Project of the Month June 2003
With no less than 12 sub-projects and a 36.3 million DKK budget the Digital Hospital project of the Frederikshavn-Skagen Hospital is by far the largest project under the Digital North Denmark. Already in the outset ambitions were high and a lot of headway has been made already - for the benefit of patients as well as staff.
By Naia Bang / Texthuset Aalborg
- Integrating the various systems in order to make them ”talk together” is an immense challenge. And we could easily spend another year on this. However that is not what reality looks like. So we need to work fast. We have been preying on our staff ruthlessly – and we still do – but generally our staff have shown an extremely positive attitude towards the project. For example they have met in during their sparetime to learn the handling of the IT technology. And eventhough the new organizational structure of the hospital has imposed even higher demands on the employees they have been tackling the subprojects head-on.
Mette Mullerup, Project manager of the Digital Hospital, makes no attempt of hiding that she is impressed with the positive attitude of the staff. She works in the project secretariat located in the 3rd floor of the Frederikshavn Hospital – in a wing that is currently characterized by the moving and rebuilding caused by the reorganisation of the hospital.
The secretariat is manned by Mette Mullerup and another project manager, seconded from IT-Sundhed, an implementation consultant, a secretary, four IT-employees, an instructor – and a nurse who is freed up to instruct colleagues in the use of the Electronic Case Record (EPJ-Elektronisk Patientjournal).
Today all patient records of the Frederikshavn-Skagen Hospital are located on a central server, and Anita Østergaard and her nurse colleagues can retrieve them when needed at all times – also on their ward rounds.
Photos: Ajs Nielsen
Had Great Ambitions
The Digital Hospital applied for funds already during the Digital North Denmark's first call for applications in 2000 - At that time our project was much more extensive than the one we are working on today. We worked on an 80 million plus DKK budget – which almost exceeded the total amount of the pool – and we were not awarded. So when we got to the second call for applications we had trimmed away parts of the budget, explains Mette Mullerup and goes on:
- But the concept was still the same: We wanted to free up ourselves from all the paperwork of the hospital procedures by making these procedures digital. And we would like to involve the patients much more actively in their own hospitalization. And this time our application was successful.
- Several of our sub-projects are already running as stand-alone projects on other hospitals. We would like to combine them – and measure the synergetic effect of a combined effort. So the Business School and the AAU are also involved in the project to measure and evaluate the effect – of both the individual projects and the individual projects as well as the total effort.
Patients are Using Personal Computers
On the Fourth of December 2001 the Digital Hospital was notified that they had won the project contest, and now they got busy.
- The first thing to do was to get the infrastructure up and running – i.e. network, hardware and all the rest. This part of the project has been completed. So now we could proceed with the remaining sub-projects, reports Mette Mullerup Jensen.
Quite a deal of the projects are now up and running – and well at that. For example the Hospital has purchased three special patient terminals. These are three PCs mounted in a special trolley, enabling the patients to write e-mails use the Internet etc. from their bed. The three patient terminals are in great demand enabling patients to keep updated with the surrounding world, even if bedridden. The hospital has also introduced the Electronic Case Record (EPJ - Elektronisk Patient Journal), which is implemented and used all over the hospital. 
Hours will not be long for Tina Brohus during her stay at the Frederikshavn Hospital. She has borrowed a patient terminal, and Mette Mullerup, project manager, is getting her started.
Photos: Ajs Nielsen
Integration – a Problem
Still there is a lot of loose ends to address:
- Our booking system and our patient system are now well interfaced, and the patient system is also communicating well with the municipal health care system. We are currently working to integrate the patient information system and our booking system. This also goes for the EPJ and the patient system, that is compatible to a certain extent. On the other hand, no integration exists between the Electronic Case Record and our anaesthetic system, between the Electronic Case Record and the Digital Dictation, nor the Electronic Case Record and the Lab system. So great challenges lie ahead in integrating the very dissimilar systems before the project is concluded on December 31rst this year, states Mette Mullerup.
Below please find an overview of the 12 subprojects. Also monitor the progress in the project website: www.detdigitalesygehus.dk- and read about the project on www.detdigitalenordjylland.dk
Facts on
A short overview of the 12 sub-projects and their status:
Information Stand: In the entrance hall of the Frederikshavn-Skagen Hospital an information stand has been set up for patients and their relatives to find useful information – for example the kiosk business hours.
Patient Terminals: The hospital has acquired three patient terminals on trolleys for the patients to use eventhough they are confined to their beds. On the terminal they have Internet acccess, they can watch DVD movies and use basic computer applications.
Patient Information:The system should enable the patient – and the general practitioner – to retrieve information via the Internet on eg. a particular type of examination, or operation scheduled for a patient. The patient information will be placed on the Internet in June. The next goal is to connect it to the booking system and have the patient automatically notified when he or she is booked for an examination or hospitalization.
Communications and calling system: In replacement of a ”bell string”, as we know it from today's hospitals, patients will be equipped with an wireless electronic call system. This enables the patient to walk around freely on the hospital premises – position transmitters will record the location from which the patient is calling. Correspondingly both doctors and patients could be equipped with a mobile phone – capable of receiving SMS text messages - so that they can be called, too. The system is currently being implemented.
Booking:Out-patient booking: Almost all out-patient wards have introduced electronic booking. This is a system, that has already been run as a pilot project in Hjørring and Aalborg, respectively.
Next step is booking for operations. This is an entirely new system to be run for demonstration in June 2003. The system will be implemented after the summer holidays.
Booking on the Web: The idea is to make the general practitioner capable of booking a patient for an examination or a hospitalization. In the first go midwives will be enabled to book pregnant patients for scanning. The system will be run as a demo and test in June 2003.
Notification of Birth:The system, which is already up and running, enables the registration of data for new borns and submitting them to the visiting nurse. Electronic Case Record, EPJ (Elektronisk Patient Journal) The EPJ offers an easier – electronically enabled – access to patient information. The system has been introduced throughout the hospital, employees have been in introductory training – and EPJ could even be brought along on ward rounds using terminals on trolleys.
Anaesthetic System: Electronic recording has been introduced on the anaesthetic ward. Next phase is the integration of the anaesthesia system and the EPJ.
Diabetes System:The vision of the sub project is to make diabetes patients take ownership of their own illness. On their personal computer they could for example measure the impact on their insulin level if they eat, say an apple. 11 patients with diabetes have been in training and learnt to use the system.
Digital Dictate: In stead of using a dictaphone – using tapes that can get lost – doctors have taken up recording their dictates to a central server.
Instruction system: In stead of every ward keeping instructions in ring binders – and maybe even forgetting to update them - these are now electronically available and thus offering access to staff throughout the hospital. Also the system can notify the accountable person of any needs for updating. The system has been commissioned on June 1rst.
Effect Appraisal: Both the individual subprojects and the effect of the entire effort is in for measuring and appraisal. The Aalborg University is now performing a usability test of the Electronic Patient Record and the Diabetes System, while the Business school is to measure the effect of the diabetes system, the Booking System, the Electronic Case Record and Digital Dictate.
Read more on the Project Web Site www.detdigitalesygehus.dk.
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