In health care, doctors, nurses and other clinicians play the starring role. But the supporting role clearly is played by the performance of the technology infrastructure. Information gathered using technological tools, and the access to information that technology supplies, helps health care live up to its promise in the 21st century.
That's why Children's Hospital of Eastern Ontario (CHEO) in Ottawa, Ontario, has long relied on HP products.
"HP has been the strong partner we need-someone that brings solutions that will solve problems that we haven't even thought of yet," says Tyson Roffey, chief information officer at CHEO. "In your most challenging moments, that's when a relationship needs to shine, and in my experience that's when HP and its local partner, Nova Networks, have stepped up and been the most fantastic."
Serving the Sickest Children
The Children's Hospital of Eastern Ontario is a pediatric health and research center that combines the best of clinical practice and health care education. The main 167-bed hospital has more than 460 on medical staff, 600 nurses and 1,500 additional staff. Because CHEO is a teaching hospital and research institute, it hosts as many as 300 learners at a time-with hundreds more as trainees in medicine, nursing, allied health and surgical specialties. Patients will drive two to three hours, from Eastern and Northern Ontario, and Western Quebec, to access the unique pediatric care available there.
CHEO sees very sick children. They range from 500-gram premature babies, up to near adults. Most patients are under age six. Their conditions change rapidly. So, the clinicians at CHEO need to be insightful, think a step ahead, and respond quickly in a crisis.
Everything depends on having good information. "Medical conditions can change quickly in pediatrics, so the ability to have information available quickly, to help assess rapid changes in a child's condition is very valuable," notes Charlotte MacDonald, RN, director of eHealth at CHEO.
Getting good information into the hospital's technology systems, and providing rapid access to it, has been the focus of the most recent technology upgrades at CHEO. "We came up with a plan to create a digital or electronic record for our patients that would be updated continuously and accessible anytime, from anywhere," says Dr. Jim King, medical director, Medical Informatics, at the hospital. "The challenge was to do it in an integrated way, so the systems all talk to each other. That's one of the reasons why we chose to partner with HP."
The newest initiative is seen throughout the hospital's clinical areas, where physicians and nurses capture and access patient data using HP Notebook PCs, often on mobile carts.
"Until recently, information would reside on paper in someone's pocket for hours," says MacDonald. "Now information can be entered into patient records immediately, so it's available more quickly to help make clinical decisions. It's a shift culturally for staff to be documenting things in real time. But we're seeing good signs of that shift and acceptance of the change."
In theory, getting patient information into a computer is simple. Plotting that patient's progress over time in a way that's immediately meaningful to clinicians-especially those working in crisis mode to save a newborn-is much different. "We've spent much of the last year ensuring we have the right tools to make that happen," Roffey explains.
HP Notebooks power clinical documentation
Under CHEO's new clinical documentation initiative, clinicians will use HP PCs to document vital signs and track patient progress. That information will not only facilitate the patient's immediate care at CHEO, but also become part of a permanent electronic medical record both at CHEO and in the provincial health care level.
The technology staff at CHEO worked with Nova Networks Inc., a local HP partner that has focused primarily on the hospital's desktop computer needs, to develop standards for the clinical documentation workstations. In most cases, they are HP EliteBook 8540p Notebook PCs, in combination with a 22-inch diagonal HP monitor on a mobile cart. The PCs access the documentation application using the hospital's wireless network.
Over three years, the hospital will roll out HP Notebook PCs, many of them on mobile carts, and refresh some 1,800 desktop PCs. The HP EliteBook 8540p Notebook PC and HP EliteBook 2740p Tablet PC were chosen based on input from 16 clinicians working with the technology team.
Large, 22-inch diagonal monitors are paired with the HP Notebook PCs to facilitate viewing by clinical teams of a dozen or more. The large monitors are particularly useful for teaching physicians doing rounds with residents or other learners.
"Mobility is key," says Dr. King. "Our goal is all about providing the right care, at the right time, in the right place. Mobile devices are crucial to doing that-either to enter information into the patient's EMR, or to access it in order to make an informed medical decision. We're always looking for devices that allow better mobility."
Roffey explains, "The hospital chose to work with Nova Networks and HP because technology is mission critical. That's where the benefits of standardization, the strength of the HP brand, and the strength of our support from Nova are so important."
Dr. King goes a step further. "Our systems aren't just business-critical. They're life-critical. So we're putting in place a business continuity model for our technology where things are up and running nonstop. If something fails, there's backup, so we can still provide care seamlessly."
< br /> Nova Networks not only helps CHEO plan PC deployments, but also provides services such as application imaging and on-site service.
Already planning ahead, the hospital is migrating many of its core clinical applications to be delivered through Citrix servers so they can be accessed remotely using HP t5740 Thin Clients. Thin clients are cost effective to deploy, easy to manage, extremely secure, and durable in the challenging clinical environment to provide a long useful life.
In addition to the mobile carts, the hospital is equipping some physicians, including Dr. King, with HP EliteBook 2740p Notebook PCs with tablet functionality. Most of the documentation process is point-and-click information. "Tablets work well for reviewing information quickly when I'm doing rounds on 20 patients," says Dr. King.
The relationship between CHEO and HP predates the new clinical documentation initiative, of course. Roffey notes that in the few years since he joined CHEO, HP has helped CHEO with several transformational technology projects.
The first was helping upgrade an aging infrastructure. "A few years ago, we had a data center on the brink-overcrowded and at capacity. Through the creativeness of our partners at HP, we've extended its life and prepared for the construction of an all-new data center next year," says Roffey.
The Emergency Department was automated so that from the moment a patient enters the facility and swipes the national health ID card, that patient is tracked throughout his or her journey. All of a patient's clinical information, and even location within the hospital, is tracked and available for immediate access so that patients receive the appropriate care and are able to leave the hospital more quickly.
As the hospital prepared to open its new critical care wing, HP and Nova worked together to ensure that the technology components were in place just as they were needed. "Our people were able to step in without worrying about whether the computers were going to work and instead, concentrate entirely on providing care," Roffey notes.
M ore recently, CHEO's staff worked with HP experts to migrate the Laboratory Information System (LIS). The LIS, which runs under Open VMS VMS VMS , was rescued from running on dated, power-hungry servers on their last legs, and moved to compact, efficient HP ProLiant blade servers to give it a long-term future at CHEO.
As part of power reduction and space consolidation efforts, the hospital's extensive medical records were consolidated onto an HP StorageWorks 8100 Enterprise Virtual Array (EVA). Originally configured with some 30 terabytes of storage, the EVA has been expanded to 70 TB and still has room to grow.
"One of the interesting things about pediatrics is that we have to keep patient records past the age of majority," Roffey explains. "If an infant spends time here, that record needs to be kept for roughly 28 years."
Through all these changes, Roffey says HP has been nearby to assist in technology planning and implementation, development of technology standards, and training. Standardization is important both to the technology staff and the medical staff.
"Decreasing variability in the way we deliver care is important to improving quality," says Dr. King. "Standardizing on one vendor that's interactive and integrates systems effectively is a key. As soon as you have multiple vendors providing things in different ways, it can lead to staff doing things differently. Having one vendor provide our hardware-and we've chosen HP-decreases that variability, so it helps us provide safer care."
Roffey adds that the HP relationship "goes well beyond getting our technology needs met. Early in my tenure here, we were able to establish a technology standard. So even with a small internal technology staff, we had a plan for how our people would be trained, the expertise they needed to develop, and the outside resources we could turn to. HP has been a major part of that from the start."
Looking ahead, Roffey is unveiling a five-year plan that begins with building a brand new data center. The data center will be the figurative heart of CHEO's clinical technology, supporting new initiatives including a new physician order entry system, electronic medical records and closed- loop medication system.
"These are all things that HP and its infrastructure will play a big part in making possible," Roffey says. "The next five years will be a busy, important time in the technology arena. We're ensuring the right tools-the best available tools to us--are in the hands of the people that provide care here. HP helped us build that plan, and now we're counting on them to help us implement it."