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Hamad Medical Corporation, Primary Health Care Corporation implement country-wide EHR
In a one-of-a-kind implementation, Hamad Medical Corporation (HMC) and Primary Health Care Corporation (PHCC) have created a country-wide electronic health record (EHR). The two health systems are based in Doha, Qatar, and together serve more than 90 percent of the country’s population of 2.3 million people.
Over the last four years HMC and PHCC have deployed a full suite of clinical, administrative and financial solutions across eight different hospitals, 23 health centers and a variety of clinics and other venues of care.
“The people of Qatar are fortunate to have this type of system,” said Dr. Ali Al Sanousi, executive chief medical information officer, HMC. “Having a longitudinal, nationwide implementation will definitely foster healthcare and improve outcomes, patient care, academic training and medical research.”
Reducing sepsis mortality
The EHR, known by users as the Clinical Information System (CIS), has already proven to be instrumental in improving patient safety. Embedded in CIS is the Cerner St John Sepsis Agent, which constantly monitors inpatients for deteriorating vital signs, organ dysfunction and potential sepsis. The algorithm alerts clinicians when a patient’s vital signs suggest the onset of sepsis, which enables the care team to intervene earlier.
At HMC’s Khor Hospital, nearly 40 percent of the patients with an alert for SIRS were progressing to a more serious sepsis alert. Within 11 months of implementing the algorithm, that percentage dropped to 17 percent. By alerting clinicians early of patients at risk of sepsis, the algorithm has helped save approximately 64 lives.
Improving efficiency and eliminating errors
In addition to improving patient safety, CIS has also increased clinical efficiency by integrating more than 2,500 lab and bedside medical devices and making all the necessary information available in one place.
“We do not need to repeat examinations,” said Alexandra Tarazi, executive director of health information systems, PHCC. “Lab, radiology, examinations across the organizations — the results are visible to clinicians at HMC and PHCC, so that’s a great achievement.”
In addition to improving clinician workflow, the CIS also benefits patients by preventing medication errors. Together, HMC and PHCC have more than 10,000 nurses who use barcode scanners that feed right into the CIS. This helps nurses administer the right medication to the right patient at the right time.
“After the introduction of barcode scanners, it’s now very easy for nurses not to make a mistake with the medication administration,” said Elizabeth Varughese, nursing informatics coordinator, HMC - Heart Hospital. “Nurses can verify with themselves and with the system that the medication they are administering to the patient is correct.”
A leader in the region and the world
The organizations are considered two of the leading health systems in the Middle East, and with the CIS in place, they’ve received international recognition. In March, HMC became the first health system in the world to have all of its hospitals accredited by the Joint Commission International (JCI) under the Academic Medical Centre program. The functionalities built into the CIS enable clinicians to maintain the highest standards of quality.
“I’m convinced that correctly utilizing an electronic medical record will improve the quality of care for our patients,” said Dr. Alejandro Kohn Tuli, senior consultant, HMC - Heart Hospital. “We will reduce the chances of error, maximize the workflow and make those workflows safer.”
To ensure a successful implementation with dozens of facilities and thousands of clinicians, PHCC designed its own strategic process. One week before each implementation the informatics team would conduct a dress rehearsal to simulate the patent’s journey through 12 different scenarios.
Training clinicians working through each scenario with a patient actor allowed end users to familiarize themselves with the system while the informatics team identified any errors with infrastructure, equipment and software.
“In the first implementation, we recorded almost 300 lessons learned, three digits,” said Lamia Al Barghouti, CIS project manager, PHCC. “By the end, we reduced the lessons learned to one digit, and this is due to communicating the lessons learned with every health center that was scheduled to go live.”
With the entire system live, HMC and PHCC clinicians look forward to transforming health care for the entire population of Qatar.
“Implementing an advanced electronic medical record like Cerner is the starting point for innovation,” said Dr. Al Sanousi. “Together, we can improve the applications and reach our goal of having the patient in the center of care and make the patient’s experience better.”
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