Sourasky Medical Center nephrology unit integrates its Electronic Medical Record with InterSystems Ensemble

Caring for patients with kidney failure

The Nephrology Department in Tel Aviv Sourasky Medical Center performs dialysis treatments for patients who suffer from kidney failure. Doctors provide treatment and medication plans that are administered and supervised by nurses. Each patient typically receives approximately 15 hours of treatment a month. The treatment starts from diagnosis and continues for the rest of the patient’s life, or until the patient receives a kidney transplant. For the safety of the patient and efficient operation of the hospital,it is important that the prescribed care protocol, medicine management,results and observations are all accurately recorded in an electronic medical record (EMR).

The combination of the EMR system from CHAMELEON with the integration provided by Ensemble has created the best solution for our dialysis department – a holistic,end-to-end system that dramatically improves efficiency and accuracy.

Doctor Esti Sayag, Deputy Director of Information System and Operations
Tel Aviv Sourasky Medical Center

Before the introduction of a solution based on InterSystems Ensemble®, an advanced platform for rapid integration and the development of connectable applications, the process involved a lot of manual effort. During treatment, the nurses sampled the dialysis machines every few minutes, collected data and examination results and entered them manually into each patient’s personal chart.The doctor then read the personal chart and tailored the treatment to the results.The transfer of this information between a doctor and nurse usually required the doctor to be present to provide implementation orders. This meant that the doctor spent time managing the process rather than with the patient.

At the Tel Aviv Sourasky Medical Center with 45 nurses operating 45 separate treatment stations – and performing about 200 treatments per day – this represented a considerable logistical and administrative challenge. Also, like any intensive, manual,paper-based process it was also exposed to errors and inaccuracies.

A new EMR that integrates seamlessly with existing information systems

For this EMRto work properlyit also needed to integrate the flow of informationfrom the hospital’s other systems into eachpatient’s single unified electronic medicalrecord. To overcome this challenge Eladchose to embed InterSystems Ensemblein its EMR solution. By using Ensemble tointerface CHAMELEON and the hospital’svarious information systems – includingthose for admission and discharge, laboratoryand the dialysis machines – the system wasoperational in just three months.

Doctor Esti Sayag, Deputy Director of Information System and Operations at the Sourasky Medical Center, summarized her viewof the solution by saying, “The combination of the EMR system from CHAMELEON with the integration provided by Ensemble has created the best solution for our dialysis department –a holistic, end-to-end system that dramatically improves efficiency and accuracy.”

We chose InterSystems Ensemble because it dramatically decreases the time for developing interfaces to connect medical information systems to CHAMELEON.

Ron Linder, CEO
Elad HealthCare Solutions

Yossi Shalom, InterSystems Israel countrymanager adds, “I am delighted that Eladchose to build its breakthrough healthcaresolution on InterSystems Ensemble. Thecombination of CHAMELEON and Ensembleat the Department of Nephrology within theTel Aviv Sourasky Medical Center is a greatexample of a connected application thatimproves the clinical process; saves timeand money; and enhances patient safety.”

The benefits of a connected, easy-to-use integration platform

There are many advantages gained froma solution like this, which uses an integrationplatform to create a connected set of processes.Ensemble enables the automatic and reliable collection of information from machines in theNephrology Department. Remote access to theEMR means doctors do not have to be on siteto supervise the process, and nurses save timebecause they no longer have to monitor thedialysis information manually.

Given that this was the first time the Israeli Ministry of Health had used Ensemble and the first instance of medical devices such as dialysis machines connected to an EMR, the speed of implementation and level of success are remarkable.

Ron Linder, CEO of Elad HealthcareSolutions thinks Elad’s partnership withInterSystems has been a major factor behindthis success.

Linder also cites other benefits: Ensembleis easy and intuitive to use and provides fastconnectivity with software and devices thatcommunicate via HL7. It is because of this thatElad has been able to connect dialysis machinesdirectly – and automatically – to the medicalrecord. Doctor Esti Sayag adds, “Big volumesof data now flow from the machines directlyinto CHAMELEON via a clear and easy-tooperateinterface. We moved from having everything on paper to using no paper at all.Our staff get a clear picture of treatment status at any given time – and all of this has been achieved in a matter of months.”

Executive Summary

The Department of Nephrology withinthe Tel Aviv Sourasky Medical Centerwas using a resource-intensive manualprocess for managing the flow of informationbetween doctors and the nurses administeringdialysis treatment. It meant that doctors hadto be present on site to prescribe treatments.The manual process was vulnerable topotential error and inaccuracy. Sinceimplementing a new EMR system, informationfrom the machines is automaticallytransferred into records, providing asignificant improvement in efficiency andreduction in risk. InterSystems Ensembleis a crucial part of this solution – providinga seamless interface between the EMR, thedialysis machines and the hospital’s otherinformation systems.