Saint Clare's Health System

Source: Healthcare Digital

Date :27/07/2007 12:53:20

Saint Clare’s Health System sits among some of the biggest and best known hospitals in the world, but that hasn’t altered its community-based focus

Written and produced by James Buchanan & Thomas Venturo

For Saint Clare’s Health System, the goal is not to compete to be the biggest in nortwestern New Jersey, but rather, to work diligently at providing quality health care to the community it serves.

“We are not trying to be a Johns Hopkins or a Mount Sinai. We really want to be a community hospital that can provide some hi-tech and cutting edge services,” says Rich Temple, CIO of Saint Clare’s. “Our focus is to provide really good care from really good doctors, so that our patients have the best experience possible, while also being treated with some of the most advanced technology available.”

According to Temple, Saint Clare’s has served the healthcare needs of northwestern New Jersey since 1895 when a group of German immigrants saw a need and opened a small wellness center. Since then, he adds, Saint Clare’s has grown to become the region’s premier provider of community-based healthcare and behavioral health services.

The organization has hospitals in Boonton Township, Denville, Dover, and Sussex Borough, with related facilities throughout Morris and Sussex counties. In all, this is a region that is growing rapidly, with a relatively mixed demography.

“Morris County is one of the wealthiest regions in the country, but we still do quite a bit of charity work,” he says. “We are a Catholic not-for-profit, and this is part of our mission - to minister to the needs of the less fortunate.

“We are looking to serve our neighbors. For the larger [healthcare providers] they want to do this to some extent, but their big marketing push is to get their name known nationally,” Temple says. “We are trying to approach it more from the totality of the patient’s experience.”

Temple goes on to add that the bulk of a patient’s experience is at the nurse level.

“They do see doctors day-to-day, but they see the nursing staff more often, and develop their sense of well - being from them throughout their stay,” he says. “They are the people who play a primary role in letting the patient know they are important and not just a number. We want to give them the sense that they are being cared for as a total person.”

The driver behind helping inculcate this sense of well - being among patients is the use of the latest technology to aid the nurses, says Temple.

The critical tool, he adds, is an electronic medical records system by Cerner Corporation. This system allows for all manner of medical record information to be available electronically as opposed to on a hard copy.

Further, computers are located on carts and networked into the system with a wireless connection, enabling nurses and doctors to view a particular patient’s chart while in the room with the patient.

For clinicians with system access privileges, says Temple, they are also able to access patient information while at home, through the hospital’s web portal.

“All they have to do is present their credentials in order to gain access to the network and access the patient’s information,” he says. “The clinician is also able to access radiology images as well. Doctors — when called late at night — can gain access and see all of the relevant information and come to the hospital prepared to meet the patient’s needs. This reduces the chance for error too, by making information available to all the right parties as soon and accurately as possible.”

The system also has a learning capability, adds Temple. For example, if a drug is prescribed that would have a negative interaction with another drug, an alert will flash on the screen requiring a validation in order for the physician to proceed, or for the pharmacist reviewing a medication order to investigate further. The software acts as a check in the process.

“What we just went through is something of a big bang implementation of technology,” he says. “An electronic medical records system is a much bigger undertaking than you could imagine. It’s a transformation of the culture that requires training and integrating into the daily work of our staff. It’s a huge deal and probably the biggest I have gone through.”

However, an electronic medical records system is not the only new technology that Saint Clare’s has brought into its operations, as the entire process is going through something of a transformation.

In general, Saint Clare’s is in the process of building a robust technology department to seek ways to take advantage of web-based technologies to build new systems to deliver information.

One of the initiatives they have developed is the means to take relevant data from across systems and make it available in a manner that shines a light on processes that may be failing, says Temple.

Waiting times in the emergency is an example of this, he says. The system gives administrators information on the length of time any particular patient has been waiting in the emergency room for treatment, so that no individual patient falls through the cracks.

Individual patient data can also be aggregated to allow administrators to see if waiting times are longer at certain times during the day, and make staffing adjustments to meet the need. Also, because the system cuts across all of the organization’s campuses, it can also detect if one location is struggling to maintain timely throughput.

The hospital has also instituted a new customer satisfaction survey tool. The patient — or a family member — is asked to fill out a questionnaire that measures a number of different elements related to the care they received, says Temple. These forms are then sent through an Optical Mark Recognition scanner where the information is automatically entered into a database.

Complaints can be identified and addressed. Administrators are also able to drill down into the data by hospital, date range, and a number of other parameters to identify averages and trends.

“This is a very effective way for us to achieve outreach with our patients and customer communities,” says Temple.

With four hospitals under its direction, Saint Clare’s has to take how it manages each bed quite seriously. To this end, the organization has created its own electronic bed management tool.

“You could buy something like this commercially, but it would be very expensive,” says Temple. “With our management tool we are able to look at any bed in the system and see if it is occupied, if the patient is waiting to be discharged, or if the patient has been discharged and the room needs cleaning. When a patient leaves a bed, an alert is sent to notify our staff that the room needs cleaning.”

Temple adds that this tool is critical to the organization’s bottom line because increasing bed use is a revenue generator.

Saint Clare’s also has a very robust intranet, says Temple, which includes an employee directory, web pages for the different departments, policies and procedures, as well as the cafeteria’s menu.

“There are a number of processes that are built off this such as our training management system,” he says. “We are able to post all of the classes people may want to take or are required to take, and they can register online; and we can verify that they show up to fulfill their training requirements.”

While a good portion of the organization’s focus has been to implement technologies that improve patient care, Saint Clare’s has also added new internal management systems.

For example, almost all of the organization’s billing is handled through a clearinghouse Saint Clare’s has contracted with.

Saint Clare’s has also instituted processes to electronically post as many third-party payments as possible to its hospital information system. And it has contracted with JP Morgan Chase to allow self-pay payments to be loaded into a batch file and posted electronically, which is highly unusual in the industry at this time, says Temple. JP Morgan Chase also provides daily electronic updates to the organization.

Ultimately, Saint Clare’s goal is to become completely paperless with a highly automated process, in order to become more efficient and remove errors from the system.

Key to achieving that goal is its Report Automation System provided by DB Technology, Inc. According to Temple, the system offers a number of benefits, not the least of which is an electronic document repository.

Documents that have been created and stored on paper are now able to be created and stored electronically. Data that used to only be available via a “greenbar” report can now be automatically loaded into spreadsheets and thus become truly actionable information.

The scanning component of the system includes scanning in insurance cards and driver’s licenses for patients when checking in.

Temple adds the system has robust security and carries out regular backups. Saint Clare’s is also far along on instituting a robust disaster plan as well, which is being produced by SunGuard.

As Saint Clare’s moves forward and looks to its future growth, Temple says the organization is looking at possible mergers with other health systems.

“Within the healthcare industry there have been moves afoot for smaller organizations to become part of larger organizations,” he says. “So it is possible and hopeful that we would become allied with a bigger organization and do what we are doing on a larger scale with greater efficiencies, but continuing with our core mission of being the community healthcare provider of choice.”

Temple also says Saint Clare’s would like to develop a means to connect all of the regional healthcare providers into a data sharing system called a Regional Health Information Organization (RHIO). The vision, he adds, is to have one big network of networks where a patient’s data can be accessed easily and securely throughout the network.