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Fall 2002
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Downey Regional Medical Center Provides High-Quality Patient Care Through GIS

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The query function allows doctors to view specific information on their patients and to provide a means of preparing physician rounds reports.

The science of medicine and physician care deals in many realms: highly skilled doctors, nurses, and hospital staff; ground-breaking advances in research and treatment; high-tech medical equipment; preventative treatment and medicines; and much more. With the latest 21st century advances in technology, the efficient management of the reams of information associated with all forms of hospital functions is now proving to be a key component in providing the best patient care.

Downey Regional Medical Center (DRMC) is a community-based hospital that has for more than 80 years maintained 199 licensed beds serving the city of Downey, California. The hospital annually admits more than 11,000 acute care patients and serves about 60,000 outpatients.

Working with state-of-the-art information system solutions and also with its leading health care professionals, DRMC has embarked on a groundbreaking GIS deployment that's using geographic applications as a central data nervous system integrated within its overall infrastructure. In so doing, DRMC sought a company with just the right expertise to lend a hand and selected Esri Business Partner Mapgistics Corporation (formerly Regulus Corporation), a professional services firm based in Riverside, California.

"This is very new and we're getting quite a bit of interest," says Gene Boyer, DRMC director of client services. "Our goal was to create an enterprise environment for integrating a lot of data that can be turned into useful information. I think we've succeeded in that."

Patient Care and Room Management

DRMC's first application success is its patient care and room management applications. Assisted by Mapgistics, DRMC created an application that leverages digital maps, analysis, and visualization for a better solution to how it assigns patients to rooms, monitors patient care, and quickly prepares rooms for new patients.

The patient management process--specifically, patient care and room management--is a large, complex, multilayered system. For patients checking in, switching rooms, checking out, and moving from in-hospital to outpatient care, a vast array of information is captured, logged, managed, and analyzed.

GIS replaced manual data tracking, providing a single, enterprise information flow. Using location as an integral data component, various data sets were combined so that hospital personnel could turn to one digital location for information retrieval. With information centralized, automated, and networked via computers, data accuracy was vastly improved and retrieval speed tremendously enhanced.

DRMC and Mapgistics performed a year-long patient intake study, scrutinizing patient flow and analyzing a way to improve processes and provide better services to patients as they move through the hospital, from the point of entry through the billing process.

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The admitting view comprises three sections within each nursing unit, identifying vital information.
 

"Bed management was an area where we could improve both our processes and our service to customers," Boyer says. "We chose Esri tools as a basis for applying technology to these processes, including patient care and patient discharging."

DRMC uses ArcGIS--specifically ArcView and ArcSDE running on SQL server--and ArcIMS to integrate the admitting and registration information system with other systems for one single source. This information updates the bed management system in real time and refreshes the view every five minutes. For its Intranet site, a Java-based ArcIMS application is used to create map services, develop Web pages for communicating with the map services, and administer GIS sites.

Automating the Patient Bed Management Process

A work flow system has been designed for the entire bed management process. From the time a patient is admitted to the time the patient is discharged, key element points are tracked so that the system can be optimized and quantifiable goals can be set and achieved.

One especially nice aspect of the system is its visual design. DRMC, like many hospitals across the United States, formerly managed beds using a large board showing rooms and patient beds, with paper forms and information; bed management personnel could view on the board which rooms were occupied, then pull up paper documents associated with each patient in each room. The new automatic system takes the concept of that board and renders a digital map.

"We made the system look and feel to some degree like the old manual process to give users a familiar setting to work with," says Boyer. "This sped up the learning curve so users could get up and running quickly. The transition has gone very well."

Patients are checked in at many different points throughout the hospital. Wherever the location, hospital administrators use the same system. Accessing the GIS, a user can view a floor plan illustrating rooms and the patients occupying each room.

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The floor view indicates whether or not the bed within each room is empty or full.

"Users can look at a floor view showing rooms and beds, click on a bed, and instantly get patient information," says Boyer.

Types of data available to the user from the admitting and registration system include demographic information as well as insurance, physician, diagnosis, and other information. This is managed in the large relational database management system. "That's the power of GIS, the ease of integrating information and providing custom views for different working groups," adds Boyer.

How It Works

Using intuitive, information-packed digital maps, a nurse can view occupied beds for a particular floor. The nurse can then select the floor plan theme to view rooms with beds color-coded by type of patient stay. In addition, type of visit, age, gender, and attending physician are used to refine the search criteria. Each of these criteria can be valuable for patient care and room management. Perhaps most important, treatment is used as a criteria to refine the room selection. Pairing patients with similar treatment to the same room provides an optimized, comfortable room setting.

The system also helps doctors more easily move from patient to patient because the patients are now grouped together by attending physician. The doctor can begin the workday by quickly pulling up the GIS application and generating a patient list mapped by floor plan.

For more information, contact Gene Boyer, director of client services, Downey Regional Medical Center (tel.: 562-622-2159, e-mail: Gene.Boyer@drmci.org).

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