Although integration most greatly concerns hospital IT, administration often leaves this critical department out of resource allocation planning. Here are a few points HIT can use to demonstrate the value of integration and the importance of their involvement in decision-making.
The history of healthcare digitalization dates back to the 1960s and 70s when institutions in the United States began developing their own hospital information systems (HIS) with mainframe computers, primarily for business and administrative functions[1]. In the early 1980s, a handful of centers in the US and Europe implemented Picture Archiving and Communications Systems (PACS)[2]. This lead to yet more medical information technology solutions being developed and implemented.
Over the last 30 years, healthcare has experienced its own version of a digital revolution, albeit at a slower pace than other, less regulated industries. That revolution, what we would now refer to as healthcare digitalization or digital health, has expanded to reach almost every corner of today’s hospitals. Digitalization stretches beyond business and admin now to patient interaction, real-time data collection, surgical assistance and hybrid operating rooms.
As a result of the trend towards healthcare digitalization, the hospital information technology (HIT) department was born. Much like in other industries, the HIT department is responsible for overseeing the information management system, including software and processes, to keep things running smoothly. In the case of hospital software related to operating rooms, emergency departments and even delivery suites, their role is absolutely critical.
With almost every department relying on their digital tools to function, HIT has never been more essential in today’s hospitals. Yet a trend we’ve noticed, despite undeniable value, is that HIT is rarely given a seat at the table when it comes to decision-making about hospital resource allocation and even the future of data architecture. Since this department has the most contact and expertise when it comes to integration and especially integrated operating room systems, it only makes good sense that HIT should be involved from the conception phase.
Below we’ve outlined some of the key points that HIT can make to ensure that their interests and expertise are addressed when upgrading medical data management systems. Most of all, in order to get buy-in from hospital administration and other decision-makers, the IT infrastructure arguments for and benefits of HIS integration should be clearly laid out.
Integration for Efficiency
Integration and efficiency go hand-in-hand. HIS integration can reduce PACS/vendor neutral archive (VNA) servers workload and decrease network traffic during peak operating hours. For example, Hospital HL7 (ADT, ORM, and/or SIU) messages can generate worklists and prefetch files of medical imaging data for use in the O.R. overnight before surgery. When staff needs to access this information along with their preferred applications, a consolidated integrated O.R. provides simple and efficient patient data management, routing, display and control.
What does this mean for IT?
Reduced demand on IT resources during business hours.
What does this mean for the hospital?
Images and patient files are ready and available for O.R. staff when they walk into surgery, saving valuable minutes in the O.R. At $22-$133 USD per operating room minute, even a savings of one minute at the beginning of every surgery can make a huge impact on overall operational costs[3].
For data center replication and continuity for fast data access, an “active-active” load balancing design is recommended. This allows for balanced distribution of workload across all nodes to prevent any single node from getting overloaded. It will also work to provide improved throughput and response times based on enterprise architecture.
Data Security and Risk Minimization
Medical data exchange is a critical moment for patient security, yet even today, many hospitals still use physical data storage like CDs and USBs to hand off information. Integration not only contributes to increased efficiency, it also works to boost data security while minimizing associated risk factors. Going fully digital reduces the risk of leaking or loss of protected health information (PHI) by, for example, removing prints and hard copies of imaging from the O.R. space. Furthermore, surgical data captured digitally can be directly exported to hospital storage archives over the hospital’s own network.
What does this mean for IT?
Eliminating CD/DVD and USB storage devices gives IT greater control and security over patient information.
What does this mean for the hospital?
Removal of these physical export options is becoming an operating room best practice. Doing away with physical exports demonstrates the hospital is deeply concerned with keeping patient data safe and data security best practices.
Becoming and Staying Future-Proof
Customization is a cornerstone of HIT integration, allowing hospitals to mix and match platforms and software applications that work for them. When choosing a software-based solution for integration, Hospital IT has the freedom to scale and tailor applications for specific clinicians and staff. It also provides the foundation for further integration of new technologies as they develop.
What does this mean for IT?
With all applications consolidated on one platform, maintenance and troubleshooting are much simpler than working within a data center infrastructure that’s been cobbled together over time.
What does this mean for the hospital?
Integrating a system that allows for future customization and scalability allows the hospital to stay flexible in the face of further technological advancements. The cost of not staying adaptable can be astronomical if the technology chosen today becomes obsolete years or even months after installation.
Hospital IT has so much to bring to the decision-making table when it comes to integration. We hope this information encourages you to raise your voice and add your expertise to decisions on healthcare IT solutions at your hospital.
[1] Collen MF, Ball MJ. The Early History of Hospital Information Systems for Inpatient Care in the United States. In: The History of Medical Informatics in the United States. London: Springer; 2016:339-383.
[2] Lemke HU. Short history of PACS (Part II: Europe). European Journal of Radiology. https://www.sciencedirect.com/science/article/abs/pii/S0720048X10002469. Published April 3, 2011. Accessed February 8, 2020.
[3] Rosenthal T. What Is a Minute Worth in the OR? OR Management News. https://www.ormanagement.net/Clinical-News/Article/06-18/What-Is-a-Minute-Worth-in-the-OR-/48791. Published June 6, 2018. Accessed February 12, 2020.