Decision support at a digital hospital, Computer Engineering

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Heart disease is the number-one killer in the United States, and in a cardiac crisis, each minute matters. Indiana Heart Hospital (IHH) is a new cardiac hospital that saves life by radically cutting the time it takes to treat a heart attack. In addition, this for-profit hospital is making profits for its investors, using state of the art information and decision support systems.

At IHH, physicians, nurses, administrators and other employees constantly make decisions. Some decisions must be made very quickly, so the needed data must be in the right time and place in seconds.

IHH is the first wholly digital hospital in the United States. Let's take a look at how decisions are supported there. At the heart of the hospital information system, as of 2005, there were 18 terabytes of data (even more today) stored in datawarehouse, which stores not only historical data, the Shark server enables the storage of both historical and real-time data. When a patient arrives at the hospital, his or her medical records can be on the screen in 15 seconds, so a quick decision can be made on what treatment or tests the patient needs. The results of any test are immediately added to the patient's medical record. Of the various software used for planning and analysis, especially in the financial area, IHH uses software solutions provided by mezzia.com. The software enables improved collaboration, and it provides support of financial and operational decisions. The data and software tools are accessible to all authorized staff. All physicians, for example, carry pocket size wireless devices for data access, entry and communication. These digital systems enable physicians to type in and send orders to the pharmacy or to testing departments. All records are digital, including X-ray films. Also all computer transactions create an audit trail that increases accountability.

In addition, having more consistent data to analyse promotes best practices that make the hospital more efficient and patients safer and healthier.

The IHH communications and collaborative system (Centricity, from GE Health care) eliminates delays in the supply chain. Doctors and other employees can consult each other, make quicker joint decisions, and locate needed experts (even outside the hospital) quickly. Centricity runs across 60 Compaq servers running Windows Server operating system and 600 laptops and other devices. Some data can be accessed by touch screens, to increase speed. In addition, there is a computer to each patient room. Medications are tracked by more than 100 wireless bar code scanners.

New devices and technologies are added all the time (e.g. sensors for vital sign monitoring). The inputs from such devices go directly to the patient's electronic chart (near the bed) as well as to the medical records. The electronic chart enable nurses to enter patient status and verifies the output of the automatic vital signs monitoring.

Physicians enter data into the system when visiting patients, so there are no scribbled notes in the hospital. All this enables nurses to stay longer with patients, increasing their safety. The digitization has contributed to a 40% reduction in length of stay at the hospital, a 75% reduction in human errors, and a significant increase in the number of patients treated in the hospital.

(a) Identify the medical and administrative decisions that the IHH system supports.

(b) Explain how the IHH system is able to reduce the time needed to make medical decisions.

(c) In your opinion, what administrative decisions that are not cited in the case can the IHH system expedite?

(d) Explain why this is a Decision Support System (DSS) application. Identify its components - the data, models and user interface cited in the case.

(e) What strategic advantage can IHH derive from its digitization?


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