'Displaying patients' health records whenever and wherever needed'

Cerner, EHR
Dr Iván Rancaño, Chief Medical Information Officer (CMIO) at the Hospital Universitario Central de Asturias (HUCA)

(HealthTech Wire / Interview) – When it comes to healthcare, the inhabitants of the autonomous community Principality of Asturias in the North of Spain live in a good spot: care facilities are fully computerised and share information in an integrated way. Dr Iván Rancaño, Chief Medical Information Officer (CMIO) at the Hospital Universitario Central de Asturias (HUCA) spoke to HealthTech Wire about his community’s health policy and the benefits of treating patients when healthcare institutions are connected.

What strategy follows Asturias’ Regional Health Service and which role does IT play in it?

The Principality of Asturias healthcare strategy foresees the implementation of information and communication technology to facilitate the sharing of information in an integrated way in real-time between organisations in the primary, secondary and tertiary care sectors. To do so, care providers had to become fully computerised.

How far along is the community with the implementation of this strategy and how long did it take?

In the Asturias region, we have 1,069,000 citizens, 12 hospitals in public ownership with 3,097 beds and 69 primary care centres. The computerisation of the primary care sector began in 1995 with the digitisation of non-clinical patient data. The implementation of electronic health record (EHR) systems in the clinical field with the Selene platform started in 2006 and was completed in 2014. The healthcare institutions are connected via the HUP (Summarised Care Record, owned by Cerner) platform that displays patients’ health records whenever and wherever needed in the network.

When HUCA was newly built we started a new EHR project with Millennium and the implementation run from November 2010 until June 2014.

In what ways has this health strategy affected the way you provide care at HUCA?

In preparing the digital transformation, our hospital analysed all existing processes. As a result, we changed them completely; nursing and physician tasks are now all workflow based. Additionally, we also externalised some tasks. For example, HUCA cut the number of beds from 1,200 to 1,073, outsourced some testing and surgeries to outpatient clinics and started offering teleophthalmology and teledermatology. We also installed a clinical decision support system to make prescribing safer.

Which benefits do you experience for patients and care providers?

I am really happy with the system. We experience various benefits at HUCA. For example, by being able to access the various labs’ information, it has become possible for us to decide whether or not we need to run a test on a patient, rather than just ordering it. This has brought financial savings. There are also other improvements, such as in the laboratory or the radiology department where we have less waiting time for appointments and results. What is more than before, though, is the sheer amount of data – probably more than we can analyse.

What is the role of Cerner in this process?

In my role as CMIO, I work with Cerner as an expert adviser. Cerner is the single EHR vendor for acute care in the whole region. We have Cerner Millennium at HUCA and Cerner Selene in the other 11 hospitals. In addition, Cerner provides the Selene HUP. That is the health information exchange that connects all primary care and acute care EHRs. In line with their clinical transformation approach, now Cerner is also enabling clinical decision support on top of Selene.

What can other care providers who want to co-ordinate care more closely learn from you?

The success of such a journey depends on the management support and how well clinical users are involved. At HUCA, we had more than 200 staff participating in the design of our EHR system, including more than 40 physicians. Now, we have a group of about 60 staff representatives from different departments that meet once a month to request changes but also to get advice on how to train their respective divisions. Furthermore, we have established a clinical transformation committee that decides on which changes to the system are necessary.

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Cerner

Cerner’s health information technologies connect people, information and systems at more than 18,000 facilities worldwide. Recognized for innovation, Cerner solutions assist clinicians in making care decisions and enable organizations to manage the health of populations. The company also offers an integrated clinical and financial system to help health care organizations manage revenue, as well as a wide range of services to support clients’ clinical, financial and operational needs. Cerner’s mission is to contribute to the improvement of health care delivery and the health of communities.
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