Somerset Medical Center

Inet and BMDI

Design and Implementation

Dennis Dacquel, RN

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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

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Somerset Medical Center Strategies

Top 100 Community Teaching Hospitals

Leapfrog

Certificatione-Health

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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

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M1 M2 M3 M4 M5 M6 M7 M8 M9 M10 M11 M12………………………………… M24

Ancillary Departments: Lab, Rx, Radiology, OR

Hospital-wide Integration at Somerset

Scheduling, EMPI, Registration

Clinical Data Repository

Chart Tracking & Deficiency

Orders, Documentation

Phase I: Replace the Core

CPOE

M.A.R.

Patient Safety Initiatives

Order Sets/Pathways

Patient Care / Physician Workflow Redesign

ICU Integration

Phase II: Add the Intelligence

E-Sign

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Critical Care Pavilion

ICU(8 beds) CCU(12 beds) IMCU(8 beds) 85 Critical Care RNs 1 Intensivist, 1 PA, 1 NP

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Timeline Summary

Inet Project Timeline Summary 2003April May June July August September October November

Design Phase

Technical Team

Testing

Education

Go-live

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Physicians SM CDepartm ents(As needed)

Care ProviderClinicalContent

Com m ittee

Care ProviderClinical Content Cm te

Chair: Sys Adm in,M edical Inform atics, M D

SM C ProcessFacilitator

Dir, Perform anceM anagem ent

Patient AccessM anagem ent

Team

Patient CareDelivery

Team

RecordsM anagem ent

Team

eBusinessTechnology

Team

SM C Im plem entation& Process Design

Project Team s

SM C ProjectExecutiveSM C M gr,

Clinical Infrom atics

Clinical System sSteering

Com m ittee

Project Organization

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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

Design and Build

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Design Sessions

Multiple ‘wish-list’ meetingsEnsuring wish-list items are JCAHO

compliant.Form designBMDI data acquisition requirements

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Inet Build

Inet OCDsUpload Event CodesUpload Event SetsCreate DTAsTurn on the Flowsheets

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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

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Technical Design

Centralized Gateway Model

- ‘thin’ clients

- 1 BMDI gateway to capture data for all bedside devices via TCPIP network

- 1 Cerner reference database

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Hardware needs

• Purchase ASAP!!!!

• BMDI gateway

• Cerner BMDI server

• Cables/terminal servers/network access etc.

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BMDI Vendor Selection

Cerner only responsible for inbound data Client responsibility to acquire gateway

solution:

- HP/Philips

- GE

- Siemens/Legacy Integrators

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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

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Critical Care Bedside Devices

29 bedside monitors

- GE Marquette Unity network14 ventilators(floating)

- Siemens Servo 3003 IABPs(floating)

- Datascope system 97

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Bedside Medical Devices Architecture(Block Diagram)

Bedside Medical Devices Architecture(Block Diagram)

Mainframe(Oracle Database)

Patient Room

Network

Terminal Server

BedsideDevice

RS-232Connections

BedsideDevice

BedsideDevice

TCP/IPBedside PC(Windows NT 4.0 Work Station)

PowerChart

Interfaces BMDI Async

(Access Databases)

Reference Activity

Active Copy of Activity Databaseon Network File Server

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Questions?