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