Clinical Workflow Automation
Case Study – IVF Clinic Workflow Automation
A world-leading in-vitro fertilization clinic (IVF) located within a major teaching hospital was growing rapidly. As demand for treatment grew it became clear that the existing hospital information systems combined with a system of IVF-focused paper charts was increasingly becoming a bottleneck to expansion.
Business Driver
During IVF treatment women are prescribed with an initial batch of medications. Each day during their cycle, the women are contacted by telephone to review lab results and get their new dosage order for that day. To manage this proces, the clinic created a paper chart for each patient and updated it daily with lab results, dosage orders, ultrasound readings and other key treatment parameters.
With over 250 attributes recorded for each woman’s cycle, the single chart provided a comprehensive view of the treatment in progress. All charts were collected in a single large binder secured at the nurses station.
Accessing this data at the primary location was relatively easy, but with the clinic opening remote facilities, access became a problem and charts would frequently need to be faxed to doctors on call.
IVF can be an emotional experience for women undergoing treatment; the medicines are powerful and in some cases may cause serious side effects. Real-time access to information is essential.
Solution Description
To meet their growing needs, the clinic asked their IT department if it was possible to add IVF functionality to the existing hospital information system. However, after analyzing the clinic's requirements, IT determined that the time needed for implementation would not meet the clinic’s expansion goals and recommended that the clinic seek an external solution.
Working together as a team, the clinic and IT investigated several companies offering software designed for IVF. However, after lengthy consideration they came to the conclusion that if they were to use these software products they would need to change the way they practiced, which they were not willing to do.
After rejecting a number of these off-the-shelf IVF systems, the IT department asked Coping Systems to evaluate the clinic’s needs. A series of interviews and analyses were made and a prototype was created.
The evaluation team determined that the Delta EMR user interface could perfectly mimic the look of their existing paper charts by converting them to a digital form with over 250 data fields on a single display which they could view, edit, email, print, and log entries to a HIPAA-compliant data base.
Through the prototype process, the clinic became confident that they could automate their workflow while at the same time maintain their established IVF protocols. Additional capabilities were implemented to unify data from external systems and establish a number of critical care KPIs. Delta was integrated with systems at the local and remote clinics and automatically captured daily laboratory and ultrasound results. Additionally, Delta linked to insurance information and accessed electronic signatures for daily orders.
Benefits
Since Delta became operational, the clinic has expanded rapidly and now has several new satellite locations supported by a centralized Delta Core Server. Doctors on call can now review patient charts remotely using a HIPAA-compliant secure VPN in real-time.
More than one thousand patients have been processed through the system since its inception. The clinic is using Delta to conduct rounds, review patient cases and monitor KPIs – processes that were cumbersome or impossible using their paper charts. Because of the seamless integration of Delta EMR with Microsoft Office, the 100-person user community finds the system familiar, easy to use and effective.
The clinic continues to expand and treat more patients. Coping Systems’ Delta products play a vital role in their continued success by unifing critical care data from multiple sources, automating workflow and enabling KPI tracking. By collaborating with Coping Systems this clinic was able to transition smoothly to digital forms, and as a result has enhanced their position in the IVF field.
Project Deployment
The phase I deployment focused on establishing Delta in the central clinic, building the forms and implementing workflows. Phase II focused on integrating the remote clinics.
Project management meetings were held on a weekly or bi-weekly basis depending on the tasks at hand and staff availability.
The clinic appointed their head nurse as their project leader; she learned the technology and taught Coping Systems the finer points of IVF and was an invaluable resource throughout the project.
Challenges met during this implementation included:
- Establishing Delta on a virtualized SQL server within the main hospital shared resource pool.
- Establishing secure VPN and Cytrix for remote access.
- Reliably integrating to multiple data feeds, some of which were poorly structured.
- Creating and testing highly detailed IVF-specific charts, workflows and alerts.
- Winning the confidence of a 100-person user community distributed across multiple locations.
System Configuration
Key Components |
|
Products |
Delta Core Server |
Services |
Detailed System Analysis and Design |
Infrastructure |
Microsoft SQL Server |
Summary |
Over 100 active users, over 1,000 patient cases, multiple satellite facilities, integration with Billing, Labs, Pharmacy and Ultrasound systems |