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Script for excellence: a large IDN moves patient data electronically, eliminating hundreds of hours of manual data entry per year.

What healthcare organization want wouldn't want to eliminate six hours of manual data entry every day? How about up to 35 hours per day? One large healthcare organization in West Virginia no longer wrestles with that question.

Data at Risk

Charleston Area Medical Center (CAMC) is West Virginia's largest medical center with 913 beds in three campuses, ambulatory facilities and multiple physician offices and health clinics. The organization needed a way to update the hospital's master patient index with information from ambulatory medical locations. The challenge was getting the hospital's Siemens Invision system and its Enterprise Access Directory (EAD) to interface effectively with Medical Manager, the system used by the organization's ambulatory offices.

Moving patient registration data between the two systems would allow emergency department doctors to determine if patients being treated at the hospital had recently been seen at one of the clinics. This is important when dealing with those in fragile categories, such as cancer patients. Sharing this sensitive information among systems is a regulatory requirement for CAMC, as well as a patient safety issue the organization wanted to address. However, CAMC struggled with a cost-effective solution to the problem.

David Dickens is a systems analyst and project manager within CAMC's 100-person 1T department, which is scattered over three campuses and is now comprised of Siemens employees, a result of CAMC's decision to outsource its IT function to that company. Dickens realized that without additional IT, integrating information between Siemens Invision and Medical Manager would require substantial manual data entry.

This process could result in multiple errors, such as duplicate patient information or, even worse, overwriting good data with incorrect data. Dickens needed a way to take selected fields from Medical Manager and expand them into Siemens Invision to get patient information into the main patient database at the hospital--and last fall he was formally tasked by the organization with solving the problem.

An End to Manual Data Entry

At a Bridgelt Solutions user training session last fall hosted by PCCS in Indianapolis, Dickens learned about Boston WorkStation from Sherborn, Mass.-based Boston Software Systems. Boston WorkStation is a script development tool that allows Dickens and his team to move data to and from any application or system regardless of platform. The software is PC-based and enables the user to create links with DOS-, character- or Windows-based applications. In essence, says Dickens, "It allows us to interface any two systems, period. If it's something a human can do, we can write a script around it using the same decision-making logic a human would use."

Dickens says that 125 to 150 patients and their data may be affected daily at CAMC's David Lee Cancer Center location, and that's just one location. The same number might be involved at CAMC Infusion Services. Also, CAMC has three HealthPlus sites offering ambulatory services where, again, patient data are involved.

CAMC's IT support had developed a quick registration process for use at the Infusion Services location, but even with "quick-reg," data had to be keyed manually. Because that might take up to three minutes per patient, it was done on the back end to prevent a delay in patient flow. According to Dickens, the real impact of Boston WorkStation was easy to project before purchase. Manually keying data at even one remote location could take six FTE hours per day. If all remote locations were figured in, CAMC might have to devote 35 FTE hours per day for manual data entry.

Dickens discussed the project's requirements with the Boston Software Systems support team. He was able to develop a process that retrieves ADT (admission, discharge, transfer) information from Medical Manager using a Boston WorkStation script to process an HL7 file from Medical Manager. The information is then posted into Invision using decision rules that CAMC designed with help from the vendor's team.

CAMC not only has the IBM mainframe platform, but also a large number of servers running both Windows and Unix. Their Medical Manager data set is a large MSO serialization running on an AIX platform, and Invision runs on a mainframe system. As a side benefit, CAMC was able to develop three daily output reports that list every patient registration the system was able to process and update the information to the master grid. These reports also "red flag" registration errors. The system sends an e-mail to management personnel, notifying them of the error, and enables data entry staff to review and correct errors.

Quantifiable Savings

Decision making, due diligence and implementation were swift. Dickens identified the product in November 2004, completed due diligence in December and put the script online in January 2005. He credits Pare Doherty (sales) and Paul Donoughe (programming) from the Boston Software team with bringing the software to launch in the shortest possible time. On Dickens's team, Chris Shaffer oversaw Invision requirements while Roger Jordan programmed the Medical Manager side, April Dawson headed the interface team, and Trudy Shaffer spearheaded data integrity with the EAD.

Results, Dickens says, are easily quantifiable. "On average, we input 125 patients per day at just one of our locations. If it takes three minutes to handle the input, we're saving more than six hours of manual labor per day--nearly $20,000 per year in cost savings--that's just for one facility." Expanded use of the program could eliminate up to 35 hours of daily input.

"Unlike some scripting programs," Dickens continues, "this software is extremely flexible. It has a wizard that takes you through every step. The trick with any software is figuring out how to exploit it. The user has to ask, 'Now that I've got it, what else can I do with it?'" Dickens took his own advice to heart recently when he showcased Boston WorkStation for other members of the IS staff, who quickly identified additional uses for it. Now CAMC is looking to expand the use of Boston WorkStation with other programs and departments within the organization.


David Dickens

Systems Analyst, Project Manager

Charleston Area Medical Center

Charleston, W. Va.


Boston WorkStation

Boston Software Systems

Sherborn, Mass.

For more information about Boston Workstation from Boston Software Systems,
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Title Annotation:Data Management: Case History
Publication:Health Management Technology
Geographic Code:1USA
Date:May 1, 2005
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Next Article:Mastering healthcare applications: Toronto hospital uses self-directed and computer-based training to meet clinical staff's learning needs.

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