Microsoft SQL ServerCustomer Solution Case Study

Waikato District Health Board automates ward information system with Microsoft SQL Se

OverviewCountry or Region: New ZealandIndustry: Hospital and health services

Customer ProfileWaikato District Health Board employs more than 6,000 people, and plans, funds and provides hospital and health services to more than 365,730 people in a region covering eight percent of New Zealand.

Business SituationWaikato District Health Board (DHB) used a manually updated whiteboard system to display patient information on the wards at Waikato Hospital in Hamilton.

SolutionWaikato DHB went through a vendor selection process and after a series of workshops and proposals chose to work with its preferred supplier, Datacom.

Benefits One time only data entry Real-time information Accurate reporting Increased productivity Color-coding information system

“We were impressed with how positively the staff responded to the new system – it was embraced very quickly.”

Allan Crome, Information Systems Project Manager for Waikato District Health Board

A key source of patient information for the medical staff at Waikato District Health Board was a manual whiteboard located in the staff workroom on the ward. An imminent plan to relocate some of the wards into a new building layout, meant that the existing whiteboard system was no longer going to be a practical option. Waikato DHB worked with Datacom to design and build a new electronic whiteboard system designed in .Net and based on a Microsoft SQL Server platform. Patient information is now handled once, electronically stored and available in real time.

SituationWaikato District Health Board (DHB) used a manually updated whiteboard system to display patient information on the wards at Waikato Hospital in Hamilton. With four general medicine wards moving into the new Acute Services Building, the proposed building layout was based on productive ward concepts of improving nurse and doctor efficiencies. Previously, information was manually written on the whiteboard to capture “patient information at a glance” for each ward. The new ward design had two staff workrooms per ward, as opposed to one. Given the constraints and inefficiencies of duplicating information on two whiteboards, manual whiteboards were no longer going to be an effective solution, therefore, an electronic solution was investigated.

This busy hospital needed an up-to-date electronic system to capture and display all relevant patient information on the ward in real time.

“Medical staff are very busy people, therefore the solution had to be simplistic in concept, intuitive to use and present the key information required for ‘patient status at a glance’,” says Allan Crome, Information Systems Project Manager for Waikato DHB.

In the old system there was a time delay between patient information being loaded on to the whiteboard and subsequent entry into the patient management system. This often caused disparities in the data. For example, when a patient was discharged, the whiteboard would be manually updated at that time. If staff were busy (which was often the case, particularly on the night shift) there could be a delay of several

hours before the patient management system was updated.

The delays in updating the patient management system led to inaccurate information in the reports. There was no link from the patient management system to the information on the manual whiteboard and often discrepancies between the two.

Once a patient was discharged, the information was wiped off the board meaning that it was lost and could not be used for reporting purposes or further analysis.

SolutionWaikato DHB went through a vendor selection process and after a series of workshops and proposals chose to work with its preferred supplier, Datacom. As a member of the Microsoft Partner Network and with several gold competencies including Server and Data Platform, Datacom were well equipped for this project. After working through the business issues, the concept of an electronic whiteboard was designed and developed to cater for Waikato DHB’s requirements.

The project team at Waikato developed a SQL Server Information Systems (SSIS) package, taking data from the existing data warehouse and loading it into the new SQL Server database, Windows Server 2008 R2. Datacom used the code first methodology, in which the database table schema is created by Microsoft Entity Framework and then developed the .NET application to display the patient information on the electronic whiteboard. In the nursing

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headquarters the electronic whiteboards are displayed on 47 inch HP monitors using Microsoft Internet Explorer running in Kiosk Mode. This removes all browser tool bar icons meaning the patient information fills the entire screen. The smooth running of the ward depends on the information being updated and visible to the staff in real time. This system is mission critical to the hospital and it was absolutely imperative to get it right.

There are thousands of patients through the hospital every week. With seventeen columns of data per patient, the volume of data in the system quickly builds up. SQL Server manages this data, refreshes it every two seconds and feeds it out to the electronic whiteboard in the relevant ward in real time.

“Dealing with this amount of data, we need to have a system agile and reliable enough to successfully administer it all. There are people depending on this information and we have been impressed at how reliable it has been overall,” says Jason Dix, Software Development Manager at Datacom.

Due to time restraints, the whole system was designed and developed in seven weeks, with another three weeks on top of that for testing.

“We invested a huge amount of time in training and establishing buy-in from the business. We knew it was going to be a major paradigm shift for the staff, for this to work absolutely everyone had to be on board,” says Allan.

It was the ultimate big bang implementation approach, with two wards

going live on 19 July and the next two on 20 July, 2011. The nurse managers worked closely with the project managers to support the nursing staff. The project was a complete success and now updating the electronic whiteboard has become embedded into the daily routine.

“We were impressed with how positively the staff responded to the new system – it was embraced very quickly,” says Allan.BenefitsWaikato DHB has seen instant results from the SQL Server-based system, with some of the key benefits being:• One time only data entry• Real-time information• Accurate reporting• Increased productivity• Color-coding information system• Data available for multiple purposes• Modern system• Reliable and agile SQL Server Platform

Patient information is now entered only once, reducing the potential for error and increasing staff productivity. When a patient's name is entered into the system some of the fields have already been completed, making the process even better. Information from the patient management system is then automatically uploaded to the electronic whiteboards in the relevant wards.

“This system has revolutionized how they do things at the hospital. The staff can get instant updates, this saves so much time and really helps them to do their jobs, which is exactly what we were trying to achieve,” says Jason.

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A single source of entry eliminates the delays between manual and electronic systems. The SSIS feed from the source data, updates the SQL Server database records every two minutes, meaning the visible data on the electronic whiteboards and in the reports, is accurate and up-to-date at all times.

The patient management system calculates the duration of patient stay based on the times entered into the system. Previously these times were often incorrect due to the delays entering the data. The time the patient was actually discharged could be quite different to the discharge time entered into the system. Patient information is now updated and visible as it happens, resulting in accurate reporting on patient statistics.

At the end of each shift, staff on the wards are required to prepare a handover report. Prior to the new system, this report was written manually and summarized the patient updates during the previous shift. As the electronic whiteboard system is constantly updated throughout the shift, the handover report can now be printed at any time without manual intervention, saving hours every day.

Eliminating manual processes, double handling of data and providing efficient color-coded data entry screens all combine to increase productivity at Waikato DHB. Time previously spent manually creating reports and updating whiteboards can now be redirected to patient care.

“It’s simply easier for them to use – new patients are highlighted in blue and some of the fields are already populated, so they

just have to fill in the empty fields, within seconds the information is visible on the screen in the ward,” says Jason.

The data captured for the electronic whiteboard, can now be made available for other purposes. For example, if patients have specific dietary requirements, this information can be used to generate reports such as catering requests, directly to the kitchen.

The electronic whiteboard system is a state-of-the-art technology solution which gives a very modern feel to the wards at Waikato Hospital. The result is a highly visual information system complete with color coding which displays information in real time. The color system provides additional information to staff while limiting the information to the public. For example, different colors refer to the status of a patient, such as green for ‘ready to discharge’. Waikato DHB has replaced a manual system with a streamlined electronic version. The .Net electronic whiteboard supported by the robust Microsoft SQL Server platform has provided a highly effective solution, specifically designed Datacom to cater for the requirements of Waikato DHB.

Microsoft Server Product PortfolioFor more information about the Microsoft server product portfolio, go to:www.microsoft.com/servers

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For More InformationFor more information about Microsoft products and services go to: www.microsoft.com

For more information about Datacom products and services, call 07 839 1318 or visit the website at: www.datacom.co.nz

For more information about Waikato District Health Board call 07 839 4679 or visit the website at: www.waikatodhb.govt.nz

This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY.