Hartford Hospital

Source: Healthcare Digital

Date :26/07/2007 14:34:09

Technology is the biggest driver in the provision of healthcare, and Hartford Hospital is helping to redefine its role in the treatment and management of patients

Written and produced by James Buchanan & Thomas Venturo

On March 2, 1854 a steam boiler exploded at the Fales & Grey railroad car factory in Hartford, Conn., immediately killing nine men and severely injuring scores more. Over the next week ten more men would die from their injuries.

This disaster, and the fact that the city’s doctors had to treat the injured in their own homes, underscored the fact that Hartford — a city of approximately 15,000 — had no general hospital.

As is often the case, tragedy served as the spark of change, as physicians, the Hartford Medical Society and the Hartford Courant newspaper combined to urge legislation creating a general hospital.

Now, 153 years later, Hartford Hospital is one of the largest teaching hospitals and tertiary care centers, with one of the state’s busiest surgery centers, says Stephan O’Neill, VP of information services for Hartford Hospital and Hartford Healthcare Corporation, the parent company of the hospital.

“In total, it’s an integrated healthcare system that provides healthcare in all of its forms, and the jewel of the crown, so-to-speak, is Hartford Hospital.”

The hospital is an 867-bed regional referral center with divisions that include The Institute of Living, a 114 bed mental health facility; and Jefferson House, a 104 bed long-term facility. Active medical staff is approximately 900 physicians and dentists within 17 departments.

In 2006, the hospital had more than 39,200 discharges, 80,000 emergency department visits, and delivered nearly 4,000 babies.

Further, the Institute of Living is located on a campus-like setting designed by Frederick Law Olmsted, the designer of Central Park in New York City.

“The campus is very much like a park, it is really a very beautiful setting to walk around in and to work in,” says O’Neill.

O’Neill goes on to say, “I think really what makes us unique are the services that we offer. Because we are a tertiary care center, we are able to provide a much higher degree of care than most of the other hospitals in the state.”

“Tertiary care,” he explains, “is the most intense level of care. This is for people who have suffered critical injuries or who have developed very serious illnesses.”

Basically, what he is saying is that Hartford Hospital has the facilities and staff that are capable of providing the highest level of care for the people who are the most seriously hurt or sick. In a sense, due to its capacities the hospital is the care giver of last resort.

In this way, it is not unusual for another hospital to transfer a patient to Hartford Hospital.

O’Neill describes a scenario where a heart attack victim requires immediate emergency care.

“Often we will helicopter them here and for someone who — for example — needs a heart catheterization,” he says, “we can provide that care quickly because we have the people and resources available that are ready to go all of the time.”

Hartford Hospital is also taking part in the latest technology revolution sweeping the healthcare industry.

According to O’Neill, the hospital is deploying the latest technology on two fronts: the equipment used to treat patients - such as robotic surgery - and the information technology used to manage the clinical operations of the hospital.

“In both, we are considered to be among the leaders in the country,” he says.

On the care side, the hospital has a wireless network that can be accessed anywhere, meaning that clinicians no longer have to be tethered to a wall jack in order to access information. The doctors are able to use a variety of devices such as handheld computers to tablet PCs to COWS (Computers on Wheels), says O’Neill.

“It is up to them what they will use,” he says. “A doctor can wheel a COWS into a room so that they don’t have to lug a computer around with them, and they can go to work right away.”

Also on the care side, the hospital has updated the way in which medical images are ordered, read, and results are delivered to the patient’s chart.

“In the old days — about two years ago — a doctor who needed an x-ray would have to fill out an order on paper and submit it to radiology. There the x-ray would be scheduled, and the image would be taken. Then the film would have to be viewed and interpreted by a radiologist, who would dictate a report. The dictated report would be typed and sent back to the radiologist for signature. Then the report would be sent to the patient’s chart where the ordering doctor could see it,” says O’Neill. “All of this could take a day or even two.

“Now, the x-ray is scheduled electronically and the image is saved in an electronic format where the radiologist views it on a screen and dictates his report into a computer through voice recognition software. It is then sent electronically into the patient’s electronic chart, where the ordering doctor can access it. The turnaround time now is in the 15 to 20 minute range, rather than a day or two.”

Looking to the future, O’Neill says the hospital will be making large investments in its clinical support systems.

“We are planning to invest $10 to $15 million to automate completely the medical record system and eliminate the paper chart,” he says.

The hospital is now 60 percent of the way toward a paperless medical record, he adds.

“However, the last 40 percent is fairly hard to get,” says O’Neill. “Currently, when a nurse or doctor visits a patient they are still writing reports and notes on paper. This will be shifted to an electronic system, where the entire chart and all of the notes and reports are written via computer. Once we’ve done that we’ll be pretty much completely on the electronic chart.”

Obviously, staff adoption of new systems is necessary in order to successfully transition. As the hospital began its move toward a more technology-infused model of care, there were staff that were resistant to a degree, says O’Neill, because they were comfortable with the old way of doing things.

“As they have seen the value of moving toward an electronic system and as they become more adept with the new skills, they are actually pushing us forward on these technologies, rather than being pulled along,” he says.

With the hospital being one of the busiest in the region, growth is not really something Hartford Hospital has to work for.

“The growth is always there,” says O’Neill. “It’s something that we don’t have to worry about as much as it is something we have to plan for. We want to grow the business, but we think that’s going to happen anyway with the aging of the Baby Boomers. We will be looking to provide more advanced healthcare systems.”

An example of these systems, he says, is a statewide medical record.

“Imagine someone is in a serious automobile accident in our area and we don’t have access to their medical record,” says O’Neill. “We don’t know if they have diabetes or what drugs they are on. This lack of knowledge causes the majority of medical errors around the country.

“Right now we are finding ways to share basic clinical information electronically, so that when a person who’s been in an accident comes to us we can find out what complicating factors may exist before we treat them.”

He adds, “This is a national initiative that is being encouraged by the federal government, but it is being handled locally at this point. They are leaving it up to us to implement it.”