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How Hackensack University Medical Center
used VNA to achieve a unified patient record
Colleen Sirhal RN, BSN, CPHIMS
• Hackensack, New Jersey (11KM west of NYC)
• Teaching acute care hospital founded in 1881
• Level 2 Trauma Center
• Magnet hospital since 1995 for nursing, paediatrics and stroke care
Agenda
• Problem Overview & Expectations
• Vision
• Journey
• Outcome Success
Problem Overview & expectations
EMR Solutions are Encounter Centric
• EMR Solutions are ‘Encounter Centric’
• Focus on ‘discrete data’ related to a visit or encounter
• Limited ability to provide view of complete patient record
• Less useful in determining the overall health of the patient
Past History?
Missing Documents?
Access to Images?
Traditional Solutions are Image Centric
• Traditional VNA and PACS solution provide an Imaging or ‘Study Centric’ view of a patients record
• Access to other documents and non-DICOM imaging is disjointed
Information that may be missing…Specialty AreaAnesthesia CardiologyDermatology ED Endocrinology Family MedicineGastroenterologyHematology ICUNephrologyNeurologyNuclear MedObstetricsOncologyOphthalmologyOral Surgery Pathology Pediatrics PulmonologyRadiologyRehabilitative Medicine Rheumatology/Immunology
SurgeryUrology
Angiogram Operative Reports CT Scan
EKG Fetal Strips Holter Monitoring Reports Mammogram
MRI U/S Renal Scan
Digital Path Images Pathology Reports Consults
Mole Mapping Wound Images
PET PT Videos Glucometer readings
PFTs Fluoroscopy
CV Cath Procedure Reports SPECT
Human Resources
Behavioral Health
Clinical Care
Admitting/Patient Registration
Accounts Payable
Physician Office
Global Consulting
Health Information Management
Auditing
Accounting
Legal
Information Technology
Patient Finance
OB/GYN
Foundation
Medical ImagingEndoscopy
Healthcare Payer
Facilities Management
Quality Management
Home Health
Anesthesiology
Cardiology
Dermatology
ED
Endocrinology
Family Medicine
Gastroenterology
Hematology
ICU
Neurology
Oncology
Ophthalmology
Oral Surgery
Pathology
Nuclear Med
Nephrology
Rheumatology/Immunology
Rehab Medicine
Radiology
Pulmonology
Pediatrics
Urology
Surgery
Vision
Clinical Content Vision
Images-DICOM and NON DICOM
Patient Centric
workflow
Encounter Visit Data
Goals of user experience
• Single point of access
• Single sign-on
• All clinical content in context with the patient
• All DICOM and non-DICOM content available
• Business continuity services
VNA and enterprise content management (ECM) capabilities are converging as the healthcare enterprise evolves.
Source: Gartner Market Guide for Vendor-Neutral Archives, Barry Runyon, August 18, 2015
Clinical Information Solution Strategy
Share Content
• Clinical Information Sharing
• Send/Receive DICOM and non-DICOM content
Archive Content
• OnBase VNA (archiving all non PACS information in OnBase)
• content from Sunset applications
• Non-dicom images and apply taxonomy and workflow
Capture Content
• Universal Scope Capture
• Mobile registration and image capture
• OnBase ECM content capture solutions
View Content
• Patient Window
• Medical Imaging Viewer
Unified Record Strategy
Journey
One Repository - One Code Base - Native Format
Structured Information
DICOM
Radiology
Cardiology
OB Ultrasound
Ophthalmology
External DICOM
One Repository - One Code Base - Native Format
UnstructuredInformation
Wound Care
Dermatology
Surgical Videos
Consent Forms
Scanned Documents
Improving the clinical experience
• EMR for consistent user experience• A 360 degree view of the complete patient record• Access to data from the Patient, Visit or Encounter level• Views that can be configured to a specific user’s needs• Organized approach to chronic disease management• Useful long term/multi-system involvement (patient care)
Unified Record View
Outcomes
Outcomes and lessons learnt
• Single integrated interface required no training
• Agile implementation team
• Strong clinical leadership, responsive and engaged
• Ease of use is recognized and valued
• 6 month data is positive
• Agfa Radiology (360K new studies/year)
• Siemens Cardiology PACS (40K new studies/year)
• Starting with Radiology (in progress – July go live)
• Migrating legacy data to OnBase VNA
Thank you!