New Hospital a Frequent Technology Test Site
When a new hospital rises from the ground up, it’s a prime opportunity to introduce the latest bells and whistles and do that in an integrated and coordinated way. That’s just what’s happening at Middle Tennessee Medical Center in Murfreesboro, fertile ground for a host of cutting-edge health information technology initiatives.
“We’re in a unique position in this period of technology, in that we are trying to give the clinical people more and more technology so they have to use it less and less,” said Dan West, MTMC’s information technology director.
The new MTMC opened its doors in October 2010 and has since served as a site used by IT developers to introduce new products and as a trial-run site for IT to be introduced throughout Ascension Health’s more than 70 hospitals. MTMC is one of four hospitals under the umbrella of Saint Thomas Health, which is a member of Ascension Health, a Catholic organization that is the nation’s largest not-for-profit health system.
By mid-July, MTMC nurses at the patient bedside will be using Cerner’s new CareAware VitalsLink, a mobile touch-screen monitor that allows clinicians to check and document a patient’s vital signs in less than 60 seconds. That’s a radical time savings, West noted.
The standalone technology replaces the traditional “stick” on wheels from which drapes a blood pressure cuff, a pulse and oxygen finger sensor, and an electronic thermometer in a sheath. The system also allows the nurse to enter a patient’s height, weight, pain score and respirations. VitalsLink requires the nurse to first bar scan his or her badge and then the patient’s ID bracelet, thus reducing the possibility of medical errors. By simply pressing “save” on the screen, the nurse captures the data, which is then sent automatically via wireless technology to the patient’s electronic medical record.
In the case of MTMC, that permanent record is housed in Kansas City, along with the EMRs of about 35 other Ascension Health hospitals. Yet, West said, MTMC holds three weeks’ worth of data on dozens of machines in-house, just in case disaster strikes and the link to Kansas City is lost.
MTMC is what is known as an “alpha site” for the VitalsLink technology — in other words, one of the first hospital providers to use the wireless monitor. “As a matter of fact, we’ve been the alpha site six times since we opened in October because this is the perfect laboratory to try something like that. Everything is new, and not a mixture of stuff, as you would have found in the other hospital,” West explained. Thus, MTMC is leading the way for Ascension as the system’s first campus to require the encryption of any removable media — from laptops to thumb drives.
Also, MTMC is the first site in the country where Cerner is rolling out its CareAware StaffLink, a software interface that ties nurses’ time clocks into the EMR. StaffLink allows nurse managers to easily ascertain who is clocked in and make patient assignments for those on-duty nurses.
Thanks to ultrasonic transmitters on employee badges, it’s easy to determine who has been with a patient and when. That goes not only for physicians and nurses, but technicians and even custodians. “That way, we can track the kind of … and amount of … care that’s given,” West said.
Similar tags on nearly every piece of equipment in the medical center help employees track down what’s needed, from wheelchairs to IV pumps. In fact, Gaylord Opryland executives headed to MTMC recently to take a look at this tag technology after motion studies revealed that certain classifications of Opryland employees were spending 25 percent of their time simply looking for things.
MTMC is using an array of Cerner modules, each designed specifically for hospital departments such as emergency, radiology, cardiology, pharmacy and laboratory. “They each have their own part and parcel of the medical record, but they’re all feeding into the same repository. One patient, one chart — that is our ultimate goal,” West said.
This allows for something West called “electronic triage.” The EMR of a patient on his or her way to any Ascension hospital should be available to hospital clinicians before the patient arrives. West said the EMR availability has made “a big difference” in measurements such as door-to-balloon times.
Once patients are admitted to MTMC, they find themselves in a Hill-Rom Smart Bed. If the rails are lowered, an alarm sounds. What’s more, nurses can weigh the patient in the bed remotely and wirelessly record the weight in the patient’s EMR.
West said the secret to introducing new technology is to introduce it incrementally and to a staff that’s willing to try new things. “We couldn’t possibly have turned on all the technology we bought on day one. We would have absolutely overwhelmed the staff, and it would have overwhelmed us, too,” he said. “We’re giving it to them in doses that both they can handle, and we can support.”
And the Technology Just Keeps Coming
MTMC Selected to Use New PICC Placement Technology
Last month, Middle Tennessee Medical Center (MTMC) was selected as one of 15 hospitals nationwide to train with new technology that provides more precise placement of a peripherally inserted central catheter (PICC). MTMC’s designation as a Clinical Center of Excellence by Bard Access Systems was instrumental in being chosen.
“The new technology allows us to place a PICC with extreme precision in the location which improves patient outcomes. This technology will allow us to speed up delivery of care,” said Caleb Kent, RN, CRNI, nurse manager of IV Therapy at MTMC.
Using the Sapiens Tip Confirmation System, PICC nurses are able to monitor the placement of the PICC through the arm and into the central venous system. This technology eliminates the need for a chest x-ray following PICC placement for an estimated 90 percent of patients, which reduces the patient’s exposure to radiation and allows them to receive quicker care. At MTMC, this will reduce x-ray volumes by 75 patients per month, freeing the usage of x-ray equipment for other cases.
MTMC has a PICC team, which places 80 to 100 PICCs per month and will be a training hospital for other PICC teams implementing this new system.