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Automation in the OR |
At Gundersen, operating rooms cost $40 a minute to run. Wasted time is wasted money. But for decades, surgical trays -- the collection of instruments specific to every procedure -- were put together slowly by hand. The assemblers consulted a library of guides and also had to laboriously document a tray's movements.
"The system was manual, pure paper," says Lathrop. "We have 8 to 10 feet of catalogs to manage 790 different procedures. The system begged for an electronic solution."
In 2004 the hospital deployed Lawson Software's Surgical Instrument Management (SIM) system, which uses wireless bar codes on every tray to document the instruments and their cleaning via handheld scanners that immediately upload the information to workstations. Only 84% of trays were correctly assembled before going to SIM; now it's 99%.
The hospital also scoured the assembly process for inefficiencies and cut down the number of steps from 60 to 16. As a result, the volume of surgery increased by 10%, while average minutes per case have declined 7%.
"The system has saved us a ton of time and increased patient safety," says Jan Jarvinen, director of materials management at Gundersen.
--M.Y.
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Going Off the Charts
In 1996, Rislow flew to San Diego for a health care technology conference. "They were talking about the electronic health record for the first time," she recalls. "I remember thinking we had all these components but they were fragmented across the system." Conference speakers hoped a technology vendor could someday deliver a system. Rislow called Lathrop from the conference. Her voice was cracked from a cold, and she practically had to shout into the phone. "I think we have a potential to build a system we can put in front of our clinicians," she rasped. "We have the data. We can do it." The doctor agreed.
The first task was to create a data warehouse, including a master person index that would gather information about the 1.2 million patients that the hospital sees every year, about 40% of whom are new patients. Unlike many hospitals that relied on handwritten charts, Gundersen had been using typed charts for years. Newer information, like billing and lab results, was already being stored on PCs. In four months, the small IT staff pulled together 10 years of data -- 5.5 million records -- into a central repository and put two terminals in the internal medicine department so doctors could access the information.
Previously, patient registration and billing information had been outsourced. When someone requested a report, it cost $30 and took a week. The new system was updated daily and eventually would contain a patient's entire medical record. "Doctors were amazed that they were getting reports just after they requested it," says Rislow. "We paid $300,000 and thought we were breaking the bank." But the system paid for itself within the year, she says.
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