Case Study

“Society cannot afford healthcare theway it’s delivered today, and so we haveto be smarter about how we take careof patients. The only way to do that isto be innovative and creative.” – David House, Baptist Health CIO

About Baptist Health Baptist Health is the largest not-for-profit healthcare organizationin Arkansas and the state’s most comprehensive healthcaresystem. For more than 80 years Baptist Health has deliveredquality healthcare. The healthcare system today has morethan 130 points of access, including four hospitals and onerehabilitation institute, family clinics therapy and wellnesscenters, and home health and hospice services.

SituationProviding patient-centered services has become a challenge forhospitals in the face of soaring healthcare costs and an agingpatient base in need of more and more expensive healthcare.Baptist Health needed new ways to deliver services to ensure thatpatients get the care they need in the most cost-effective ways.

Solution Baptist Health uses technology to create new service deliverymodels that extend healthcare into the rural communities itserves throughout Arkansas. The healthcare organization uses itsAT&T network to give patients in remote locations access to thesame intensive care services available to patients in its flagshipLittle Rock hospital. Baptist Health’s newest hospital in HeberSprings connects with Little Rock via AT&T’s Megalink® CustomServcice delivering a speed of 45 Megabits per second. The localservice is provided via Smarttrunk® service, an AT&T Primary RateInterface using Integrated Services Digital Network. Thesenetworking solutions allow rural patients to access quality careat home or near home.

Extending the Hospital into the CommunityImagine retiring to a peaceful lakeside community in the beautifulfoothills of the Ozarks and leaving behind city life – withouthampering access to first class healthcare services. Baptist Healthhas developed effective ways to provide growing numbers ofpeople throughout Arkansas, including an increasing numbers ofretirees, with excellent healthcare regardless of their location.

To address rising healthcare costs, Baptist Health has sought waysto provide care as cost-effectively as possible. “Society cannotafford healthcare the way it’s delivered today, and so we haveto be smarter about how we take care of patients,” said BaptistHealth CIO David House. “The only way to do that is to beinnovative and creative.”

One way that Baptist Health meets the needs of retirees andother rural residents in north central Arkansas is with a newhospital in Heber Springs, a growing retirement and recreationdestination on Greers Ferry Lake. The all-digital hospital storespatient records and diagnostic images on a network instead of

At Home or in Community Hospitals,Baptist Health Patients GetState-of-the-Art Care

• Business NeedsA way to stretch shrinking healthcare dollars to betterserve patients throughout Arkansas

• Networking SolutionTechnology supports new service delivery models thatextend healthcare into the community and acrossthe state

• Business ValueIncreased patient satisfaction, shorter hospital stays anddecreased mortality rates

• Industry FocusHealthcare

• SizeThe largest not-for-profit healthcare system in Arkansas

Baptist Health Facts

Case Study - At Home or in Community Hospitals, Baptist Health Patients Get State-of-the-Art Care____________________________________________ 2

on paper and film, which gives physicians, nurses and other caregiversinstant access to critical patient information.

To extend healthcare outside the four walls of the hospital, BaptistHealth developed an innovative eICU care that gives patients in ruralhospitals like Heber Springs round-the-clock access to Little Rockspecialists and to an extensive Home Health Services program. As aresult, patients experience shorter hospital stays and decreasedmortality rates, and the not-for-profit healthcare system savesprecious resources.

Revolutionary Initiative Brings Big-City Care to Small HospitalsBaptist Health’s eICU features interactive video technology thatenables doctors and nurses in the Little Rock Intensive Care Unit toevaluate patients in three Baptist Health hospitals. Plans include afourth hospital in the near future. Baptist Health President RussHarrington called the eICU one of the most exciting advancementsin medical technology he has seen in his 30-plus years in healthcare.“This new initiative is almost revolutionary in using technology tosignificantly improve outcomes in critical care patients,” he said.

Typically, the eICU clinical operations room receives data from patientmonitoring systems at each facility, which it integrates with patients’electronic medical records, diagnostic images and physician dictation.“Every piece of patient information is readily available in oneapplication,” said Vicki Norman, director of eICU care. An automatedsystem analyzes the patient data and alerts doctors and nurses topotential problems long before they would otherwise be noticed.

Specialists in Little Rock can make “e-rounds” of rural Baptist Healthfacilities, actually seeing and conversing with patients via two-wayvideoconferencing. Patients can see the doctors and nurses, provideinformation and ask questions. The eICU videoconferencing model isone of the first of its kind in the nation. Norman believes solutionslike this will help healthcare professionals extend their influence.“Nationwide there are about 6,000 intensivists and there is a needfor about 50,000,” she said. “This is one way for all of our criticalcare physicians to extend their expertise to our smaller hospitalsso that patients can benefit from this high level of care.”

Staff also benefit from the eICU. “It’s a good recruitment and retentiontool,” Norman noted. “I worked 13 years in intensive care; I think thisgives staff added peace of mind, knowing that they have such goodresources at their fingertips. It takes a load off the shoulders ofcharge nurses.”

Although long-term studies on the eICU success rate are in process,initial data from the Baptist Health Little Rock and North Little Rockhospitals indicate a 17 percent decrease in mortality since the eICU waslaunched. Thanks to the eICU, patients who arrive at rural emergencyrooms can sometimes get the treatment they need in their communityhospital rather than having to be transported to a larger city.

The backbone of the eICU and many other Baptist Health initiativesis its sophisticated network, which connects its hospitals with morethan 100 clinics, rehabilitation centers and other facilities. “Ourtelecommunications infrastructure is what drives everything,” House said.

There’s No Place like HomeBaptist Health’s Home Health Network also utilizes the system’sinfrastructure to help keep patients out of the hospital. Telehealthmonitors transmit healthcare data from a patient’s home to the homehealth office. The patients are directed to take daily measurementsspecified by their doctors, including vital signs such as blood pressure,temperature, heart rate, weight, blood sugar and blood oxygen. Themonitor then sends the information over phone lines to home healthregistered nurses who watch over each patient's medical conditionseven days a week. When the data indicates a possible problem, thenurse can intervene appropriately.

In addition to telemonitoring, patients also receive visits by aregistered nurse case manager who assesses their needs, assists withtreatments and medication and provides patient education. BethHennessey, administrator for Baptist Health Home Health Network,is excited about the new care delivery model created by pairingtelemonitoring with nursing visits; “Telehome care has had a dramaticeffect on our re-hospitalization rate, reducing it by over 50%. We cannow respond to patient’s needs as they arise, rather than on apredetermined visit schedule. This benefits the entire system, aswell as improves the patient’s quality of life. It is truly a win-winfor everyone.”

Paula Suter, TeleHealth Program Manager, said patients appreciatereceiving excellent care regardless of where they live; “This technologyenables patients across the state to benefit from expert care guidedby clinical specialists. As a result, patients experience better outcomesand express greater satisfaction with the care they receive.”

House said the program offers patients significant benefits. “Ratherthan treating a patient based on a calendar, we are able to actuallytreat a patient based on clinical need,” he said. “There is no waywe can extend this treatment without a robust telecommunicationsnetwork.”

The goal is to keep patients in their own communities and wheneverpossible in their own homes. “It’s more economical and the patientsdo better as well,” he said. “Most people would much rather be intheir own beds than in a hospital bed.”

Doing the Right Thing for PatientsBaptist Health’s network gives home health care case managers,physicians at the rural hospital and in the eICU control center in

“Rather than treating a patient based ona calendar, we are able to actually treata patient based on clinical need. Wethink that's pretty important, and thereis no way we can extend this treatmentwithout a robust telecommunicationnetwork.” – David House, Baptist Health CIO

Case Study - At Home or in Community Hospitals, Baptist Health Patients Get State-of-the-Art Care____________________________________________ 3

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Little Rock, quick access to medical records. “We have a complete visithistory for all our patients that are linked together by a master patientindex and are accessible no matter where in the system the patientpresents. That’s a pretty big strength for us,” said House. Patientrecords are stored securely in the hospital’s primary data center, andreplicated in a data center in a second location. “The network plays akey role - highly available, affordable bandwidth is important to us,” he added.

The health system’s network enables specialists anywhere within theBaptist Health organization to acquire and view diagnostic imagessuch as X-rays, magnetic resonance images and mammograms.Smaller hospitals that couldn’t afford to have a radiologist available 24 hours a day benefit from a Picture Archive and CommunicationsSystem (PACS) that transports radiological images to physicians inLittle Rock, who can view and manipulate the images and offerdiagnoses. “That’s another example of how remote operations canleverage technology to provide the same quality of care as largerhospitals,” House said.

Baptist Health also uses a voice-activated communication systemthat’s popular with clinicians. “We’re able to do that becausewe have a robust wireless network,” House said. In addition, physicianscan download clinical results to their PDAs. “That’s proven to be apowerful tool for them,” House said.

Investing in its network enables Baptist Health to fulfill its mission ofreaching out into communities throughout Arkansas. “We are trying tocontinually drive value for the investments that we make and wechoose proven technology,” said House. “We have to really believethat it’s going to make a difference, if it’s the right thing to do for ourpatients and we can afford to do, we do it.”

Doing the right thing for its patients has put Baptist Health inthe national spotlight once again. It was recently named to thenation’s “Most Wired” list published by Hospitals & Health Networksmagazine which surveyed 1284 hospitals. The nation’s 100 Most Wiredhospitals show better outcomes in mortality rates, patient safetymeasures and average length of stay. Baptist Health has receivedthe “Most Wired” distinction five out of the last eight years.

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