INTRODUCING THE RELIEF REGISTRY Dr. Jaron Rabinovici Sheba Medical Center, Israel.
NODE Health Case Study of Digital Medicine Innovation Center: Sheba Medical Center, Telaviv
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Transcript of NODE Health Case Study of Digital Medicine Innovation Center: Sheba Medical Center, Telaviv
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The Hospital of Israel
February 17, 2016
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Israel's National Medical Center
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Born in 1948...
Born in 1948 along with the fledgling State ofIsrael to treat the wounded of Israel’s War ofIndependence.Tasked personally by Prime Minister DavidBen-Gurion, Dr. Chaim Sheba opened asmall military hospital at Tel Litwinsky (laterrenamed Tel Hashomer, meaning 'Hill of
Guardians') to heal the brave men and women injured in thepivotal battle for Jerusalem.Tel Hashomer Hospital became the Sheba Medical Centeras it grew to encompass four specialized hospitals andhundreds of medical clinics and scientific
laboratories…
Eyal Zimlichman MD, MSc Sheba Medical Center
Among Our Goals• A comprehensive hospital where the
patient is at the center• Providing the highest quality health
care to patients and their families• Synergism between medical care and
research• Development of new and leading
technologies• Education of all health professionals
with emphasis on future team leaders• Economic stability
Eyal Zimlichman MD, MSc Sheba Medical Center
Lab Complex
Sheba Medical CenterGeneral Hospital
Academic
Rehabilitation
Facts and Figures• Comprises 120 departments and
clinics, 1,482 licensed beds, 7,200 healthcare professionals, including 1,000 doctors 2,300 nurses and 1,500 paramedical personnel.
• 1.4 million patient visits a year, 185,000 emergency visits95,000 inpatients, 600,000 hospitalization days and 10,500 newborn deliveries.
• Situated on a 150-acre campus.• A built-up area of over 4,000,000 sq.
ft.Eyal Zimlichman MD, MSc Sheba Medical Center
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Medical Education• MD programs with the Sackler Faculty of Medicine, Tel-Aviv University 4 years, 6 years, and American programs• MD programs with London Saint George University• Residency and Fellowship programs• Sheba School of Nursing
A four-year BA program affiliated to Tel-Aviv University
Post graduate nursing programs• Academic School of Physical therapy• Academic School of Speech Therapy• Medical Simulation CenterEyal Zimlichman MD, MSc Sheba Medical Center
Medical Research• 25% of all Israeli medical clinical research is conducted at Sheba.• The main clinical trial venue for the Weizmann Institute, Tel Aviv and Bar-Ilan universities.• A key partner with industry as testing center for Israeli medical technology and new drugs.• One of two medical centers in Israel with US Dep. of Health federal wide assurance designation.• A home to major research centers in regenerative medicine, neuroscience, cancer, heart disease and genetics
Eyal Zimlichman MD, MSc Sheba Medical Center
Tech Transfer and Commercialization Strategies
Successfully Transfer and Commercialize Technologies that Lead to Economic Development
Technology transfer is a complex process. It operates as part of the Hospital’s internal culture and environment and as part of the external environment in the community and state.
Internally, the “culture” is one of the strongest and most pervasive influences on its technology transfer and commercialization performance. This includes incentives to inventors, rewards, and leadership from management.
Sheba Medical CenterMinistry of Health – Central LaboratoriesBarzilai Medical CenterZiv Medical CenterGalilee Medical CenterWolfson Medical CenterMental Health Center
Lateral Technology Transfer Company
The Acute Care General Hospital
Safra Pediatric HospitalHospitalization tower
Buchman Women’s Division
Lab Complex
Teaching Campus
The Rehabilitation Hospital
Rehabilitation
Geriatrics
The Rehabilitation Hospital
A Central rehabilitation hospital in Israel400 beds, 14 buildings.
Comprehensive rehabilitation including:orthopedic, neurological, respiratory, psychiatric,geriatric, trauma and MS rehabilitation.Utilize High-Tech and Low-tech technologies as well as social support to supply an integrated care to its patients
Eyal Zimlichman MD, MSc Sheba Medical Center
Quality and safetyThe Strategy
Sheba Medical Center considers quality and safety as a priority.
Achieving quality is accomplished through standardization of care, implementation
guidelines and protocols to reduce variance, continuous measurement and feedback, constant drive to improve outcomes with minimal patient
harm, and promoting staff education for high quality care.
Eyal Zimlichman MD, MSc Sheba Medical Center
MSR – The Israeli VisionNational resource for comprehensive inter-
disciplinary, multimodality medical simulation center dedicated to:
Patient safety and quality careHands-on training Readiness to clinical practicePerformance assessment
Cultural Change Vehicle
Eyal Zimlichman MD, MSc Sheba Medical Center
MSR - Virtual Medical Environment
• Broad-spectrum simulation modalities Simulated patients / Hybrids High-tech simulators Task trainers / Skills lab
• Clinical environments Home, Field, ER, OR, clinic Customized - EMR
• Debriefing capabilities One-way mirrors Digital A-V equipment Debriefing software
• Multidisciplinary staffEyal Zimlichman MD, MSc Sheba Medical Center
Simulation Modalities
Eyal Zimlichman MD, MSc Sheba Medical Center
IT in Sheba
EnterpriseData
Warehouse
Vital Signs Systems
EMR & CPOE Chameleon-Elad
groupMetavision-
iMDsoft
Laboratory - AutoLIMS
Imaging- Pacs, Carestream, C-
Pacs
Medical Admin. Logistics
HR
Finance-TMR, Gomla Ltd.
Supply Systems
Information exchange-dbMotion
Eyal Zimlichman MD, MSc Sheba Medical Center
Sheba’s EMR
Inpatient
Critical Care
Outpatient
Emergency Rooms
One ComprehensiveSystem
14 Years of EMR Experience
Eyal Zimlichman MD, MSc Sheba Medical Center
Eyal Zimlichman MD, MSc Sheba Medical Center
Computerized Departments
Inpatient Departments Surgery, Internal, Critical Care, Gynecology, Neonatal, Maternity, Psychiatry,Geriatrics, Rehabilitation Diagnostic ImagingRadiology, Cardiology, Nuclear MedicineLaboratoriesPathology, Microbiology, Chemistry, Hematology, Genetics, Reproduction ……… OncologyOutpatients, Chemo, RadiotherapyEmergency Rooms
Outpatient Departments
Eyal Zimlichman MD, MSc Sheba Medical Center
SmartDoc
Smartphone Applications for Physicians
Eyal Zimlichman MD, MSc Sheba Medical Center
Patient Portal: Sheba Yashir
Patient Internet Environment Private Area Communicator Tool Personal Documents
Lab ResultsImaging ResultsDischarge PapersOutpatient Visit Papers
Ask the Doc Conferences and Special Events Medical Articles Patient Empowerment
Eyal Zimlichman MD, MSc Sheba Medical Center
A Computer for Every Patient
Empowerment Opinions and Surveys Personal Medical Documents
(Sheba Yashir) Entertainment
InternetIPTVVOD
Communication ToolFamilyFriendsStaff
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IT solution to address hand hygiene compliance through
patient empowerment
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CLINICAL STANDARDIZATION
Clinical care
pathways
Guidelines
Checklists
Risk assessment
Decision support
Clinical Standardization Through Information Technology
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Preventing Adverse Drug Events
David W. Bates
Eyal Zimlichman MD, MSc Sheba Medical Center
Medication Decision Support
CurrentlyDrug-Drug InteractionsDrug-Allergy Alerts Drug Dosage AlertsDrug- Blood Tests (renal function) Duplicate Therapy
In developmentRight Drug in the Right DepartmentContinuous monitoringAdaptable algorithms
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- Big data- NLP- Machine
learning
Our BI System:CHESS (Clinical Health Economy and Satisfaction Simulator)
EMR
Lab
ADT
PACS
CPOE
IRB
HR
Financial
Academic
Safety/RM
Infec. Dis. Training
DATA WAREHOUSEData analytics
Case-mix adjustment
CHESS measures
SQL data
Dashboard presented on an
organizational web portal (Microsoft
office SharePoint)
Overall – 86 quality indicators:
43 – clinical perspective18 – financial perspective11 – patient perspective9 – Crew resource and
academic perspective5 – Case-mix measures
Dashboard
Balanced Score Card Approach
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CHESSBI Dashboard
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CHESS
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Patient Reported Outcomes Program at Sheba Medical Center
a. Developing and implementing a patient reported outcomes system that would collect, analyze and report patient reports concerning health status.
b. Personal and aggregate reports are fed back to both the electronic medical record as well as to the patient portal.
c. This project is being conducted together with Clalit Health Services, Israel's largest HMO.
Eyal Zimlichman MD, MSc Sheba Medical Center
Patient Reported Outcomes Program: Tablet Patient Interface
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Patient Reported Outcomes Program: Smartphone Patient Interface
Patient Reported Outcomes Program: Patient Report
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PROs CollaborationsPatient Reported Outcomes Measures Collaborative• Cleveland Clinic
(Cleveland, OH)• Partners Healthcare
System (Boston, MA)• Allina Health
(Minneapolis, MN)• Sheba Medical Center
(Israel)• Dartmouth-Hitchcock
Medical Center• St. Antonius, NL• Radboud Medical
Center, NL
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Thank you
Eyal Zimlichman MD, [email protected]
ov.ilDeputy General Director
Chief Quality OfficerSheba Medical Center