Nationwide Children's Hospital doesn't want to see premature babies separated from their mothers because neonatal care isn't available at other hospitals in the region. Such transfers to NCH's neonatal intensive care unit (NICU) put the most vulnerable patients at risk and added stress to their families.
To avoid such transfers, Columbus-based NCH has partnered with Ohio Health, a hospital group in the region, and Mount Carmel Health System for years to run NICUs in five adult-oriented facilities, letting mother and baby stay in the same hospital while each received specialized care. In 2010, Nationwide Children's IT team embarked on a significant IT effort to increase collaboration among the facilities, and the first implementation of that effort went live in January.
Getting the project off the ground was complicated. NCH is the only children's hospital in the region operating NICUs in adult facilities, so there was no model to follow. NCH still is overcoming some technology challenges; for example, the pilot site at Riverside Methodist Hospital is on NCH's electronic medical record system, but the other NICUs in Ohio Health facilities still use paper records until they move to the EMR in the coming year. For each hospital and NICU, "the two organizations have different operational processes," CIO and VP Denise Zabawski says. "We had to get the networks to coexist."
Integration of remote NICU staff with NCH relies on the use of Citrix virtual desktops to provide access to NCH's Epic EHR system from other hospitals and doctor offices. Virtual desktops also help address information security, since the health record data is maintained at a data center at the main NCH campus and not stored on an individual's device.
NCH also had to extend specialized resources to pharmacies serving the NICUs. Precision is critical in neonatal care -- an incorrect dosage, even one just slightly off, can be deadly for a tiny, premature infant. NCH's goal is to have neonatal pharmacists administer medication whenever possible, but because emergency situations don't always allow that, NCH set up live video feeds between the off-site NICUs and the main campus pharmacy. When a non-NCH pharmacist must administer medication, a specialist can view each step of the preparation and check for accuracy.
NCH chose to partner with Ohio Health because it's one of the larger adult systems and operates a sizable maternity business. "For Ohio Health, it's a selling point," Zabawski says. "If something goes wrong, they have a specialized NICU." By overcoming integration, collaboration and security barriers to these remote NICUs, the IT team helped NCH increase revenue and deliver a big value to the smallest patients and their families.