Accelerating clinical workflow at the Virgen del Rocio hospital complex

Eduardo Vigil Martín
Head
Clinical Documentation Centre

Jaime Nieto Cervera
Assistant Director
Information Systems Hospitales
Universitarios Virgen del Rocío
Seville, Spain

The Virgen del Rocío hospital complex, which opened in 1955, has become one of the most important hospitals in Europe because of its size. Today it has grown to include seven hospitals and two specialist centres, with 1,750 beds and 8,300 staff. It also has a reputation as a national reference centre for pathology. In 2002, Virgen del Rocío  started a project for developing and implementing an  information system combining document management  functionality with clinical workstation, electronic patient  record and knowledge management capabilities. This  innovative approach has culminated in the development of an information system of national renown, whose success has led to the exportation of the model to other hospitals located in Spain and Europe.

A new information system
In 2002, the Virgen del Rocío Hospital had already  centralised its eight medical record files in the Advanced  Clinical Documentation Centre, which contains nearly 2.5  million paper medical records. The hospital information  system (HIS) that was originally deployed addressed the  administrative necessities but it did not provide a solution  for the clinical processes development. The hospital had an  increasing number of disparate and nonintegrated information systems. In addition, the electronic patient record systems analysed in the market did not offer either the functional or technical requirements for working with such information volume and number of users.

We proposed the selection of a professional document  management platform that would be used for the construction of the Virgen del Rocío’s corporative clinical workstation with several very clearly defined targets:

• It must be the working tool of clinicians, helping them with the daily medical tasks and reaching a level of support  for clinical processes not covered by any other systems.
• It must have the following characteristics: simplicity,  usability, versatility and stability.
• The clinical professionals must cooperate with the project not only in the analysis and design, but also at every project stage.
• It must keep the current information systems map,  maximising their value without requiring replacements.
• It must make the integration and the integrated management of the data possible – including the information dispersed across the seven hospitals and in their respective information systems.
• It must be oriented to information and knowledge, taking advantage of such data volumes to provide knowledge management and research capabilities.
• The proposal must demonstrate a quick return on  investment.

After a benchmarking analysis with the help of DMR  Consulting, Documentum (EMC) was selected as the best  solution for the new information system. After a further  public tender, Virgen del Rocío counted on DMR Consulting  again to construct SIDCA, the new clinical workstation,  electronic patient record and advanced clinical  documentation management system.

Current situation
Today, the system has 2,230 users distributed among 1,059  doctors, 887 nurses and 212 clerks. It is running in  hospital services from anaesthesia and reanimation to  urology. The clinical workstation has over 1.3 million  electronic patient records and manages more than 4.5 million clinical episodes. Tables 1 and 2 show several indicators that represent an approach to the volume of the information manager.

[[HHE06_table1_IT32]]

[[HHE06_table2_IT33]]

Benefits of the new information system
The Virgen del Rocío clinical workstation has been deployed  for three years and provides the following benefits to the  hospital:

• Immediate access to clinical information reduces time to diagnosis and increases productivity.
• Provides clinicians with the maximum level of available information, to provide safer patient care and to reduce the possibility of preventable medical errors.
• Enabling timely access to patient information has reduced repetition of tests such as laboratory samples, imaging scans and diagnostic exams.
• Improves the services provided and the quality perceived by the patient.
• Acts as a fundamental tool for clinicians, making possible the advance exploitation of the clinical compiled information, both for measuring the  quality and for obtaining management indicators.
• Improves the investment return in the existing information systems, because now the hospital has better capacities for managing and exploiting of the information that was dispersed and with difficulty accessible before.
• Increases hospital efficiency and efficacy in clinical  research and, as a consequence, the financing of research projects by national and international agencies.
• It is improving the work and efficiency of the hospital’s Quality Committee.

Conclusions
Deploying a document management platform has enabled the hospital to establish common practices for managing complex patient information across the healthcare enterprise. This solution now allows clinical professionals to gain immediate access to clinical documentation, complementary tests and medical images to provide safer, clinical care.
 
The clinical workstation developed by Virgen del Rocío  serves as an excellent example of how a healthcare  organisation can benefit from the deployment of a  comprehensive document management strategy to enhance safe and efficient patient care delivery. This unique and and innovative technological approach and architectural design has resulted in the realisation of a renowned information system that can be leveraged by other hospitals in Spain and Europe.