Cone Hospital review [January, 1986]

              revi e w ®
IE MOSES H. CONE MEMORIAL HOSPITAL
GREENSBORO, NORTH CAROLINA
MCH Pioneers Local Area Network
Approach To Computerization
The Moses H. Cone Memorial Hospital is
gaining national recognition as one of the
first hospitals in the United States to have
its hospital information system based on
local area networking technology. Our
hospital was recently recognized in Computers in Healthcare, a national magazine,
as one of two hospitals to use an "open"
network computer system. In addition, an
article titled "Distributed Processing in a
Large Hospital," authored by Vice President
James W. Albright and James M. Gabler,
Director of Management Systems, was
published in the December/January 1986
issue of the national publication Software
in Healthcare.
'Tart of the elegance of the
STAT LAN computer system
comes from its simplicity."
Typically, large hospitals install a large
computer with all hospital functions addressed by a single vendor. This not only requires
a multi-million dollar investment initially,
computer upgrades to increase capacity are
also expensive. More critically, when this
single system is down, it affects the entire
hospital since all areas are tied into this
single central system. This model does not
integrate well with special purpose systems,
such as our own Sunquest Lab Computer.
Nursing involement is limited to the vendor's
approach, which is generally order entry/charge capture, thus inter-unit activities
(orders, results, for instance) are better addressed than intra-unit patient care
activities.
The new system being installed at Moses
Cone Hospital, called STAT LAN, from
Simborg Systems, will consist of cables and
micro-processor boxes. Departmental
systems and IBM PCs/ATs will be attached
to this cable network, permitting individual
department systems to interact with the entire hospital.
A network manager will be installed in the
Management Systems area. The network
manager insures that messages which must
be delivered to several systems (for example, admits, discharges, transfers) are
delivered even if parts of the network are
not functioning at that moment. It stores
review ®
January, 1986
What's new in '86?
Bone Bank 2
New Department 2
Very Unordinary Dolls 2
Home Visits to New 2
Mothers & Babies
Employee Wellness Program .... 3
Retirement Planning 3
Service Awards 4
RADIOLOGY
Neatar LAN
FINANCE
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messages, monitors to determine if any
module (department system) is down, and
when the inoperative system is back in
operation, all missed messages will be forwarded. The network manager has several
other functions designed to keep the flow
of informtion consistent and to get this information to its destination. One especially
useful function will be providing a consistent time and date to all computers on the
network.
The STAT LAN System will also feature
a nursing information manager, which can
be utilized from any clinical area. With the
installation of this system, all nursing units
will have the ability to enter orders for most
ancillaries, display results from computerized ancillaries and reflect actual patient locations. Lab results will be the first to be made
available, followed before the year's end by
Radiology and Pharmacy. Displays from one
to three ancillaries can be viewed
simultaneously. Future developments will
address intra-unit requirements once this
foundation is established.
A STAT message mail manager will provide two valuable capabilities for Moses
Cone. First, an electronic mail capability,
similar to that within the Lab system, will
be available throughout the hospital, providing an alternative to telephoning. Second,
any STAT results can be treated as high
priority mail messages which notify the nursing unit rather than blindly printing. When
the STAT waiting message starts blinking
at the unit, someone must call it up for
display and printing — thus insuring that
someone specifically handles this critical
information. Additionally, a new automated
registration-admission/discharge/transfer
(bed control) system is also being installed
to insure timely patient bed assignments.
REVIEW
Moses Cone Hospital
1200 North Elm Street
Greensboro, North Carolina 27401-1020
Address Correction Requested
Non Profit Org.
Bulk Rate
U.S. Postage
PAID
Permit No. 195
Greensboro, N.C.
Carolyn Ford, Editor
The system has been planned to grow with
the needs of the hospital. "Additional
departmental management systems may be
installed in the future to meet the needs of
our progressive health care institution," said
Jim Gabler. "Capabilities of this system will
also enable physicians' offices to access our
network — inputting patient admission information and requests for ancillary orders
and receiving information such as patient
room assignments and transfers, ancillary
results and other information concerning
their patients. Patient privacy will be ensured by the assignment of access codes."
he continued.
A timetable has been established for the
installation and hook-up of the new STAT
LAN system. Cable installation began in
January, 1986. A patient identification
system will be installed in Medical Records,
replacing the manual "tub" file during
February. The registration and admitting
system is expected to be functional in
March. Following the installation of the network manager later in March, testing of the
Laboratory system connection will begin.
Sometime in April, the Admitting computer
will begin automatically providing inpatient
admission, discharge and transfer activities
as well as outpatient registrations to the
Laboratory computer via the network
manager. Pharmacy's computer system is
expected to join the network in the latter
part of next summer. Radiology's computer
will be connected into the network later in
1986.
The nursing unit manager will be
delivered in late May. Following check-out
and training, it will be phased on to the nursing units starting in July. Once Lab activities
are fully handled on the nursing unit system,
the direct Lab terminals will be removed.
The new system will then provide expanding
nursing functions such as Pharmacy,
Radiology and mail through a single
methodology.
"Eventually, many more department computers will be joined n the network," Gabler
said. "The timing and order of these connections will depend on the users' needs to
be part of the network and on hospital
priorities."
Albright and Gabler cite a number of
reasons why the traditional approach to
hospital computerization is less that ideal.
"Individual hospital departments are more
complex that their counterparts in other industries," Albright stated. "Few of the
hospital's clients pay their own bills — the
resulting mix of insurance company
payments, partial payments and reporting
requirements makes for a uniquely complex
environment.
"There are many unpredictable factors
(when a bed will be vacated, for example)
that other schedulers, such as those for
airline reservations, do not have to deal
with. Additionally, each hospital department
has significantly different computer processing requirements. Yet, these departments
are interdependent, because a given patient
will involve many or perhaps all hospital
(see p.2)