Thalassemia is an inherited blood disorder that causes the body to produce an abnormal form of haemoglobin, the protein molecule in red blood cells that carries oxygen. The disorder results in excessive destruction of red blood cells, which leads to anaemia, a condition in which the body doesn’t have enough normal, healthy red blood cells.
Routine hospital visits are integral to treating thalassemia patients, who require complex clinical and diagnostic assessments to help decide about the frequency of required transfusions, chelation therapy and other necessary medications. Ensuring that routine hospital care can be well planned to suit the patient and family preferences, while also meeting the need for every patient to have access to skilled specialist health care professionals with interest, experience and knowledge of the condition, led to the development and implementation of the thalassemia module within Cerner Millennium®.
Challenge
The Thalassemia Center at Fujairah hospital has been serving the thalassemic population of the emirates and the surrounding region for several years. Its leadership and management decided to utilize Wareed, their ‘one patient, one record’ powered by the Millennium electronic health record (EHR), as a catalyst to drive the agenda for service enhancement and quality improvement.
Wareed provided the opportunity to make information highly available, introduce checks and alerts, implement care pathways within the care workflow and, most importantly, monitor the impact by running frequent reports and analyze data for insights. The center also benefited from the automation of clinical documentation and CPOE (among other functionalities).
The aim was to introduce patient centricity, improve patient satisfaction and focus on efficiency gains. There was a realization by physicians that Wareed can streamline and automate most of the repetitive tasks within the care process. The team also aimed to get the center accredited internationally and utilized associated standards to inform the transformation process.
Implementation
The Cerner application team included consultants who specialize in physician and nursing workflows. In addition, the project team included thalassemia specialist physicians, nursing staff and center management with immense support from hospital executive leadership.
The team started the transformation process by understanding and documenting current processes, patient journeys and important aspects of the care provided. These included:
- Registration of patients
- Scheduling for appointments
- Assessments and care planning
- Compliance to the required clinical documentation and what is currently practiced
- Current policies
- Communication with the blood bank, blood availability and arrangement of blood products
- Discharge process
This helped to identify process inefficiencies and redundancies.
To take this mission forward, the project team embarked upon the process of identifying workflow steps that would impact patients the most. The decision was made to focus on those elements first. A patient-centric workflow was developed and agreed. Our center application consultant identified the best approach to develop and implement technological solutions for every step identified, with the process resulting in six separate interventions to improve the process and patient experience.
