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City Hospital in Birmingham
Birmingham’s City Hospital needed world -class information systems to deliver high quality, leading-edge healthcare to over half a million patients each year.
City Hospital chose iSOFT’s i.Patient Manager as its world-class solution, with its mix of functionality, flexibility and leading-edge technology platform. With iSOFT’s Managed Services, City Hospital can concentrate on treating patients – not managing computer systems.
Innovative solutions for an innovative hospital
City Hospital NHS Trust is a large inner-city district general hospital in the east of Birmingham. It is at the forefront of developing innovative ways to deliver healthcare and will soon be unveiling one of the first ambulatory care centres in the country. As well as delivering the broad range of services typical for a large district general hospital, the Trust is home to several regional specialities, including the Birmingham and Midland Eye Centre and the Birmingham Skin Centre. With more than 700 beds, an annual budget of over £100 million and 3500 staff, the Trust treats around half a million patients each year.
The Solution – iSOFT’s i.Patient Manager
After an extensive evaluation and procurement process, the Trust selected iSOFT’s i.Patient Manager as its enterprise-wide patient information system, due to its leading-edge, modern technology platform.
“Many systems may look modern but actually only have a modern user-interface bolted onto an old-fashioned technical platform.”
Tim Atack, Associate Director of IM&T at the Trust explains: “i.Patient Manager was backed by a large multinational company which could deliver the functionality the Trust was looking for, at a price it could afford”.
i.Patient Manager has been provided as a managed service by iSOFT under the Private Finance Initiative(PFI) since March 1997. By October 1997, iSOFT and City Hospital had implemented the master patient index, inpatient management and clinical coding function sets, with outpatients rolling out shortly afterwards. Hospital staff throughout the Trust enthusiastically embraced i.Patient Manager due to the success of the implementation.
Since then, iSOFT and City Hospital have implemented i.Patient Manager within A&E department and introduced inpatient waiting lists and results reporting.
“We implemented Results Reporting in August 1999 with the new intake of junior doctors and rolled it out to all remaining staff,” explains Mike Barton, Clinical Projects Manager. “It has proved extremely popular, not least of all because it makes information so readily available. Previously, staff could access electronic results via one of only ten points within the Trust. Now results are available at over 500 workstations around the Trust, with at least two on each ward.”
i.Patient Manager has been a key element in the Trust’s participation as a Phase One site in the National “Booked Admissions” project. This project, known locally as Rapport, is exploring issues surrounding the booking of outpatients appointments by GPs while patients are still in the GP surgery. The Trust developed a web-based system, which used clinical rules to determine the severity, of the patients condition (from information provided by the GP) before allocating an appointment within the appropriate time frame.
“Using this system, healthcare professional working remotely, who do not have direct access to i.Patient Manager, can now book appointments in i.Patient Manager.”
Mike Barton.
In fact, the solution developed by the Trust has been made so generic that it not only allows GPs to link to i.Patient Manager at Birmingham City Hospital, but supports booking appointments in any hospital system.
The flexibility of i.Patient Manager has allowed the Trust to use web technologies to access live data in i.Patient Manager and extend access to clinicians working remotely.
“i.Patient Manager is so flexible that we can provide different interfaces for each user group. For some users, such as ward clerks, they will use the Microsoft Windows 95 i.Patient Manager interface. For others, who do not need access to i.Patient Manager functions or patient information, we can offer a simplified Microsoft Internet Explorer view provides faster access to core information,” explains Mike Barton.
The benefits of i.Patient Manager – fast, accurate patient information
Tangible benefits for clinical and administrative staff have come from using i.Patient Manager. Ward-based results has reduced time spent chasing information and staff now have quicker access to more information to make better decisions. In the pathology department, telephone calls have dropped sixty per cent since results reporting was introduced, allowing pathology staff to concentrate on analysing samples rather than answering queries.
The functional richness of i.Patient Manager enables the Trust to adopt new, flexible working practices. The Trust has been able to improve management of its waiting lists while reducing resources in that area. It is now looking to apply the same approach to outpatient waiting lists, which deal with around four times as many patients. The Trust is also moving away from traditional operating regimes in clinics.
Further benefits have been realised from the use of iSOFT’s modern technologies, the Trust has been able to quickly develop a comprehensive range of new reports using web technology. The flexibility of iSOFT’s products and iSOFT’s productive partnership with the Trust has allowed i.Patient Manager to be developed beyond its original specification.
“The technology and underlying design of i.Patient Manager made it flexible enough to cope with our changing demands. iSOFT reacts quickly to our requests for changes,” says Tim Atack “and the flexibility of the contract we have made with iSOFT has been critical in permitting changes to the service to be made.”
iSOFT’s Managed Services contract has also allowed the Trust to convert capital investment into revenue payments while transferring a number of technical risks to iSOFT.
“For example, iSOFT is responsible for ensuring the system is properly specified and it also assumes responsibility for ensuring the right staff are available to operate and maintain the system,” Tim Atack points out. “We will always have a relatively small IT department at the Trust, but the managed services contract ensures our staff concentrate on the important things, such as acting as an interface between users and iSOFT setting the strategic IT direction for the Trust, and implementing systems.”
Finally – and perhaps most importantly – the introduction of i.Patient Manager has created a dramatic change in attitudes toward IM&T amongst staff at the Trust.
“Staff now believe that the corporate IT team can deliver good solutions and are willing to let them handle their local needs,” says Mike Barton. “Staff are comfortable using i.Patient Manager and we have a wide range of staff in our user community who are taking the IM&T agenda forward.”
Looking to the future
The Trust is widening access to i.Patient Manager by ensuring it is available in all clinical rooms. It also intends to introduce several more function sets including, electronic ordering of tests through i.Patient Manager, electronic scheduling for both internal staff and local GPs, and electronic prescribing. By combining these factors with the clincial information project, this will contribute to the development of an electronic patient record (EPR).
Tim Atack concludes: “Over the last three years, the Trust has concentrated on new modes of care and new ways of working both within the Trust and with other care providers. We recognise the need for robust IM&T to support some of those new working practices. Our new ambulatory care centre, for example, will need sound admissions, scheduling and care systems. We see iSOFT as a significant player in delivering many of those applications.”
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