Collaboration Technology for Real-time Treatment of Patients
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April 1 - June 30, 1997
The objective of this task is to demonstrate the usefulness of computer-assisted collaboration technologies in patient care, where the general practitioner in charge of a patient's care is not physically collocated with an appropriate expert consultant. This task will demonstrate remote consultation in two specific instances: 1) between a primary care obstetrician and a tertiary care perinatologist and 2) between a primary care provider and a tertiary care radiologist.
Radiology scenario -- The X-ray scanning hardware and software are physically located at the Radiology Department of Cabell Huntington Hospital (CHH). The process for using them is still being finalized. The current thinking for the deployment process is the "on-demand request" of specific X-rays by Valley Health Systems' (VHS) physicians. These requests can be faxed, providing details regarding patient identification. CHH can then scan the X-ray and make it available electronically to VHS physicians as part of the electronic record. We hope to have this process operational in the coming month.
Ultrasound scenario -- It is still unclear how we can make this happen, given the organizational and process changes that have taken place between VHS and the hospitals. We are having ongoing discussions about making VHS obstetric records available from CHH and St. Mary's Hospital. The wider deployment of the dictation and transcription system and its use by Obstetrics and Gynecologist is necessary, however, before any useful information will be available from VHS and CHH.
During this phase, the major work included:
Community health care primarily involves preventive and primary health care for community residents through the participation of individual practices, group practices, federally-funded clinics, community centers, and hospitals. Collaboration and cooperation among these multiple parties is essential for effective healthcare delivery. Limited resources and medical staff, coupled with the lack of proper health education and awareness among the population, make it difficult to provide healthcare in rural areas. The objective of this task is to develop a community care network (CCN) that will allow a community of healthcare professionals to provide quality care to a rural population.
Dr. Merkin has been using the dictation system for over a month now. He uses it every Thursday to perform his dictations; on a typical day, he dictates about 20-22 reports. To date, he has dictated about 75-85 reports, and those reports have been transcribed by the transcriptionists. During this period, Dr. Merkin has been simultaneously using both a hand-held dictation device and the computer dictation module. The computer dictation goes to one person for transcription, and the other goes through the clinic's previously-developed transcription process. We have not yet started collecting actual data or performed any analysis. However, the computer processes have resulted in significant improvement in turnaround times, as was expected. Some reports were transcribed within 25 minutes of dictation.
The nurse data entry modules are undergoing final testing onsite. Some additional modifications (suggested by the users) are required before they can be deployed. We are also working on the next version of the dictation and transcription system. This will be the final version of the system that will be delivered to VHS. It will use Microsoft Word for transcribing.
The following work was completed in this reporting period:
The objective of this task is to develop a domain-specific reference architecture for statewide collaboration in the health care domain that can serve as a model for promoting the use of such technology. Through direct experience with the experimental tasks, Tasks 1 and 2, we expect the architecture to evolve in its construction over the course of the project.
This task manages the planning and installation of infrastructure elements, networks, computers, etc., in the community care network. It also contributes to the overall effort to evaluate the effectiveness of the network and its individual elements.
Clinical usage of the dictation/transcription system began in this period.
The three additional sites at Valley Health Systems (VHS) are all now on line, with active users of basic services.
The major work during this period included:
The objective of this task is to demonstrate open and easy access to patient information from legacy hospital information systems. This task is now focusing on integration at Cabell Huntington Hospital (CHH).
We were once again stymied by the changing business relationships among our partners, Valley Health Systems (VHS), Cabell Huntington Hospital (CHH), and St. Mary's Hospital. VHS primary care and internal medicine physicians are no longer treating patients in the hospitals -- VHS patients are now being admitted and treated by physician groups from the Marshall University School of Medicine.
Our method of providing outside access to hospital records was dependent on the admitting physician being on the VHS staff. We are working with medical records directors at both hospitals to find ways to provide controlled and appropriate access to records of VHS patients treated in these facilities.
The major work for this period included:
http://www.cerc.wvu.edu/nlm/artemis/project_reports/p2q11.html
September 3, 1997, by Mary Carriger
Copyright © 1997 Concurrent Engineering Research Center