How Hackensack University Medical Center

used VNA to achieve a unified patient record

Colleen Sirhal RN, BSN, CPHIMS

• Hackensack, New Jersey (11KM west of NYC)

• Teaching acute care hospital founded in 1881

• Level 2 Trauma Center

• Magnet hospital since 1995 for nursing, paediatrics and stroke care

Agenda

• Problem Overview & Expectations

• Vision

• Journey

• Outcome Success

Problem Overview & expectations

EMR Solutions are Encounter Centric

• EMR Solutions are ‘Encounter Centric’

• Focus on ‘discrete data’ related to a visit or encounter

• Limited ability to provide view of complete patient record

• Less useful in determining the overall health of the patient

Past History?

Missing Documents?

Access to Images?

Traditional Solutions are Image Centric

• Traditional VNA and PACS solution provide an Imaging or ‘Study Centric’ view of a patients record

• Access to other documents and non-DICOM imaging is disjointed

Information that may be missing…Specialty AreaAnesthesia CardiologyDermatology ED Endocrinology Family MedicineGastroenterologyHematology ICUNephrologyNeurologyNuclear MedObstetricsOncologyOphthalmologyOral Surgery Pathology Pediatrics PulmonologyRadiologyRehabilitative Medicine Rheumatology/Immunology

SurgeryUrology

Angiogram Operative Reports CT Scan

EKG Fetal Strips Holter Monitoring Reports Mammogram

MRI U/S Renal Scan

Digital Path Images Pathology Reports Consults

Mole Mapping Wound Images

PET PT Videos Glucometer readings

PFTs Fluoroscopy

CV Cath Procedure Reports SPECT

Human Resources

Behavioral Health

Clinical Care

Admitting/Patient Registration

Accounts Payable

Physician Office

Global Consulting

Health Information Management

Auditing

Accounting

Legal

Information Technology

Patient Finance

OB/GYN

Foundation

Medical ImagingEndoscopy

Healthcare Payer

Facilities Management

Quality Management

Home Health

Anesthesiology

Cardiology

Dermatology

ED

Endocrinology

Family Medicine

Gastroenterology

Hematology

ICU

Neurology

Oncology

Ophthalmology

Oral Surgery

Pathology

Nuclear Med

Nephrology

Rheumatology/Immunology

Rehab Medicine

Radiology

Pulmonology

Pediatrics

Urology

Surgery

Vision

Clinical Content Vision

Images-DICOM and NON DICOM

Patient Centric

workflow

Encounter Visit Data

Goals of user experience

• Single point of access

• Single sign-on

• All clinical content in context with the patient

• All DICOM and non-DICOM content available

• Business continuity services

VNA and enterprise content management (ECM) capabilities are converging as the healthcare enterprise evolves.

Source: Gartner Market Guide for Vendor-Neutral Archives, Barry Runyon, August 18, 2015

Clinical Information Solution Strategy

Share Content

• Clinical Information Sharing

• Send/Receive DICOM and non-DICOM content

Archive Content

• OnBase VNA (archiving all non PACS information in OnBase)

• content from Sunset applications

• Non-dicom images and apply taxonomy and workflow

Capture Content

• Universal Scope Capture

• Mobile registration and image capture

• OnBase ECM content capture solutions

View Content

• Patient Window

• Medical Imaging Viewer

Unified Record Strategy

Journey

One Repository - One Code Base - Native Format

Structured Information

DICOM

Radiology

Cardiology

OB Ultrasound

Ophthalmology

External DICOM

One Repository - One Code Base - Native Format

UnstructuredInformation

Wound Care

Dermatology

Surgical Videos

Consent Forms

Scanned Documents

Improving the clinical experience

• EMR for consistent user experience• A 360 degree view of the complete patient record• Access to data from the Patient, Visit or Encounter level• Views that can be configured to a specific user’s needs• Organized approach to chronic disease management• Useful long term/multi-system involvement (patient care)

Unified Record View

Outcomes

Outcomes and lessons learnt

• Single integrated interface required no training

• Agile implementation team

• Strong clinical leadership, responsive and engaged

• Ease of use is recognized and valued

• 6 month data is positive

• Agfa Radiology (360K new studies/year)

• Siemens Cardiology PACS (40K new studies/year)

• Starting with Radiology (in progress – July go live)

• Migrating legacy data to OnBase VNA

Thank you!