Hospital Enhances Information-Sharing with New Online Portal

Situation

Since it was established by Imperial decree of the Meiji Emperor in 1911, Fukui Saiseikai Hospital has made saving lives its number one priority. Located in the city of Fukui, in the Hokuriku region of central Japan, Fukui Saiseikai is constantly contributing to the revitalization of regional healthcare. The hospital is a member of the Social Welfare Organization Saiseikai Imperial Gift Foundation Inc.

In 1993, Fukui Saiseikai Hospital moved to a newly-constructed healthcare facility with 417 beds, and it is now the center of healthcare services for the Hokuriku region. Tetsuya Saito, Section Manager of the Business Planning Section at Fukui Saiseikai Hospital, recalls the need to improve information-sharing in order to help employees understand the patient’s perspective. “At the time we moved to this location, there were over 500 personnel, and we have since grown to over 1,000. Of course, as the number of staff increases, sharing of information becomes more difficult. The amount of information that the staff needs to know has increased, and we also need them to fully utilize that knowledge for the sake of the patients. We needed a tool that would help us standardize and enhance our operations. When we looked into how to resolve the issue of organizational operations, we came across the Balanced Scorecard (BSC) management method.”

The BSC is a management philosophy that measures hospital performance on “four perspectives” of evaluation. Saito explains, “First, the ‘customer perspective’ is the perspective of the patient and regional medical practitioners. Next, the ‘innovation and learning perspective’ is the perspective of the staff. The ‘financial perspective’ concerns investment in medical equipment and training, such as non-invasive cancer treatment equipment that can cost upwards of 500 million yen.” The fourth BSC perspective is the “internal process perspective,” which concerns maximizing the efficiency of hospital operations.

Saito describes the use of the BSC at Fukui Saiseikai Hospital. “The first thing we did after implementing the BSC was check the daily clinical results. We designed a checklist including items such as patient symptoms, medical procedures performed, and so forth. As each patient was examined, staff members complete the checklist items for that patient so that we can record all symptoms and assess the level of service each patient is receiving.”

The patient checklist records are collected in the BSC database, which was initially based on Microsoft® Office Access® 2003 database software. Saito says that the checklists have been useful in the sharing of knowledge. “There are experienced individuals on the staff to whom others feel comfortable asking questions. That knowledge—the operational process of the person inquiring what to do in a certain situation—is entered into the checklist. In this way, everyone works with the same set of information.”

To fully achieve the four perspectives of the BSC, Fukui Saiseikai Hospital embarked on an effort to computerize its record-keeping, implement an electronic application system, and share information via an internal online portal. Saito explains: “An accurate process starts with accurate information. However, during the transmission of data from one person to another, information often becomes altered. For us, it was essential to use an online tool that would ensure the flow of accurate and consistent information within the hospital.”

Solution

Hospital management needed to develop an IT infrastructure that would enable the sharing of a clear sense of purpose through a common understanding of the BSC, and provide the accurate notification of messages from the hospital director and occasional indicators. “The BSC is an extremely effective tool for instilling a clear sense of purpose all the way to the on-site staff. We need our employees to be focused on goals, not tools,” explains Saito.

As the foundation of its new IT infrastructure, the hospital selected Microsoft Office SharePoint® Server 2007 and Office InfoPath® 2007 information gathering program. Masa Takeuchi of the Business Planning Section explains the reasons for choosing this software. “We originally accumulated information in the database using Microsoft Office Access 2003 as the interface. Using Office SharePoint Server 2007 with Office PerformancePoint® services, we were able to use our existing database without modification. Using Office InfoPath 2007, we created automated applications for time-off and other information, and we were able to use the available data to create useful statistical displays.”

Takeuchi led the design phase project by personally implementing the system. “The Dashboard Designer feature of PerformancePoint services made constructing the site relatively easy. I also liked the fact that KPI’s and objectives could be configured in more detail than ever before,” Takeuchi recalls.

The internal portal is accessible to all employees, and is an important part of the hospital’s information infrastructure. This portal contains the following content and functions:

Messages from the hospital director

Clinical performance indicators

Saiseikai Hospitality Reports for sharing useful employee information

“Discussions” – electronic meetings for exchanging ideas

Electronic applications using Office InfoPath 2007

Formal construction of the portal began in January 2008, and it went live in September. Takeuchi describes the construction of the portal: “We believe the internal portal is still in its early stages. There are functions and content that haven’t yet been implemented, and I estimate that it’s only operating at about 30 percent of its capacity. By receiving feedback from the staff, I believe the level of sophistication will increase.”

The number one objective of the portal is the transmission of accurate information to all staff within the hospital. “When a medical professional logs in to a PC, the portal loads and then the electronic chart is displayed,” says Saito. “All of the doctors can check the important indicators of the facility and begin daily operations.”

According to Takeuchi, it was especially important to consider the system’s ease of use. “From the perspective of the user, it makes no difference what kind of technology was used to create the portal. What’s important is the ability to instinctively use it at first glance. Forcing staff to learn new technology is a backwards approach. Since Microsoft Office system applications such as Word and Excel® are already in wide use throughout the hospital, we believe using Office SharePoint Server 2007 and other Office system products was the right decision.”

Ryo Saito, section manager of the Systems Division of Hokkoku INTEC Service Inc., which provided technical support of the portal construction, describes Office SharePoint Server 2007 from a technical perspective. “The best thing about Office SharePoint Server is that it is not a narrow product. It is a versatile information system platform that can be integrated easily with .NET, Visual Studio®, and SQL Server®.”

Itsuro Kishi, Division Manager of the IT Platform Services Division of Hokkoku INTEC, calls attention to another point: “It’s not the device, but what’s on the inside that matters. While we built the portal infrastructure, Mr. Saito and Mr. Takeuchi were able to clearly define exactly what information from Fukui Saiseikai Hospital was to be shared and utilized. Their vision was very clear, so we were able to choose a tool to fit their objectives. It definitely is not your run-of-the-mill software product.”

Benefits

The new portal is allowing medical staff to collaborate more quickly and easily. Moreover, it is providing a strong foundation for future IT initiatives, including a plan to migrate clinical data in the near future.

Faster Communication, More Efficient Operations

One of the most widely-used functions of Fukui Saiseikai Hospital’s new online portal is the distribution of Saiseikai Hospitality Reports, which inform staff about strong performance at the hospital. There are three different types of Hospitality Reports: “Reports of appreciation,” which profile staff members who provided service that was highly appreciated by patients or staff members; “Good idea reports,” which share outstanding ideas from staff members; and “Best staff reports,” which profile outstanding individuals.

The hospital began using the Saiseikai Hospitality Reports in 2007, and today they are generated by the hospital director. The reports have greatly contributed to boosting staff motivation. Originally, the information had been shared mainly by internal e-mail distribution, but since the introduction of the portal, the reports are now posted online for all staff to see.

Saito says, “In the case of e-mail, you might skip reading the report and be done with it, but by posting it on the portal, more people see it, even if they don’t want to. With “Good idea reports,” staff ideas are judged not only by direct superiors, by all staff members including executives and the hospital director. This enables a process in which we can all learn new information from each other, and that leads to spontaneous action.”

Another important content item is “Discussions,” which is expected to reduce the amount of time spent in meetings. Various types of meetings are held at the hospital, but there is a limit to the amount of time staff members can sacrifice to attend. Furthermore, in cases where meetings require the attendance of 10 or more people, often several people are not able to attend.

These “Discussions” can be used to obtain opinions of the intended meeting participants and share simple papers, agendas, and other information, thereby enabling smoother coordination of actual meetings. Also, members of the panel who know they will not be able to attend can be reassured and put their trust into the decisions of the actual meeting based on the opinions and information they provide using “Discussions.”

Future Outlook: Records Management Based on ISO 9001

Fukui Saiseikai Hospital is already planning to integrate records-management capabilities into the online portal, based on the ISO 9001 international standard for quality management systems. Kotaro Nakamura, Chief of the Business Planning Section, is coordinating this effort, and he has this to say: “Since the BSC was introduced into this facility in 2003, we have been using ISO 9001 standards. We plan on migrating our medical data to the new portal within the year, which will allow us to become much more efficient. For example, currently whenever the manual of an operating procedure is updated, we need to distribute paper copies to all concerned staff. So even if the document had been updated, some staff might still be using the old procedure. In the future, we can consolidate all important procedural information in the portal so that everyone can view the latest information and carry out the new process.”

Saito explains the future objectives of the hospital. “We would like our portal to connect with other Saiseikai hospitals. There are some issues concerning security and master administration, but it would be very useful to share clinical knowledge and other information across the system.”

Saito continues, “We are a regional organization, so we must reach out to people in the region to use our services. We will continue to provide reliable healthcare, and we’ll continue to gain even stronger public confidence as we maintain an image of an advanced facility. To continue to be a hospital that all patients can trust, we must thoroughly ensure the job satisfaction of our employees. We are striving to encourage collaboration throughout the hospital regardless of medical field, an environment that will contribute to future growth.”

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