Access for the Moment of Care
Hospital patients may think doctors only consider their conditions and
care during the brief daily visits. But, according to Dr. Huy Nguyen,
this isn’t the case.
“I find that my time with my patients is limited,” he says. “Because of
this, I think about their diagnoses and treatment at various times
during the day. This is what I have defined as the ‘Moment of Care’ or
that moment when care providers find themselves considering patient
care. When this moment occurs for me—wherever I may be—it is important
that I have access to all the information I need to make accurate
decisions and be able to affect patient care anywhere at any time.”
In typical hospital settings, however, the only way to access that
information is to visit the patient’s bedside or make calls to the
nursing station, lab or radiology department. Given the patient load
carried by most physicians, this can consume an enormous amount of time.
Dr. Nguyen co-founded Cogon Systems to help create the Moment of Care
Information Systems (MCIS), expanding the availability of critical
patient information to physicians, nurses and other health care
professionals.
At the heart of MCIS is SQL Anywhere Studio from iAnywhere, a subsidiary of Sybase.
The SQL Anywhere Studio-powered solution works by accessing and
consolidating health care data into a relational database from multiple
hospital information systems. MCIS then delivers that data to health
care professionals’ desktop PCs and mobile devices, literally placing
critical health care information at their fingertips.
“What we’ve done with MCIS is to create a new data pipeline which
allows health care institutions to increase the quality and
cost-efficiency of patient care,” explains David Hsu, co-founder and
chief technical officer, Cogon Systems. “Physicians, nurses and other
users of the system can access and update information on their patients
as often as necessary by synchronizing their PDAs with the consolidated
server via device cradles, infrared ports, LAN or Wireless LAN
connection, or directly connect to the consolidated server via a Web
interface.
“We’ve also designed MCIS to do this in a way that leverages existing
legacy systems, and is secure and compliant with the mandates of the
Health Insurance Portability and Accountability Act (HIPAA),” he says.
SQL Anywhere: “The Leading Mobile Data Management Solution”
“We selected SQL Anywhere Studio as our mobile database and
synchronization technology for several reasons,” Hsu says. “First, we
knew that SQL Anywhere Studio was the leading mobile data management
solution. Its ‘always available’ model fit our usage model perfectly,
and its open technology enabled us to support multiple platforms now
and in the future using the same code base.”
Currently, MCIS supports Palm- and Pocket PC-based PDAs as well as
Windows-based desktop, laptop and tablet PCs. In the future, Cogon
expects to extend support to Symbian and possibly RIM Blackberry and
J2ME devices. Hsu says that SQL Anywhere Studio’s open architecture
made the broad support possible and enables them to connect a variety
of back-end systems.
“Using SQL Anywhere Studio’s MobiLink synchronization technology also
allows us to deliver only the necessary data to users, instead of the
whole kitchen sink,” Hsu says. “That ability to tailor data delivery to
end users adds to the efficiency of the system and enables users to
synchronize their mobile devices in less than 30 seconds. Given SQL
Anywhere Studio’s capabilities, we didn’t feel the need to evaluate
other vendors’ mobile solutions.”
Improves Ability to Monitor and Respond to Patients
With a 432-bed hospital in Pensacola, Fla. and a 50-bed hospital in
Sandestin, Fla., Sacred Heart Health System implemented MCIS in 2001
and has found it to be an extremely effective system.
According to Dr. Paul T. Baroco, senior vice president for medical
affairs at Sacred Heart, its health care professionals faced challenges
getting immediate access to information that directly affected patient
care.
“For example, if a physician makes rounds at 8 a.m. and orders lab
work, x-rays or other tests, he typically would not have access to the
results of those tests until he returned to the hospital the next day,”
Dr. Baroco says. “With Moment of Care, he can synchronize his PDA
multiple times throughout the day and have the results before the next
day’s rounds. This allows the doctor to make any necessary changes to
the treatment plan or to alert the nursing station to prepare the
patient for discharge. It’s a great system that’s easy to learn and use
and is extremely reliable.”
According to Nguyen, MCIS delivers a significant return on investment.
He cited the example of hospitals potentially saving tens of thousands
of dollars each month by reducing adverse patient events. And since the
MCIS decreases time spent searching for patient data by up to 15
percent, hospital staff can focus on other priorities.
“I’m Completely Up to Speed Before I See the Patient”
As patient care manager for Critical Care, Progressive Care and
Dialysis and as a clinical nurse specialist in Sacred Heart’s
Hospitalist Group, Tracey Graham has used MCIS for a year and a half.
In both roles, she typically carries a load of 50 to 60 patients per
day. Prior to using MCIS, it could take her 40 minutes each morning
just to gather laboratory and radiology data on a single patient. That
didn’t give her time to get much more than a “Reader’s Digest condensed
version” of patient conditions.
“However, with Moment of Care, I just sync my handheld when I come in
in the morning, and I can review the lab and radiology data without
ever having to make a phone call,” Graham says. “That way, I’m
completely up to speed before I see our patients, return calls to
family members and consult with physicians about the patients’ daily
care. And I can keep up with changes in patient data as they occur
throughout the day.
“The information I can access on my handheld is also more comprehensive
than what you typically get in a phone call to the lab or radiology
department, so MCIS also reduces the chance of errors in
interpretation,” she says. “MCIS is very convenient. It allows us to
spend more time with patients to provide definitive care more
accurately and efficiently. It has become such an integral part of my
preparation and delivery of care that I would be lost without it.”
“It Totally Changes the Way You Practice Medicine”
Dr. Sergio Castillo, director of Sacred Heart’s Hospitalist Program, is another fan of the Moment of Care system.
“It’s a very convenient, powerful and efficient system that totally
changes the way you practice medicine,” he explains. “It puts
information that would otherwise take hours and hours to obtain
manually and transpose to paper charts right at your fingertips when
you need it. The system is updated every 15 minutes so you can retrieve
up-to-the minute information throughout the day, which allows you to
manage your patients’ care very efficiently. I tell other doctors, ‘You
have to try it. You won’t know how you lived without it.’”
Sacred Heart Hospital is currently working with Cogon Systems to enable
Moment of Care users to access data from outside the hospital via the
Internet.
“As we expand the capabilities of MCIS, SQL Anywhere Studio will
continue to be our core mobile technology,” Dr. Hsu says. “It is an
intuitive, reliable, powerful technology, and its open architecture
provides us with the flexibility we need as the system evolves.”
