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Internet Librarian 2007
Technologies & Information:Integration in HospitalsSandra Kendall BA MLSMount Sinai HospitalToronto, Canada
Technologies & Information: Integration in Hospitals
• Introduction to Mount Sinai Hospital (within context)
• Medical Milestones • Information Highlights• What’s here and what’s around the
corner
Mount Sinai Hospital
Mount Sinai Hospital
• Corporate calculation of revenue per employee with estimated 2005 figures
• $1.3 million in revenue /Google employee
Source:Mckinsey report
craigslist• Corporate calculation of revenue per
employee with estimated 2005 figures
• $1.0 million revenues / craigslist employee
Mount Sinai Hospital
• $100,000 revenues /employee
Through extreme competition there is a marked collapse of prices for technology and dramatic global participation
Medical Milestones
•1840’s to current
Medical Milestones • Sanitation - 1848• Antibiotics - 1940• Anaesthesia - 1846• Vaccines – 1885 rabies vaccine• Discovery of DNA structure - 1953• Oral contraceptive pill - 1951• Oral rehydration therapy – early 1970’s • Germ theory - 1847• Medical imaging (x-rays) - 1895• Computers – 21st century• Evidence-based medicine – 1991
(But where is PubMed and aspirin)
BMJ, 2007. Volume 334, Issue suppl 1
Let’s look at some library resources
• Primal Images/ Anatomy TV• Up-To-Date• Micromedex
Available full text, online, wireless, synthesized to create best practices, linked in the patient record and moving to integration
Patient Record Integration
GE Centricity EMR• Pop-up window, automatic login, CME credit
• Separate form, or integrated into existing forms
Search Box with Pull-down List• Enter search term …
or select from problems, meds, orders, protocols
Patient Info Button• Bias search to patient information
topics
Pediatric Results• Adds pediatric search term, if age <
18
GE Centricity• Account management is IT admin task
Moving Towards Integration
THOMSON HEALTHCARE
INFOBUTTON ACCESS
Overview
INTRODUCTION• A broad range of medical questions challenge nurses and physicians in the course of treating patients.
• Drug and Disease information is frequently needed, readily available, yet when available often insufficient or difficult to access:
Fact: The questions go unanswered and the possibilities of practice variation, medical errors, preventable adverse events,
and even patient death all exist.
Launch Application
Power ChartMicromedex
Micromedex
User clicks on InfoButton in EHR
Info
Bu
tto
n S
ervi
ce
http://healthcare.thomsonhc.com/search.cgi?MainSearchConcept=lisinopril
InfoButton Technology
Content:
-DrugPoints
-DrugNotes
-LabAdvisor
-Disease Briefs
-CareNotes
Clinical Drug Info:
Lisinopril
Patient Information:
Lisinopril
Context information is “pulled” from the EHR and sent as search request parameters to InfoButton application.
InfoButton sends back a web page of relevant search results:Additional result options:
• If a single document is found, the document will display instead of search results.• If a document section is specified, such as Adult Dose, just the document section is returned.• DrugPoint and Disease Brief documents link directly to DrugDex and DiseaseDex monographs on Healthcare Series Online.
InfoButton Access – How it works
InfoButton Access quickly searches, retrieves and returns relevant results
Message Parameters Accepted
Inpatient
Outpatient
Emergency
Care Setting
Means to request a specific section of document.Modifier
Provider-level information (Clinical) or Patient-level information.Content Target
Indicates whether document is preferred in English or Spanish language.
Language
(for Patient information only)
Problem List
Medication List
Lab Results
Application Context
Clinical Problem (Text or ICD-9)
Medication (Text or NDC)
Lab Test (Text or LOINC)
Main Search Concept
OptionsParameter
Inpatient
Outpatient
Emergency
Care Setting
Means to request a specific section of document.Modifier
Provider-level information (Clinical) or Patient-level information.Content Target
Indicates whether document is preferred in English or Spanish language.
Language
(for Patient information only)
Problem List
Medication List
Lab Results
Application Context
Clinical Problem (Text or ICD-9)
Medication (Text or NDC)
Lab Test (Text or LOINC)
Main Search Concept
OptionsParameter
InfoButton Access from Medication Administration Workflow
InfoButton - Brief Results
Selecting “Dosage, Adult”
Activates Link and launches MDX HCS in a Browser Window.
Host application launches DrugPoints for the selected drug and displays “Actionable” Professional Evidence
InfoButton – Detailed Results from Healthcare Series
User Delivered directly to Full Evidence Dosing Information section for Ranitidine in
MDX HCS Intranet version of DRUGDEX in a Browser Window.
Case Study – Partners Healthcare
11279
1662
22150
13408856 3895
1526 3127
134320
0
20000
40000
60000
80000
100000
120000
140000
Clinical Searches
Unknown Admin MD Med Asst NP Pharm RD Research RN
User Role
InfoButton Total Searchs 8/20/04 - 10/24/05
Total Searches
Opportunity to see things differently
What’s coming?
Surgery without scalpels
Verichip
“In a post-information society, it’s the attention you get….that counts.”
Smartphone Screenshots
Motorola Q Smartphone (Windows)
Motorola Q Smartphone (Windows)
Motorola Q Smartphone (Windows)
Pocket PC Screenshots
Main Index
Table of Contents
Topic View
BlackBerry Screenshots
BlackBerry 8800 – My Skyscape View
Clicking on the application button
creates the following menu
“My Skyscape” Sorts all of your programs by
type for easy access or you can view all of your
installed software in one single list.
Clicking on the Tools button gives you the following options where you can
administer your Skyscape experience.
BlackBerry 8800 – Main Index View
Clicking on the application button creates the following menu which
includes an option to view the selected topic.
BlackBerry 8800 – Table of Contents View
Clicking on the application button creates the following menu which includes an option to collapse or
expand the selected section.
BlackBerry 8800 – Topic View
Smart Tabs for the topic can be found across the top. You can
select each tab by selecting the corresponding letter on the
keyboard for each tab or by using the menu
iPhone Screenshots
iPhone – My Skyscape
iPhone – Book Navigation
iPhone – Main Index
iPhone – Table of Contents
iTakeCharge!Palm Screenshots
Main Index
Table of Contents
Topic View
Acknowledgements
• Jason Weshler MBA• Skyscape• Thomson Healthcare: Micromedex• Up-To-Date• Jerry Z Zeidenberg, Publisher and Editor of Canadian Healthcare Technology
THANK YOU and HAPPY HALLOWE’EN
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