Lifehouse goes live with iPad-controlled patient big screen

When the Chris O'Brien Lifehouse integrated cancer hospital in Sydney opened its doors to inpatients in February, it also went live with a new patient entertainment and communications system specifically designed to ensure that the hospital's philosophy of offering everything a cancer patient needs in one place is reflected even in its ICT systems.

From swiping a Medicare card or appointment letter barcode at a self-check-in kiosk at the entrance to the hospital to iPad-controlled big screens in each patient room complete with screencasting ability, the IT has been designed to ensure that as little stress and as much information is provided to Lifehouse patients as possible.

As Lifehouse CIO Anne-Marie Hadley puts it, there was an expectation that this hospital would be different, and it is. The purpose-built, $260 million facility has an integrated care philosophy that extends to hosting complementary therapies that are rarely if ever provided in the hospital setting.

The nine floors of the hospital include full onsite pathology and radiology services; a floor called Lifehouse LivingRoom that provides complementary therapies, nutritional services and patient-only areas based around the UK's Maggie's Centre model of specialist facilities for cancer patients; as well as a whole floor for the 200 or so scientists and cancer researchers who are also an integrated part of the hospital.

Co-located with the Royal Prince Alfred Hospital in Sydney's Camperdown, and taking over the services provided previously by the Sydney Cancer Centre, Lifehouse has been offering day services including chemotherapy and radiotherapy and outpatients clinics since last November.

Surgery, inpatients and an intensive care unit, which is set to go live with version 6 of the MetaVision ICU system from iMDSoft, are now open as well.

Lifehouse has installed the Q-Flow self-service kiosk at the entrance at the entrance to the hospital so patients can check themselves for their appointment when they arrive. The check-in screens also function as part of the digital signage and wayfinding system, so patients and family don't have to go searching for help.

“Most patients have to come in regularly so they just have to swipe their Medicare card or scan their appointment letter and they will be checked in,” Ms Hadley said.

The hospital has also set up a patient portal that patients can access at home and which hosts their future appointments schedule. Called My Schedule, this is also accessible on the huge flat screens in each inpatient room, which is also the patient's portal to a range of services including the infotainment system.

What is a bit different about the Lifehouse infotainment system, built in association with Sony and with software provided by OneView, is the range of other services available. Each screen has a patient whiteboard which displays their attending doctor's name and photo, their rostered nurse's name and photo and their expected discharge date.

“That means they can be sure of their length of stay,” Ms Hadley said. “Unfortunately, this sort of information is not often provided to the patient.”

The patient controls the big screen through an iPad, which they can also use to take their own photo and upload it to the OneView system. The iPad is VOIP-enabled so it works as a communication device if they need it.

They can also use the system to access My Schedule, fill out surveys and order their own meals at any time, and the whole package is accessible to day patients and to family and friends on tablets and iPads with headphones.

While integrated meal ordering and access to pay TV and movies on demand are nothing new in hospitals these days, at Lifehouse the patient can order food at any time, the movies will be refreshed regularly and there is IT assistance 24 hours a day. And according to Ms Hadley, there is a strong reason for that.

“Some patients are regularly admitted so we need to keep the entertainment fresh, but more importantly, if the TV isn't working at 3am, that needs to be fixed for these patients. And they need to order food whenever they like – it's important for cancer patients to eat when they need to.”

The screen also has real-time surveys so if the patient likes something or doesn't, it can be captured in real time. The survey system is managed Lifehouse's head of patient experience.

While the patients can operate the full system on the big screen through an iPad, if they simply want to watch the TV they can just push a button on the nurse call handset. The handset also has separate buttons to call for a glass of water or new linen, which is answered by housekeeping staff rather than interrupting a nurse.

Lifehouse is using the Responder 5 nurse call system, which allows the patient to talk directly into the handset to communicate with their nurse, meaning the nurse doesn't have to come all the way to the room if it's not urgent. Responder 5 has been integrated with a Cisco alert system so if the allocated nurse can't respond to a call, it is automatically escalated to the next nurse.

There is also a room and equipment management device near the door in each room that automates housekeeping and cleaning rotas. Nurses can simply press a button to ask for a discharge clean or a quick clean, and the system is also used to track infection risk.

Clinical systems

The big screen in each patient's room can also be used by clinicians to screencast or project clinical images or data from their own iPad or laptop if they want to go through them with patients. All staff carry RFID-enabled proximity cards from Imprivata which also provide single sign-on capabilities to the clinical systems.

While the patient infotainment, wayfinding and communications systems are pretty cool – and Ms Hadley has on staff a dedicated gadget guy who is most pleased with his job – it has not all been smooth sailing getting the IT up and running.

The hospital took five years to build and in that time IT systems, particularly the gadgets, have changed immeasurably. From the clinical systems perspective, however, there were a few hiccups along the way in setting up the EMR, known as the Lifehouse Oncology Information System (LOIS).

Lifehouse had expected to open with a fully integrated, oncology-specific electronic medical record from Queensland-based oncology IT specialist Charm Health, but the proposed system from Charm did not eventuate as planned.

Ms Hadley then re-evaluated what was required for LOIS and decided on a Meditech system from the US – widely used in Australia in Ramsay Healthcare hospitals – to provide the patient administration and clinical system, along with the Vitro system from Slainte Healthcare for clinical documentation and treatment protocols.

There is also a portal into the Cerner clinical system used by the Sydney Local Health District so clinicians can see the patient's previous medical file.

The hospital is also just about to go live with MetaVision in its ICU, and is using the Merlin pharmacy system and the Pyxis automated dispensing system from CareFusion.

The hospital is also due to be linked to the PCEHR, having been successful in receiving some funding from NEHTA as part of its drive to link private hospitals to the national system.

While the super-duper EMR didn't quite turn out as expected, Ms Hadley is proud to be an early adopter of version 6 of the MetaVision ICU system from iMDSoft. Thought to be the first in the country to be set to implement this version, Lifehouse has recruited Rachel Byrne, who formerly worked with St Vincent's Hospital on many of its PCEHR projects, to manage its roll out.

Also working on the project is clinical pharmacist Nicole Cerruto, who is helping to configure MetaVision for the very specific medications and vital signs readings used in an ICU in a cancer hospital.

“It is detailed enough that it can give you the right fluid balance, which is essential for cancer patients,” Ms Cerruto said. “It will capture all infusions but also fluids from enteral feeds and PEG tubes, gained and lost, so it can automatically calculate an exact fluid balance.”

Clinicians will prescribe and administer medications through MetaVision – although infusion pumps will still be done manually – with MetaVision able to interface with the Pyxis automatic dispensing cabinets. Pyxis in turn communicates with the Merlin system used by pharmacy.

Posted in Australian eHealth

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