Aexis Medical, Tienen, Belgium
Hospital information systems (HISs) and Patient Data Management Systems (PDMSs) are being used by the vast majority of hospitals; Electronic Health Records are increasingly being implemented. Simultaneously, economic and regulatory needs require ever more complex yet lean processes to manage logistics, patients and materials; particularly in Operating Theatres, Intensive Care Units, Central Sterilisation Departments and warehouses.
The fundamental question is how the foundation of such a system will look like in the future. Perioperative charting is a way to design and monitor new processes with minimum effort and using existing systems like HIS and PDMS, not only in the field of logistics (for track and trace purposes) but also in the management of patients, materials, sterile goods and billing.
Key words: perioperative charting, CSSD management, operation room logistics, clinical decision support, patient flow monitoring
To detect opportunities to integrate current or future hospital IT systems in with operating theatre management and logistics software for perioperative charting.
Reviewing and reporting a case series of 50 implementations in Belgium, the Netherlands and France.
Defining “perioperative charting”
Perioperative charting documents all perioperative processes, and extends to both preoperative and postoperative processes. Typically two main systems are involved:
– The actual “perioperative charting” system: planning, management, administration, reporting, coding and invoicing at patient level; staff, equipment, loan gear, instruments, sterile consumables and logistics
– The PDMS system, combining vital data from monitoring devices with inputs of planned and completed medical procedures, ultimately feeding the collected data to the electronic health record (EHR)
Perioperative charting – delivering data to the HIS and EHR
– The perioperative charting system collects data about medical actions and logistical workflows (including track and trace of material and medicines) and partly about the medical procedures (excluding checklists).
– The PDMS collects data about the patient’s health status.
Why perioperative charting?
– Hospital management requires all electronic health records to be uniform, paperless and complete. Medical decisions such as product documentation must be justified.
– The pressure on health services (and in particular their IT systems) to offer accountable healthcare increases continually.
– The efficiency of hospital operations should increase, along with the quality of healthcare provided and patient safety, without conflicting with each other.
Perioperative charting versus HIS and EHR
When planning complex future systems, hospitals should consider perioperative charting as a separate yet fully integrated, “collaborative” part of their IT infrastructure, starting from the (regulatory) need for specific logistics management. So-called “plug-ins” and “modules” for an existing or planned HIS or EHR are generally well integrated, but do not meet the complex and detailed requirements of daily operations in the most critical hospital departments.
Benefits of perioperative charting
– Fulfils the detailed operational requirements of multiple stakeholders in the operating theatre
– An easy-to-use interface triggers high user acceptance in all perioperative and supportive departments
– Offers a single-source “actual state” at multiple levels (patient, operating theatre, staff, equipment, sterile sets, loan gear) on departmental monitors and dashboards
– Allows localisation of all these levels in real time
Complete operating charting and further support
The efficiency of perioperative charting increases dramatically when not only focussed on the actual operating theatres, but when “peripheral” departments and “suppliers” are managed as well.
– It extends the functionality of the HIS/EHR in critical departments (Operating Theatre, Emergency Room, Intensive Care Unit, intermediate care, Recovery).
– It extends the functionality of the HIS/EHR in supporting departments (Central Sterilisation Department, central warehouse, operating theatre stock, patient transport, bed management).
– It increases the operational efficiency by integrating with the hospital’s PACS (picture archiving and communication system), laboratory information management system, enterprise-resource-planning / supply chain management and pharmacy systems.
Improving hospital profitability
– Increased efficiency by eliminating many manual processes and redundant paths
– Combined with the PDMS, perioperative charting offers a complete view of all processes during the patient’s treatment: planning, execution and reporting
– Saves costs and leads to better accountability
– Fewer cancelled operations, fewer errors in materials planning
– Improved registration of medical actions in customisable nomenclature (coding and billing)
– Documenting the entire medical process without extra effort
Belgium: the workshop of perioperative charting
More than half of Belgian hospitals have recently upgraded and complemented the functionality of their existing HIS/EHR using perioperative charting as part of their strategic approach.
No conflict of interest relevant to this article was reported.
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