gms | German Medical Science

Background: In many hospitals, the medical staff in operating rooms as well as in other therapeutic settings, such as interventional radiology, cardiac catheter labs or endoscopy, are currently facing a severe administrative burden in handling, documenting, and re-stocking medical devices (e.g. implants, sterile instruments, pharmaceutical products). Several different processes and IT systems are being used for billing, documentation in national registers, documentation in (electronic) patient records, issuing implant passports, and replenish stocks. Usually, all of these processes have to be initiated manually and separated from one another. At the same time, there is a lack of organization-wide transparency for the use of materials as information is stored in several different systems – some of them on paper only. In this project, our goal was to develop a flexible solution for the medical staff (mostly nurses) that connects, streamlines and digitizes the abovementioned processes in order to reduce documentation burden while optimizing material and medical controlling options. This paper describes work in progress and focusses on the requirement analysis phase.

Methods: We choose a user-centered design approach in order to optimize for usability and user satisfaction. Specifically, we conducted a series of interviews, a supplementary online survey and four one-day workshops with a total of 120 future key users of all relevant medical and administrative departments in a hospital system that comprises of 7 acute care facilities with a total of 3,200 beds. The input from the users was analyzed regarding to-be processes, actors and data and subsequently translated into process models.

Results: Building on the interviews, the workshops and survey results, we developed 15 process models, spanning various ordering and documentation processes as well as controlling measures, which served as the foundation for the design for a multi-layered IT architecture. It includes the use of mobile devices with a scan-engine and android based user-interfaces for the different workflows on the front-end, and an information distribution mechanism, referred to as a “central process intelligence”, on the back-end that connects to the various components of the SAP based hospital information system. The already existing IT applications remains in place as the solution only builds on top by creating a series of interfaces. This design enables the user to automatically trigger several tasks and processes across different information systems with just one scan.

Conclusion: The comprehensive compilation of processes that resulted from the users' input demonstrated the extensive optimization potential of an intelligent, information-controlled management of medical devices. The next steps will be to translate the requirements into software pilots, test them in realistic environments, refine them and prepare the underlying master data. These steps are necessary preconditions for performing quantitative and qualitative evaluations that will measure the administrative burden for the clinical staff, the degree of transparency and of the suitability to enable analyses on the clinical effectiveness of medical devices. Key challenges lay in the significant complexity as many different sub-systems are affected and different stakeholders along the medical and administrative workflows as well as the supply chain need to be engaged.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.