Supporting Hospital Quality Initiatives with Standardized Technology

By John Hotchkiss

Vice President of Research and Development, LiveData, Inc.

April 2009

LiveData introduces OR-Notify, a tool for automatically gathering, formatting, and delivering timely notifications from the operating room. OR-Notify seizes real-time information from OR-Dashboard and sends it directly to hospital professionals, wherever and whenever they want to receive it. Of key importance is that the information is sent via tools they are accustomed to using: VOIP phones, pagers, internal hospital streaming RSS feeds, emails, dynamic web-pages, or the hospital’s intranet.

Equally significant, our recent success at the IHE 2009 Connectathon assures hospitals that OR-Notify will interoperate with leading industry providers of enterprise communication services and patient care devices providing the underlying relevant information. A proving ground for medical device integration, the Connectathon brings together users and developers of healthcare IT systems to address interoperability issues that impact clinical care. Ultimately IHE is working toward an infrastructure where patient data is authorized and securely transferred to the right physician or system at the right time in the correct format, thereby helping patients obtain the best care with the least avoidable risk.

LiveData's recent participation in the Connectathon reflects both our ongoing support of standard profile development by leading healthcare industry players and our commitment to providing hospitals with solutions that can be deployed today. The full range of profiles defined in the IHE Technical Frameworks is tested in a carefully organized and supervised environment. Each profile represents an aspect of patient data that needs to be shared electronically. The end result of the process turns communication standards into effective recipes for real-world use.

By retaining a commitment to real-world application while advancing interoperability standards, LiveData develops flexible solutions that can accommodate future expansion. The LiveData technology that underlies OR-Notify will be applied in the Step Down Unit of the HiMSS09 IHE Interoperability Showcase to demonstrate future possibilities for hospitals: sending alarms from medical devices to a wireless Polycom phone. For now, OR-Notify provides hospitals with a powerful tool for relaying crucial OR information throughout the hospital and beyond, which will be demonstrated in the OR area of the Showcase.

The Impact of Accurate, Timely Information on the Effectiveness of Patient Safety Processes

LiveData OR-Notify is a logical extension of OR-Dashboard, a solution designed to make essential information on the patient and operation readily available to those who need it, when they need it, regardless of whether they are in the operating room. By assimilating and actively monitoring the perioperative workflow, OR-Dashboard  can determine whether the correct activity is occurring when it should; and, if not, notify the appropriate staff member while there is still an opportunity to rectify the oversight.

OR-Notify therefore allows hospitals to monitor hospital quality initiatives and respond to process failures before they create a problem for the patient and/or hospital. OR-Notify conveys messages ranging from summary information about overall quality goals, such as compliance with critical patient safety initiatives, to near real-time monitoring of operational elements such as turnover time and first case delays.

Relaying information related to prophylactic antibiotic administration provides a good example of the impact OR-Notify can make on the success of hospital quality processes, which typically cover both patient safety and regulatory compliance procedures. Hospitals following guidelines established by the Surgical Care Improvement Project (SCIP) are required to administer a prophylactic antibiotic within one hour prior to incision; failure to do so can impact the patient, and failure to document can impact CMS and other reimbursement opportunities. But under current hospital reporting systems, it is not unusual to find an omission for days or even weeks after a particular surgery, when reviewing SCIP data. Or-Notify makes it possible to avoid documentation omissions altogether since LiveData can forward information on the status of antibiotic administration directly from OR-Dashboard to the circulator's phone or pager, or to the attending anesthesiologist.

In order to reduce the incidence of preventable errors and surgical complications, the healthcare industry is increasingly turning to best practices as developed by safety-conscious industries like aviation. Best practice techniques demand constant vigilance and effective, timely feedback—objectives that are difficult to achieve in today’s demanding, resource-constrained healthcare environment. Clinicians are necessarily focused on the here-and-now care of their patients. OR-Notify, like all LiveData solutions, is a unique combination of real-time integration technology and human-factors engineering. It is technology that is designed to simplify, not further complicate, an already complex environment. Automatic delivery of timely messages via familiar devices and systems allows staff to obtain essential information with minimal interruption from the work at hand.

As a hospital's quality systems mature, the LiveData system can be refined to focus on the next quality improvement objective. LiveData OR-Dashboard provides hospitals with a solid foundation for creating an environment that promotes continuous improvement in processes related to patient safety, regulatory compliance, and OR efficiency. Our goal is to close-the-loop for healthcare quality in the operating room as well as in other procedural care environments.