Mount Sinai Hospital digitizes ambulatory patient data

Mount Sinai Hospital on Monday said it is extending its electronic health record project by offering online access to ambulatory data on about 500,000 patients a year to more than 500 physicians.

The hospital said it will use

Nightingale Informix Corp.’s Enterprise Practice Management and Electronic Medical Record for the project, which is expected to take up to about three years to roll out. Offered through an application service provider (ASP) model, Nightingale’s software uses two-factor authentication to manage multiple physical locations in real time. The company said its system will be integrated with the existing systems of MSH to exchange information for diagnostic imaging, laboratory results, pharmacy and scheduling.

Dr. Lynn Nagle, Mount Sinai’s senior vice-president of technology and knowledge management, said the hospital has been working on digitizing in-patient records for some time, and is about 80 per cent complete. The ambulatory record management system project, in contrast, will integrate outpatient information on those who haven’t yet been admitted to the hospital but who were served from some 130 ambulatory clinics.

“Not many organizations have actually attended to this,” Nagle said. “It’s a matter of putting the building blocks in place. Until a year and half ago, we weren’t entering ambulatory patients into clinical information systems. If you visited a clinic, that information would not be logged into the hospital information system.”

The implementation will also see the creation of a central repository for all notes pertaining to a patient, Nagle said. Traditionally, clinicians, nutritionists, nurses and physicians would all keep their own notes separately. The Nightingale software will also embed schedules so that patients with appointments at a fracture clinic or a cardiologist can be viewed more holistically, she said.

Nightingale CEO Sam Chebib said Enterprise Practice Management and Electronic Medical Record has been in use for about two years, and Mount Sinai represents its largest hospital implementation to date. The emphasis, he said, is creating a tool that is efficient and simple for physicians to use, something which dovetails with the economies of scale in an ASP model, he said. 

“As a Web-based system, we’ve eliminated all the barriers in terms IT investments,” he said. “You don’t have to worry about running servers.”

Mount Sinai went live with an online physician order entry last week, Nagle said, which has helped galvanize interest around further digitization of key processes at the hospital.

“This is not a project to be lead by the CIO — these are clinician-led projects,” she said. “Over time, you find those clinical champions that push the agenda . . . When we started talking about ambulatory records, it was the doctors and nurses who said they’re ready.”

Chebib said the Nightingale software includes templates to help users customize the forms into something that resembles the paper ones they have used in the past.

“It’s really becoming a knowledge transfer platform in an ASP model,” he said.

Last year, Mount Sinai Hospital was among three organizations testing software from DataGlider to allow the creation of e-health portals that would allow patient data to follow individuals as they moved to another Canadian city.

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