Prioritization and harmonization
of care plans
SUBJECT
Digital transformation of HMPIT Anesthesia-Resuscitation department with Medilsys solutions project.
About HMPIT Anaesthesia-
Resuscitation Department
The Principal Military Hospital of Instruction of Tunis (HMPIT) is one of the largest and most prestigious university hospitals in Africa. It is a health facility under the jurisdiction of the Tunisian Ministry of National Defence.
Its Anesthesia-Resuscitation department is the excellent resuscitation department for the most complicated cases. Since January 2019, HMPIT has been equipped by Medilsys Intensive Care System (MICS) as a Clinical Information System (CIS) for its 22 intensive care beds.
The purpose of the project
The HMPIT Anesthesia-Resuscitation department sought a CIS providing comprehensive computerized medical records along with advanced clinical assessment, care planning and decision support tools for its resuscitation unit. As a university hospital, it shall also carry out conduct clinical research based on accurate and comprehensive data.
The management of clinical information would enable them to record and analyze their clinical and therapeutic practice.
The objective being:
Compliance with
therapeutic protocols
Availability of information with a reduction in information overload
Provision of the best possible
care for their patients at all times
Limitation of the risk
of therapeutic error.
Thus the needs have been defined as follows:
- A graphic representation of the main clinical, biological,bacteriological and ultrasound data collected on a daily basis.
- Graphic display of critical data (blood pressure, heart and respiratory rate, SpO2) on a time scale varying from one minute to the next, on an ongoing basis with generation of an alarm sound in the event of a failure.
- Instant and automatic collection of laboratory data, cardiovascular monitors, respirators and haemodialyzers.
- Rapid access to biological data with sound alarms related to life-threatening disorders.
- Eliminating paperwork with the digitisation of data that can be consulted and used simultaneously by several people located in several different areas.
- Securing medical prescription.
- Automatic generation of medical tasks from a care plan drawn up by the doctors.
- System flexibility with the ability to change it easily after the initial start-up in order to comply with changing needs
over time. - Automation of hospitalization report writing and coding based on medical observation.
- An advanced search to select patients based on key words (query on database)
- Networked access to the various resuscitation and continuous care units.
Solution
In order to implement its MICS solution, Medilsys provided an on- site implementation team that supported the medical and paramedical staff during the training process, assisted with the commissioning and responded to any arising issues. MICS interfaces are intuitive and easy to use. Users have mastered the MICS tool in a “blink of an eye”.
Since its launch in January 2019, the impact of information in records was immediately felt.
Paper-based medical records have been replaced by comprehensive digital medical records, containing advanced management of drugs, fluids, paramedical tasks, clinical alarms and automated scoring and calculations.
MICS ensures (i) automated data collection from laboratories and bedside devices and (ii) full data transmission from medical records without loss of information, thus improving the quality of analysis and patient follow-up.
Other key factors that led to the choice of Medilsys Intensive care consisted in its advanced predictive diagnostic tools, its ability to increase patient safety through the standardisation of clinical protocols, security of prescriptions and its ability to analyse and aggregate clinical data for research.
The selection of relevant data with graphical modelling has, moreover, avoided information overload, thus improving diagnostic efficacy and reducing the number of medical errors.
The MICS solution initially covered 18 beds. The flexibility and speed of integration of the solution made it possible to equip 4 additional beds immediately.
Doctors use a task-generating notification system for the paramedical team to facilitate the implementation of complex
protocols, which they can then assess the impact thereof. Remote access to a resuscitation patient’s computerised medical
record could make up for the absence of a specialist doctor on site.
Results
The collaboration with Medilsys was successful. After going into production, HMPIT Anaesthesia-Resuscitation Department achieved remarkable clinical, operational and financial improvements.
This software has great flexibility and numerous configuration possibilities, improving the quality of support and reducing the risk of errors.
MICS has adapted without difficulty to the clinical processes of HMPIT resuscitation unit, respecting its needs and complex
practice models.
The digitization of data associated with Big Data and Artificial Intelligence has enabled the development of predictive tools for sepsis, dyskalaemia and renal failure which have a direct impact on morbidity and mortality.
Securing prescriptions through the integration of the Vidal pharmaceutical base into MICS makes it possible to secure
prescriptions by detecting drug interactions, inappropriate dosages and allergic reactions.
Following the deployment of Medilsys Alarm Management System and the direct transmission of laboratory data, we have calculated a 12% reduction in dyskaliemia occurrence and a potential reduction in associated mortality between July 2019 and January 2020 (dyskalemia is a major ionic disorder responsible for heart rhythm disorders with a high mortality rate).
The impact of sepsis predictive diagnosis tool on mortality was the subject of a prospective study. Our calculations showed an early detection of 6 hours on average, which can reduce the associated mortality by 36%.
We have also measured a 13% reduction in length of stay per patient between January 2019 and June 2020 (equivalent to 17 hours per patient for an average length of stay of 127 hours).
MICS integrates a task engine that guides the bedside nurse in real time with regard to the paramedical tasks to be performed,
providing detailed guidance whenever needed. As a result, the nursing staff spends more time with the patient without needing to regularly check the medical record.
24/7 access to patient records from any area in the department makes it easier for doctors to treat patients. Thanks to
digitization, the medical staff can access the clinical data of medical records exhaustively during team meetings.
Thanks to the automatic generation of reports from medical records, doctors spend much less time on medical reporting.
Indeed, doctors save on average 75 minutes of their time per day to devote it to their patients.
The ease of extracting data from MICS has allowed the department to increase its publishing capacity. Indeed, thanks to the
automatic collection and storage of clinical parameters, doctors can base their observations on exhaustive and quickly accessible information.
MICS has simplified the invoicing process with 100% billable procedures. Directors know that all billable actions of the unit
are accurately captured and tracked.
Medilsys has adapted its implementation and training methodology to the needs of the intensive care unit.
Starting with a flexible 8-week schedule, MICS was successfully put into operation on time.
Medilsys full web and multi-platform technologies have significantly reduced the need for hardware investment by allowing
the use of existing hardware.