The best system for everyone ‒ standardization and centralization at Helios Kliniken
With 90 acute care clinics, where over 70,000 employees care for around 5.2 million patients annually, the Helios Kliniken are one of the largest providers of inpatient and outpatient care in Europe, providing facilities ranging from specialist hospitals to maximum care providers. During the i.s.h.med User Days 2021, participants learned how the project revolving around the electronic health record (EHR) is being implemented in the hospital network in the wake of standardization of clinical core processes.
Markus Schwarz is head of clinical workplace systems at Helios IT Service GmbH. When asked about the demands of the EHR project – which Helios will roll out by the end of 2022 – he gets straight to the point: “We want the best system for everyone.” For him, a successful rollout depends primarily on two critical factors of success: standardization of clinical processes and centralization of the digitalization strategy. Both play a significant role in the success of the EHR.
Remapping processes in the team ‒ with the knowledge and experience of everyone
In total, there are four clinical information systems in use at Helios, including i.s.h.med® as an established EHR, with a powerful spectrum around core clinical processes. Many of these are currently eligible for funding through the Hospital Future Act (Krankenhauszukunftsgesetz, KHZG). But more on that later. Why i.s.h.med? “At Helios, we have been working with i.s.h.med for a long time and consider it a particularly secure and flexible EHR that offers all the options with which we can realize end-to-end digitalization,” says Markus Schwarz. Analyses of the processes in the hospital and the transfer to a digital solution are prerequisites for a successful implementation. Close cooperation between physicians and IT is important. At Helios, the interdisciplinary IT process team works closely with a total of 30 specialized medical groups and multiple working groups. All digitalization projects are submitted, decided, and controlled in the so-called ‘DIGI board’.
Standardized processes improve usage and create added value
There is no ‘IT follows process’ mode at Helios. From the start, all processes are reviewed in terms of their digitalization potential, and the best possible digital process for each case is defined. In particular, it is not about turning analog into digital. “We want a synergy of process and digital solution options. The other way around, it is not worth designing processes that cannot be mapped digitally afterwards or that do not make sense,” explains Markus Schwarz. Specifically, it is about gathering information only once so that it is then available at all points in the patient journey. This way, current patient data can be accessed outside the demographics profile from the electronic chart and the discharge process – regardless of whether the data was documented in the emergency room or as part of the inpatient medical history. Digital processes must support data collection and information processing in patient treatment. This data carries an added value too for future uses, be it for research purposes or studies ‒ with the patient’s permission, of course. Based on this data, the treatment of patients can be further improved. Information collected in a standardized way is an important basis for data-based, fully or partially automated clinical decision support, which is one of the core processes funded by the KHZG.
Crucial support: clinical decision support tool in i.s.h.med
Sandra Herbst has been part of the i.s.h.med product management team at Helios since 2019 and is responsible for the clinical decision support (CDS) tool project. “We wanted a tool to support and interact with our medical staff during patient treatment in their busy daily routine, helping them to make the best decision for the individual patient.” In collaboration with the experts from Cerner, the i.s.h.med CDS tool will be made available from the end of 2022. Fully integrated into the digital clinical process, physicians are supported by rule-based warnings, alarms, notes and action guidelines during patient treatment. This is based on existing information within the clinical workstation system, which the tool processes by providing data sources such as patient data, diagnoses, laboratory values, etc. The digitalization of core processes that will be consistently mapped in the i.s.h.med health record creates a decisive added value. The subproject at Helios is being implemented with i.s.h.med Model System, the Cerner clinical process model, used to drive end-to-end digitalization of clinical processes and to continuously optimize existing implementations.
Agile in development, swift in implementation: many subprojects become an overall solution
Markus Schwarz is confident that the rollout of EHRs at all 90 Helios sites will be completed by the end of 2022, with 60% of the implementation in the central processes having already been covered. At Helios, it was clear from the beginning that implementing everything at once is impossible. The digital solutions are developed as a standard in various stages depending on their complexity and rolled out after successful piloting. During the rollout, it is important that everyone involved at the headquarters, in the respective regions and on-site work hand in hand, to ensure that the digital solutions are successfully implemented in the four Helios regions for the benefit of all users and the people they are caring for.