Keys to Building a Successful Hospital Information System

I recently engaged with Mr. Gilberto Guzman, Executive Director of Hospital Vivian Pellas in Nicaragua, a client of IFC. The hospital has developed a new hospital information system. After 30 years of working in the health sector, I must admit I have grown a bit skeptical on this issue. Time and time again I see costly systems getting purchased and installed only to have their potential benefits lost due to poor implementation, data management needs not understood from the outset, poor alignment (or realignment) of information systems to operational and clinical processes and often, a one size fits all attitude of vendors.  But this time I am happy to report a more positive story. Our client, with modest resources, was able to put in place a well-functioning, fully-integrated system that gives management, clinicians, and patients what they want. I asked Gilberto how they did it:

Why did you decide to install a new hospital administration system and an electronic medical record?

When we inaugurated the hospital back in 2004, we looked at different options for installing a new system. We were looking for a simple, user-friendly, reasonably-priced system. Unfortunately, we could not find many options that met all these needs. We ended up buying a software system that had basic functionalities for admitting patients, bed assignment, and billing. Medical records of patients had to remain on paper.

After a few years, we decided to upgrade our system and introduce an electronic medical record. Again, the options that we researched were either too complex or too expensive. That prompted us to consider developing our own system that met the needs of both clinical and administrative users. Step one in the process was sending our software developers to several hospitals in the United States to study different systems in operation. After that, we gave the project the green light, allocated necessary resources, and installed the system with ample participation of doctors and nurses in an interactive way. It has been fully operational for the past year.

How did you develop the software?

We designed the system to follow operational and clinical processes in a friendly and interactive manner, a way that is easy to use and innovative. We used cutting-edge development tools including artificial intelligence. We made sure it was compatible with mobile technologies. We developed it in an integrated way, avoiding additional work for doctors when they write up patient evolution notes and medical orders.  Importantly the system has been designed from the perspective of the clinician, management, and patient.

How was the implementation?

We implemented the systems gradually by area, starting with the pediatric ward and eventually extending to all other departments, leading to a phaseout of manual records. Our method was to train key users per department and then have them train users in the wards. Training the doctors was a huge task. We set up a training room directed by our medical information officer and doctors would come in groups of four-to-six to learn how to use the system. During implementation, the full project team immersed themselves in the real experience of patient interaction. This allowed us to see where the pain points were and to make improvements.

What are the key elements to success in this area?

Based on our experience, I would say the involvement of the hospital’s leadership at the highest level, ensuring ample participation of doctors and nurses during the implementation phase, and incorporating their feedback so they feel the system has been designed according to their needs. A critical positive element was to have technology leadership with ample knowledge of healthcare, so the system could be designed in a friendly and innovative manner.

What functionalities does the system have?

It is fully integrated, covering all functionalities for patient care, including doctors’ notes and orders and nurses' notes and care task recordings. The clinical orders written by the doctors are clearly presented to the nurses. It also covers all administrative issues like admission, billing, and control of medications and materials. Reporting is dynamic and adaptable to user needs. The system also has several functionalities useful for quality control, including event reporting and evaluation of the medical staff.

How has it made your hospital better?

We see many improvements and benefits, both in clinical and administrative areas. Firstly, the software gets utilized from the moment doctors and nurses write up their notes in the course of their regular work, creating no additional work for them. The orders are clearly presented and easily understood. It enables tighter control of prescriptions and deliveries of supplies and medications, with tracking capacity and quality standards control. It produces clear and precise bills. The reporting functionality is dynamic and extremely adaptable to user needs. Finally, the system can be accessed from outside the facility from mobile devices.

What are your plans for the future?

We feel that we have developed something that could prove very useful to other hospitals and clinics considering installing a new system and moving to electronic medical records. And so we want to offer the system to them, tailored naturally to meet their specific needs plus at a sensible cost for hospitals operating in markets like ours. Our vision is to obtain equally impressive results for our clients.

To learn more, go to info@hassolutions.net or contact Mr. Gilberto Guzman directly at gilberto.guzman@hospitalvivianpellas.com.

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