Tag Archive for: Digital transformation

Design and implementation of the new SIO

In Campus Bio-Medico University (hereinafter UCBM) we have launched a phase of ICT assessment & planning and redefinition of corporate operational processes as a preparatory intervention for the evolution of the applications that make up the Hospital Information System (SIO) . The intervention involved the adoption of a Enterprise Service Bus centralized ( ESB ) and the replacement of most of the application components of the SIO, in particular: MPI, CDR, ADT, CUP, Laboratory Analysis, Operating Block, Intensive Care, Medical / Nursing Medical Record, Drug Management (Prescription, Preparation, Transport, Administration).

Once the ICT Assessment , the strategic evolution plan of the SIO was defined (ICT Planning) based on a path lasting over 2 years, in which the process of progressive implementation and release of the individual application components was orchestrated, taking into account the related interdependencies.

Each of the interventions to replace application areas can be considered a project that substantially follows the same development logic, proceeding with the following operational steps:

  • AS-IS analysis , aimed at documenting the current processes in the area and the use of the current application, highlighting any organizational criticalities, operational processes or available application functions.
  • Collection of requirements , aimed at collecting and documenting the functional requirements of the applications to be identified, the improvements that can be made to the current processes in the area and the possible improvements in the use of a new application to replace the existing one, highlighting the process, organizational and functional improvements that can be obtained.
  • TO-BE analysis, pursues the objective of documenting the new operational processes that are to be introduced in the area of interest and the way in which they will be supported by the use of the future application, highlighting the overcoming of the organizational and technical criticalities identified in the previous phases and possibly defining some KPI (Key Performance Indicator) that can serve as indicators to measure the real achievement of the set objectives.
  • SW selection and drafting of the specifications , aimed at carrying out market scouting to identify the application solutions that best meet the requirements and prospective needs of UCBM , organize any presentations of the solution suppliers, support you in highlighting the level of compliance of the solutions with respect to your functional, process and strategic requirements, drafting of tender specifications, weighing criteria for the evaluation of supply components, etc.
  • Support during the tender phase , necessary to support you in answering questions for clarification, in the technical evaluation of offers, in the preparation of the supplier evaluation grids and in the formulation of answers to suppliers.
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Clinical Data Repository

The project resulted in the implementation of an innovative solution logically transversal to the Hospital Information System (SIO) that would enhance the wealth of clinical data generated by the various vertical departments / applications that support them and at the same time guarantee interoperability between the various application areas.

In fact the Clinical Data Repository (CDR) represented a fundamental piece for the architecture of Knowledge Management , whose implementation took place through the interfacing of the individual vertical applications present at the hospital, through middleware Enterprise Service Bus (ESB) which ensured the consistency of the overall information flows of the SIO Hospital Information System .

The “container” that collects and collects all the data produced by the application architecture is therefore the CDR , which guarantees an added value in making the clinical data of any patient who has come into contact with Azienda dei Colli available in a controlled manner by any requesting facility.

With this in mind, the Clinical Data Repository has a multiple value:

  • clinical ‐ health: as an element enabling a single and unambiguous vision of the patient, which collects the data and reports produced during the various events that characterize a treatment path, the repository is characterized by the role of a support tool for the daily assistance delivery activity , which captures the information as it is generated, places it in the precise context to which it belongs and “writes” the individual history of the patient within the health / hospital company, building it incrementally, on the occasion of the patient’s contacts with the company itself;
  • technological / architectural: it acts as a central system at company level, i.e. as a single interface, on the one hand, for the SIO applications, on the other hand towards the future ESF, assuming an essential role in the cooperation between systems and subsystems that share information , since it allows the centralization of administration and management functions;
  • organizational: as an element that decouples the departmental and departmental dimension from the corporate dimension, it guarantees full autonomy to the Company, in terms of management of the information assets, with the possibility of distinguishing and selecting among the relevant elements in the ordinary activity of providing assistance pertinent to the Health Record from those that are of “historical” interest and must be registered in the CDR;
  • source of information : as an original element for the establishment of the centralized clinical data repository at company level.
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Virtual clinics

Downstream of hospitalization in an inpatient ward or at the end of the treatment path, the need may arise to keep the patient under control through periodic check-ups, to be provided on an outpatient basis. Therefore, after the protected discharge of the patient or following a first outpatient visit, it is agreed that the patient should be managed remotely and then assigned to the management system of virtual outpatient clinics.

This decision determines the passage of a series of information from the SIO of AOS Colli to the system of virtual clinics, since it is a real patient care. In particular, the data that are transferred from the HIS to the virtual clinics are the following:

  • Patient personal data: name, surname, address, date of birth, etc.
  • Clinical data of the patient: blood group, allergies, etc.
  • Measurements carried out of vital parameters;
  • Reports of the diagnostic tests carried out;
  • Pharmacological therapy in discharge;
  • Diagnosis of entry into virtual clinics.

Once taken over by the system, the following steps take place:

  • The patient is assigned a kit of electro-medical tools to allow remote monitoring of his health status;
  • An APP is made available to be installed on your smartphone and on those of relatives or care givers to allow remote visits or direct interaction with the supervision center;
  • The patient is assigned a therapeutic protocol that can also be managed through the APP provision which includes:
    • Vital parameters to be detected at certain times;
    • Medicines to be administered at certain times;
    • Any activities to be carried out at certain times.
  • The patient can make a cumulative or punctual booking of the outpatient visits that have been prescribed and pay for the requested services;
  • At the date and time booked, the patient’s scheduled check-up is carried out, which includes:
    • Tele-visit via smartphone or PC located at the patient’s home;
    • Patient status report;
    • Direct detection and verification of vital parameters;
    • Possible variation of the therapy according to the verified results;
    • Possible request for diagnostic tests;
    • Issue of dematerialized prescriptions corresponding to the new drugs prescribed or the diagnostic tests requested.
  • In case of emergency, the patient, relative or care giver can report it to the supervision center requesting an emergency visit or transport of the patient to the emergency room. Similarly to the occurrence of abnormalities in the level of vital signs measured, the supervision center may request an emergency visit or transport the patient to the emergency room.
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