The ability to provide enhanced levels of care to the southwest Georgia community is a top priority at Phoebe Putney Health System. With this goal in mind, Phoebe broke ground on a new Trauma & Critical Care Tower at the downtown Albany campus of Phoebe Putney Memorial Hospital in 2023. The construction expansion dovetailed with a comprehensive project reviewing clinical workflow and data capture in first steps toward a new trauma designation. To meet the regulatory milestones, Phoebe had to discover creative solutions with existing software platforms to capture key components within the electronic medical record.
Teaching an Old Interface a New Trick
Trauma designation requirements vary from state to state and involve multiple data and reporting points of the facility involved. Here we’re focusing on only one such requirement: the ability to demonstrate availability of trauma surgeon coverage.
While there were processes in place at Phoebe to manually document provider availability, that was deemed insufficient for the designation process. An interdisciplinary team was gathered to discuss available options with existing tools. They quickly identified that the need to automate the recording of arrival time in the electronic medical record (EMR) was going to be complex and require a new path of integration across six systems.
The team chose a proximity badge reader in the trauma area as the data capture point. It allows the provider to record their presence with the patient upon entering the room without disrupting their workflow. From there, the team needed to create a process that takes the captured arrival timestamp from the reader at the door, matches it with the correct patient, and then writes it to the EMR. This was not a small task, but it would result in a reportable element within the patient record that requires no separate manual data entry.
Data on the Move
Like every good workflow in healthcare, you must begin with the patient. Ours is a trauma patient arriving in the emergency department. The individual is registered within MEDITECH with the correct admit priority, an action that generates a specific interface message unique to a trauma visit. This message is recognized by the interface engine and triggers a remote stored procedure to record the account number and arrival time within a custom database separate from the EMR. This is a placeholder while we continue to work through the process.
To keep data gathering timely, the badge data for that specific reader is extracted and written to a separate database used by the interface engine at regular intervals. Later that time stamp is matched to the patient when the trauma surgeon becomes the admitting and/or attending provider on the visit. Multiple sets of data are married within this custom database and then written back into MEDITECH utilizing the existing inbound vitals interface. The timestamp data element is matched to the patient through a new “monitor type,” normally utilized in relaying vitals information, but repurposed specifically for this interface.
For traumas, speed and efficiency is critical. Allowing the trauma surgeon to simply arrive and swipe their badge via a proximity reader prevents unnecessary time spent logging into the EMR and performing chart navigation. The ability to use the existing vitals interface and write the timestamp as discrete, and therefor reportable, data was the final piece of the puzzle for the team.
The result is an automated trip for a piece of data across six technology platforms and a reportable measure easily captured directly from the patient record.
Author
Ginger NeSmith
Financial Applications Manager, Information Systems
Phoebe Health, Albany, Georgia