference database
26
Hardware needs
• Purchase ASAP!!!!
• BMDI gateway
• Cerner BMDI server
• Cables/terminal servers/network access
etc.
27
BMDI Vendor Selection


Cerner only responsible for inbound data
Client responsibility to acquire gateway
solution:
- HP/Philips
- GE
- Siemens/Legacy Integrators
28
Siemens/Legacy Centralized
Solution





Auto device ID & detection
Port independence - any device / any port.
Network based - efficient and fast.
Flexibility - 4 ports at the bedside
Scalability - deploy in 1 care unit, multiple
units, or the entire hospital
29
Critical Care Bedside Devices
29 bedside monitors
- GE Marquette Unity network
 14 ventilators(floating)
- Siemens Servo 300
 3 IABPs(floating)
- Datascope system 97

30
B e d s id e M e d ic a l D e v ic e s A rc h ite c tu re
(B lo c k D ia g ra m )
(W
T C P /IP
B e d s id e P C
i n d o w s N T 4 .0 W o r k S t a t i o n )
R S -2 3 2
C on n e c ti on s
P o w er C h a r t
I nte rfa ce s
(A c c es s
B M D I Asyn c
D a t a b a s es
R efer en ce
T e r m i n a l S e r v er
B ed s id e
D ev ice
B ed s id e
D ev ice
B ed s id e
D ev ice
)
A c t iv i t y
P a ti e n t R o o m
A c t i v e C o p y o f A c t i v it y D a t a b a s e
M a inf ra m
o n N e t w o r k F i le S e r v e r
N e tw o r k
(O r ac l e D a ta b
31
32
33
34
35
36
Questions?