Everyone who watches Shortland Street knows the problem: a doctor wants to advance the treatment of a patient but cannot find his or her file – the bulky manual folder of notes on every consultation and treatment that patient has received in the hospital.
The problem has been greatly lessened for doctors at Taranaki Base Hospital. Patient notes are stored digitally and available at any of scores of networked PCs around the hospital and at its smaller companion clinics.
“I have a much better picture of what I am doing,” says Dr Cherian Sebastian, in Taranaki’s intensive care unit. Instant results from tests performed on patients are probably the biggest benefit, he says. No longer does he have to phone the lab and ask for them; they’re there on the database. He can even connect from home and check the results, as well as preview his likely workload for the day.
Taranaki wants to extend the system, allowing outpatients’ notes to be checked from their own home or even from the car via a notebook – with appropriate security protection, says IT manager Jenny Murray. Community nurses, charged with looking after outpatients, especially in remote areas, will be able to use the system to help answer patients’ questions, she says.
The system, from Australian health software company IBA Technologies, manages a range of hospital applications from tracking the admission, treatment and discharge of patients to organising their meals. Even a seemingly trivial application – reporting a patient’s condition to inquiring relatives – is said to save nurses up to six hours a week, now the information is available on-screen at the telephone switchboard.
IBA has been running Taranaki Base Hospital’s system for seven years. Until the latest upgrade the hospital was using a DOS character-based version of the company’s applications. While the servers - one at either end of the hospital to aid disaster recovery – now run NT and Microsoft’s Terminal Server with Citrix Metaframe, the PCs still run under DOS, with a small Citrix client. This allows use of cheap, even second-hand machines.
Taranaki considered a client-server system, says infrastructure manager Darren Hepple, but it would have been far more costly and probably have required a yearly upgrade of the PCs.
“I’ve worked in the health sector for 25 years,” says chief executive John O’Neill, “and I’ve not seen tangible benefits from a computer system until now.”
Development of the web-based network came just in time for the hospital, which was “in a precarious financial position” three years ago, he says. Its installation enabled the hospital to reduce staff levels and employ time more productively.
In 1997 IT had lost its way, O’Neill says. “There were systems half-started throughout the organisation and they wanted to roll out a new infrastructure, which would have cost a fortune. So we got rid of the old IT people and got in a new team, which set about doing a web-enabled version.”
The network has begun to be deployed through the wards, where, in addition to desktops at main centres of information requirement and collection, wireless notebooks on a trolley can be taken to a patient’s bedside. A briefcase-sized radio transmitter covers the whole of the first test ward, and has proved effective from the floor below, so the IT people predict that a scheme of one transmitter for every two floors should be workable.
The Taranaki Base system has a permanent line to community health centres in Stratford, Patea and Hawera, with four others operating through dial-up. The permanent lines are only 48kbits/second at present, and it shows in the slow display of intranet pages at Stratford. Telecom promises an upgrade to 128kbit/s shortly.
The whole system is scheduled for completion “about this time next year”, but may be ready to go by mid-2001, Murray says. The outpatients module will be the last piece.
The hospital is undergoing extensive building work, and this will delay rollout more than the technology does, she says.