Medical Solutions IT Edition February 2006

Information Technology Vital forGlobal HealthcareImprovementsAptly recognized as Toronto’s “Urban Angel,”St. Michael’s Hospital is heading towards thefuture of healthcare. Through a powerfulinformation technology initiative, the visionaryCanadian care center is transforming clinicalpractice across the continuum of care.by Laina Minervino

CARECONTINUUM OF CARE

“The future of healthcare relies on ourability to utilize technology to under-stand disease earlier, develop the besttreatment plans, improve clinicalworkflow, and decrease costs – andultimately help patients enjoy longerand healthier lives,” said Prof. Dr. ErichReinhardt, President and CEO,Siemens Medical Solutions.As connectivity and interoperabilitycontinue to drive healthcare discus-sions around the globe, solutions thathelp link physicians with the wholepatient story throughout the health-care continuum are essential.

Global Partners DrivingChange

The key to transforming healthcarethrough information technology liesin how well healthcare systems andtechnology solution providers worktogether. More than 2,700 hospitalsaround the globe have moved into theelectronic healthcare age usingSiemens equipment, including 30 inCanada. As in the United States, the Canadiangovernment has mandated IT to drivehealthcare forward. As a result, thegovernment has formed the CanadaHealth Infoway, an independent, pub-licly funded organization to makestrategic advancements in the elec-tronic health record (EHR) projectsthat can be replicated throughout thecountry.1

More and more Canadian hospitals areturning to healthcare IT, and one hos-pital – St. Michael’s Hospital in Toron-to, Ontario – is taking a thoughtfuland measured approach to ensure theintroduction of new technology isabout much more than simplyautomating existing paper systems.Helping them through this process is apartnership with Siemens.

The Urban Angel and Project Gemini

St. Michael’s Hospital (SMH) is a 600-bed facility located in downtown Toron-to. The facility provides primary and sec-ondary care, serves as a downtowntrauma center, and is a leading teachingfacility fully affiliated with the Universityof Toronto. Its dedication to treating andprotecting the city’s vulnerable hasearned SMH its reputation as the “UrbanAngel.”The healthcare environment in whichSMH is thriving is undergoing manychanges. Ontario is in the midst of athree-year, province-wide health systemtransformation, and new provincial pri-vacy legislation governing the collec-tion, use, and disclosure of personalhealth information – Personal HealthInformation Protection Act – came intoeffect in November 2004.“Canada has made significant advancesin healthcare IT in the past two or threeyears,” said Jeffrey Lozon, chief execu-tive officer of St. Michael’s Hospital.“Infoway, the provinces, and healthcareorganizations have invested significantresources in EHRs. Everyone is watchingwhat we do.”And, SMH hopes to do a lot.In 2002, the executive team shaped anextensive information managementplan and establishing an internal EHRemerged as a key corporate priority. Theproject was named “Project Gemini” toreflect the hospital’s vision of “twinning”the transformation of clinical practicewith technology.

2006 • Healthcare IT MEDICAL SOLUTIONS • Special Edition 53

»Our clinical vision for transformation is about much

more than simply automating our existing paper

system. It is about designing a patient-centered, best

practice framework.«

Anne Trafford, chief information officer, SMH


“We were behind the times withrespect to the whole world of comput-erized information,” said John King,executive vice president, chief admin-istrative officer, SMH. “We were verypaper-based and needed a strategicplan to move forward.”“With Project Gemini, we were lookingto implement best-of-breed ideas andsolutions that would link the entirepatient care system,” King added.

Project Gemini RedefinesCareLozon recalls that Project Gemini startedwith four specific goals:

• improving patient care • improving the working life of SMH

staff• connecting with other employees

and outside professionals• improving efficiencies throughout

the hospitalTo achieve these goals, SMH charted acourse to implement a system thatwould build and present a coherentpatient story (record) across the continu-um of care, empower interdisciplinarycare and provide quick access to relevantdata at the point of care to all 3,500 clinicians practicing at SMH.“Our clinical vision for transformation isabout much more than simply automat-ing our existing paper system,” saidAnne Trafford, chief information officer,SMH. “It is about designing a patient-centered, best practice framework.”To achieve this vision, SMH went to themarket and decided on the Siemenssolution. “Soarian® was the only productwith embedded analytics and a work-flow engine. We needed to change the

54 MEDICAL SOLUTIONS • Special Edition 2006 • Healthcare IT

St. Michael’s executive team underscores information technology’s vital role in achieving the hospital’s vision for improved patient

safety and care.

(left to right: John King, chief administration officer; Jeffrey Lozon, chief executive officer, and Anne Trafford, chief information officer.

»The future of healthcare relies on ourability to utilize technology to under-

stand disease earlier, develop the besttreatment plans, improve clinical

workflow and decrease costs – and ultimately help patients enjoy longer and

healthier lives.«Prof. Dr. Erich Reinhardt, President and CEO, Siemens Medical Solutions


Envisioning a Connected Health System: Siemens Shapes Tomorrow’s Care

While St. Michael’s in Toronto has a clear vision for moving towards an electronic health record (EHR)

and incorporating healthcare information technology (IT) solutions into the continuum of care,

Siemens Medical Solutions also has a vision for helping healthcare providers around the globe achieve

integrated care. As the first major diagnostic technology vendor to provide a comprehensive portfolio

of integrated imaging and IT solutions, Siemens knows first-hand the power of transforming care.

Siemens journey started more than five years ago and was propelled by the acquisition of Shared Med-

ical Systems in 2000 as a strategic move that merged Siemens imaging expertise with a company with

established leadership in healthcare IT.

Since launching Soarian® in 2001 – the core element of its IT strategy – Siemens remains the only ven-

dor to develop a new, Web-based, workflow-driven health information system (HIS). More than 100

healthcare facilities are live on Soarian modules. According to Dr. Sami Atiya, senior vice president at

Siemens Medical, Soarian is a workflow system that manages the execution of processes to reduce

handoffs, enable concurrent activities, and automate routine work, resulting in higher productivity,

increased throughput, and optimal outcomes.

One of the first steps in integrating imaging and IT was the creation of syngo®, an intuitive user inter-

face that bridges all imaging hardware with a common look and feel. More than 40,000 licenses have

been sold for solutions from Siemens enhanced with syngo. Siemens has expanded the successful syn-

go image management platform, including integrated radiology information systems (RIS) and picture

archiving and communication systems (PACS), with unprecedented linkages to Soarian. This brings

together all Siemens software into a single instrument to support patient care.

“Siemens understood the importance of integrating imaging and IT workflow early on, embarking

upon a trendsetting strategy,” said Tom Miller, president, healthcare IT division, Siemens Medical Solu-

tions. “With the syngo Suite and Soarian we are driving the future of healthcare by helping to advance

accurate, quick diagnoses and early disease detection.”

The combination of syngo and Soarian within any healthcare environment provides the foundation for

an EHR that goes across boundaries or information silos to assist with workflow concerns and drive

clinical benefits. Such a free flow of information leads to treatment that is not limited to a hospital or

doctor’s office, collaboration and communications that are streamlined across departments and disci-

plines, and outcomes that are focused on improving patient care.

process of how we did things andwork with technology for better out-comes and measurement,” King said.“Siemens and SMH have a true part-nership,” added Trafford. “Siemens isan active member of our strategicalliance council.”Ultimately, the workflow technologywithin the hospital will help bridge thesilos and enhance the interprofession-al culture. “Electronic systems willallow care teams to work together,

not in silos, to plan the patient’s care,”said Trafford.

Seeing IT Benefits

The first phase of Project Gemini – aWeb-based tool that allows cliniciansto view patient information – wentlive 18 months ago. To date, the hospi-tal has introduced Soarian ClinicalAccess, a radiology information sys-tem (RIS), and a new pharmacy man-



road to hospital-wide use of the schedul-ing application, this quick win promptedrequests from other clinics hoping toautomate their patient scheduling prac-tices.

A Journey’s Lessons

Even with successful implementations,the process to complete IT integration isa continual journey. SMH has only laidthe foundation for this multi-year proj-ect, and like many other healthcareorganizations, learned many lessonsalong the way. Despite its challenges,SMH has successfully positioned itselffor the implementation of more com-plex applications such as order entry andautomated clinical documentation.“Phase one made us realize how com-plex this was and made us set more real-istic expectations,” explained King. “Weweren’t totally naïve, but we now have a

56 MEDICAL SOLUTIONS • Special Edition 2006 • Healthcare IT

Toronto’s “Urban Angel,” St. Michael’s Hospital is recognized as a leader in global health

and information technology initiatives.

Photo courtesy of St. Michael’s Hospital

agement system. And, SMH sawimmediate success with the imple-mentation of the picture archival andcommunications system (PACS). “We went from a traditional film envi-ronment to filmless in about 10 days,”said Trafford. King echoed: “One of the major bene-fits of phase one was the instantaccess to images. Our clinicians nolonger had to wait to review criticalpatient tests and more than one pro-fessional can view the images at atime. This has been a huge advance-ment for us.”A more recent success was seen inSMH’s Fracture Clinic when thedepartment went live with electronicscheduling. “The team adapted quicklyand won’t go back to paper process-es,” said Trafford. While this is only the first of manysteps Project Gemini will take on the


»Soarian was the only product with

embedded analytics and a workflow engine. We

needed to change the process of how we did things

and work with technology for better outcomes and

measurement.«

John King, executive vice president, chief administrative officer, SMH

“We believe very strongly in seeing Pro-ject Gemini through to the end,” saidKing. “We are anxious to implementadvanced technologies, but don’t wantto lose sight of our mission and our spe-cial hands-on approach. Ultimately, thetechnology will enhance how we serveour mission by helping us make betterbedside decisions.”When asked what SMH will look like fiveyears from now, the goal is still clear:“St. Michael’s will look quite different.We will see all of the components of ourintegrated solution in place for betterpatient care,” said Lozon.

1 Dorrel, Linda, et al. “Name Game: Canada’s Blueprint for a Nationwide Master Person Index.”Journal of AHIMA 75, no.9 (October 2004): 40-42.

better understanding of just howcomplex this process is.” Trafford added: “Our initial implemen-tation was very IT driven and the clini-cal side couldn’t see the benefits. Wenow know what the clinicians need toget on board with the change. We areable to plan better for later phases andwe now have significant clinicalengagement. “As SMH learned, the implementationof healthcare IT solutions dramaticallychanges the infrastructure of anyhealthcare organization. King andTrafford believe it is essential thatorganizations understand the impacton the personnel in both patient-focused and non-patient focusedroles.“This is a big change,” said King. “Thereare and will continue to be mixed reac-tions among the staff. However, thereare also huge advancements and ben-efits throughout the hospital. It’sabout managing expectationsthroughout the entire process.” Expectation management is alsoessential because technology can betemperamental and infrastructurechanges don’t happen over night.“These things take time, and I’m notsure it can be done faster,” explainedLozon. “Even if hospitals or govern-ments throw more money at IT, thesethings take time and the change man-agement effort is considerable.”“This is a whole new world for manypeople in this industry and at St.Michael’s,” added King. “It is importantto take the transition slow and realizethat implementation is very complex.You also need to remember that youare dealing with people and everyoneadjusts to change differently. The keyis to never lose site of the goal toimprove patient safety. “

Staying the Course

The whole new world holds muchpotential for SMH and Canada.


Beulah Hibbert, film library clerk at St. Michael’s, copies a patient’s test

images onto a CD using Siemens PACS archive technology.

Photo courtesy of St. Michael’s Hospital

Medical Solutions IT Edition February 2006

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