Harnessing clinical information has become imperative in driving continuous improvements in care delivery and the intensive care unit is one area where digital transformations have been made.
During the "Digital ICU Evolution: Past, Present and Future" webinar on 4 August, A/Prof John Santamaria, ICU director at St Vincent's Hospital and Chris Wise, Clinical Information System manager at Royal Prince Alfred Hospital (RPAH), shared their hospitals' journey in digitising critical care and shared how critical care information systems help improve patient outcomes.
Private ICUs cannot easily go digital, due to perceived costs. Santamaria laid out some of the benefits of having a clinical information system (CIS) to help convince healthcare institutions to kick-start their digital transformations:
- The electronic medical records in ICUs make it easier for coders to find all diagnostic codes they need for applying for funds.
- A digitised ICU also means expediting patients' transition through intensive care as "[harnessing] more information cuts down their length of stay".
- Features of medical and billing systems can also be integrated into a CIS.
Having a CIS, such as in the case of RPAH, is helpful in sepsis management. The hospital uses a system that alerts nursing staff when certain conditions are met. It is situated at the bedside where they can input observations. Once an alert is made, the staff can then refer the situation to medical staff.
St Vincent's Hospital, according to Santamaria, has not yet used such a tool for sepsis management despite having it built into its system. He claimed that sepsis management solutions are best used in the hospital wards than in their ICUs because they are already hands-on in supervising patients.
Having electronic records in ICUs also save time and enable remote access especially during the pandemic, Wise said. "You have access to the system, either at home by VPN. And this is time-saving as well; you don't have to don your PPE to go into the room to review a chart," he explained.
"Over a much longer period of time, you should start to see something like a reduction in mortality rates as well," he added.
In the early days of CIS implementation at St Vincent's Hospital in 1993, Santamaria recalled "very little" resistance from medical and nursing staff as the move was also well supported by hospital executives.
On his end, Wise said he only noted resistance in going back to a paper mode of operations during a planned upgrade and unplanned downtime of the system.
"People can't cope with going from an electronic system that's available everywhere [where] everything is available at your fingertips immediately to a piece of paper," he said.
Meanwhile, there is an ongoing push around Australia to adopt hospital-wide generic CIS instead of customisable ICU-specific information systems. The former, Wise said, enables the seamless transition of patient care from the ward to ICU and vice versa.
For Dr Charles Alessi, chief clinical officer at HIMSS UK, who also moderated the webinar, it becomes a matter of whether or not organisations should take down their present systems to introduce a hospital-wide CIS.
He asked: "In the interim, until we introduce it to everywhere, do we stop doing what we're doing until we have the perfect solution to implement everywhere at the same time?"
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To get all the insights from this webinar, click here.
This was the second episode in a three-part series. To watch the first episode, click here.
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