Case Study from two perspectives
Patient Perspective – True story 6/2024
Mid-June, my 88 year old mother began having significant cognitive issues. Emergency response was called. She was taken to a nearby hospital for treatment. She was admitted, received an initial assessment, a battery of blood work, a CRT, and a MRI. She was admitted to the hospital for several days, receiving repeats of all initial testing and more tests including a lumbar puncture. Days later she was discharged after no root cause could be determined. Follow-up psychiatric care was suggested as was on-site nursing visits, occupational therapy and physical therapy.
IT Perspective
I am a retired IT Director with many years in healthcare, specifically Radiology. I look at events through a different lens because I know all the complexity of what must be connected and working 100% to allow clinical staff to address patient care. My perspective became personal as I considered all the resources that come into play. Below is a partial list of obvious and not-so-obvious touchpoints.
In the ER Department
* Was the admitting workstation on-line and functional as well as the laser printer used to print documents and armbands.
* My mother’s demographic information was entered, and insurance verified.
* Was the HL7 messaging application fully on-line to receive demographic information
from the EMR and send orders to both the lab and radiology applications?
* Was there a HL7 interface to an outside insurance provider so real- time verification
could be performed.
* Was there any kind of interface between my mother’s primary care physician’s EMR and the hospital EMR. She is allergic to many drugs so hoping her allergy list could be transferred, otherwise I would need to manually obtain the list.
In the hospital
* Was the HL7 interface between the lab and the EMR working so her lab results could quickly be available to all clinical staff In the medical imaging department
* Two orders for imaging were received. Orders could be received into a RIS, into an intelligent workflow solution, or maybe into another application. Were all of the application servers on-line, expected applications running, and were they able to receive orders. These servers could be on-site, at a colo location, or in the cloud. I did not care, nor would any clinician care.
* Was the application that provides modality worklists connected and working? A
modality worklist is just that, a list of patients to be scanned. A worklist is critical so the
tech does not have to enter information manually which can create errors and delays.
* Studies were completed, and images were sent to one, maybe several applications. I
can name many applications that come into play, not to mention the physical
components to make sure the images were available to a Radiologist. Was the speed
of image transfer as expected throughout the maze of connections? Was one or
several AI applications used as part of the Radiologist’s diagnosis? Was the
Radiologist reading workstation connected and working as expected, knowing the
workstation could be at the hospital, at the Radiologist’s home, or literally across the
country. Were all servers tied to the voice recognition system in play? The touchpoints
are massive.
I’m reminded of what a Radiologist said to me many years ago… If there is a problem
IT needs to know about it before I do…
Summary
I have identified only a small number of resources and workflows that come into play when treating patients. In many environments resources must be connected 7x24x365. When there is a problem, timely notification must be sent to the appropriate teams and individuals, so remediation can begin. Time is of the essence.
PRTG’s solution can monitor all the touchpoints I’ve listed above using out-of-the- box components without ever installing a software agent on any workstation or clinical device.
Proactive monitoring in a healthcare setting is much different than monitoring other environments. It is patient care. It will affect you and your family at some point, and I sincerely hope your medical environment has done all they can to ensure all is well.