Rural Hospitals Prescribe Gov 2.0 Solution with Digital Dashboards

If state and local governments need proof that strategic partnerships can attract federal funding for smart technology, public officials might want to examine two community hospitals in a rural strip of northern Ohio.

Supported by federal stimulus funds, Fisher-Titus Medical Center in Norwalk, Ohio, and Magruder Hospital in Port Clinton, Ohio, plan to implement Cerner health-care technology systems in the next 10 months, a move that would put the two organizations among the first all-digital, smart hospitals in the nation.

These independent hospitals have been partnering for years, but this advanced automated technology, set to go live in April, would create an infrastructure that could eventually build a connected health network.

"From a patient perspective, we wanted to move toward a comprehensive, integrated solution," said John Britton, vice president of Information Services at Fisher-Titus and CIO consultant at Magruder.

The push for patients to participate in the care process echoes the latest efforts made by state and local governments to involve the public more in the government process. In the past few years, citizen demand has driven governments to publish public data sets, and community feedback has fueled innovation contests like Washington, D.C.'s Apps for Democracy.

"One of the things that we were so proud of when [we] launched Data.gov was how many state and local governments replicated the model," Federal Chief Technology Officer Aneesh Chopra said in December as he unveiled the Open Government Directive. "We see this as a key pillar of public-sector work -- not just within the Obama administration. ... We think, we hope, this will be a helpful tool in support of state and local entrepreneurial activities to promote open government."

E-government scores remain at an all-time high. But 90 percent of state comptrollers reported that individual state agencies indentified the federal grant opportunities with no centralized support, according to the 2009 State Comptrollers Survey. At a time when U.S. hospitals are making critical upgrades to health IT systems, Fisher-Titus and Magruder demonstrate how technology can be used to serve people and collaboration can help organizations receive optimal funding support.

Customize Technology for Consumers

In the two community hospitals in Ohio, all rooms will be private, and the patient care systems will be fully digital. To put vital information in the hands of the patient, the Cerner Smart Room has four major components:

• A clinical, digital dashboard gives caregivers a summary view of all relevant health information and medical records. With a wireless keyboard, they'll be able to watch educational videos.
• With biometric fingerprint identification, real-time location technology alerts inform patients when a physician enters the room, putting their name, photo and biography on a digital television screen. Outside of the room, a digital display gives doctors relevant information such as patient allergies, diets and special orders.
• Integrated devices like IV pumps and blood pressure monitors feed data directly into the electronic health record (EHR), eliminating transcribing errors and updating the EHR in real time.
• The interactive patient station gives patients and their families access to clinical team member bios and a daily schedule. On the digital screen, they can also update and track goals, surf the Web, listen to music, play games and order movies.

Similarly, with the government 2.0 movement, citizens have access to public data and can use it to create new shared applications. The new nonprofit, Code for America, seeks to build Web 2.0 solutions for local governments to allow citizens to create their own data. The idea is that through technology and online applications, policymakers can interact with the citizens they serve; the move toward a fully digital hospital reflects the

same goal.

"It really allows you to actively participate in what's happening," said Kelli Christman, Cerner spokesperson. "It's about creating a new patient experience. The entire system should revolve around the consumer, not the other way around."

Partner to Maximize Resources

Two years ago, administrators at the Ohio hospitals developed ideas for the all-digital conversion project and created an agreement to spend a total of about $30 million over 10 years for hardware, software, room remodeling, training and other costs.

At the time, they planned to fund the project with hospital revenues. But then the American Reinvestment and Recovery Act of 2009 was announced, and hospitals around the country saw an opportunity to make essential upgrades and recoup expenses.

For the Magruder and Fisher-Titus project, the stimulus package will provide about $8 million in projected reimbursements for both facilities, 33 percent of the total cost, Britton said.

"Ultimately the stimulus dollars were sort of the icing on the cake," he said, adding that both hospitals still need to do some upgrades to meet stimulus requirements, including e-prescribing.

But Fisher-Titus and Magruder are independent hospitals. No single board or group owns both. Still, management realized early on that collaboration could drive efficiency, and many governments have seen similar effects when joining forces for broadband funds.

"That's important because you have a lot of competition out there right now," Britton said. "Instead of working together, you have people trying to one-up one another. By working together, we're able to afford this level of technology, which we would not likely have been able to have on our own."