"We're a big factory," observed CIO Malcolm Thatcher.
Consequently, Mater has a serious IT agenda, topped by a move towards electronic health records (EHRs). "Everyone's heading for the nirvana of getting rid of the paper," said Thatcher.
However, he conceded that the hospital will never be completely paperless as scanning of all the old patient charts in the hospitals' archive could not be justified, largely because clinicians discount the value of data that's more than a year old.
Another issue is that it is still a legal requirement that some documents (eg, pathology requests) are on paper and signed by the doctor.
Continuity of care is an important consideration. Heath care tends to be episodic, involving visits to general practitioners, hospitals, rehabilitation services and other providers.
Information must flow freely for optimal care, but Thatcher points out that you can't have a national EHR if providers don't have their own EHRs. He suspects that Australia could be as much as a decade away from a national EHR.
Another goal is the integration of the various clinical systems in use at the hospitals. Thatcher explained that part of the problem is that "there's no ERP for health care," and consequently Mater needs to integrate information from a slew of individual 'best fit' applications that have been purchased or developed internally.
These and other goals are supported by a layered IT architecture comprising virtualised storage and servers, a Cisco medical-grade network (802.11a/g and Gigabit Ethernet), a data warehouse with analytics, around 240 applications, with Intersystems' Ensemble and CachÃ© as an integration layer between the applications and a series of portals that provide access to clinicians, patients, and outside providers.
According to Thatcher, Cisco is the only network vendor committed to the needs of the health sector.
Mater is using or trialling a wide variety of devices, including Panasonic Toughbook tablets designed specifically for the medical setting, netbooks, Cisco wireless phones and various other handheld devices, OCR pens, voice recognition (for dictation) and RFID tags on equipment and patient wristbands.
Despite Mater's huge efforts to advance the use of IT in the medical setting, its IT expenditure is approximately 2% of revenue - "that's about [the] industry norm," said Thatcher.
Projects set to go live in the coming months include the digital recording of labour and birth details using a touchscreen system to eliminate paper form the birthing suite; a patient data management system for newborns that will, for example, remind staff to check certain pathology results; a clinical information system for the neonatal intensive care unit allowing clinicians to remotely check the progress of premature babies; and an integrated nurse-call system.
Mater is one of the first Australian hospitals to appoint a chief medical information officer (CMIO), although the position is well established in the US where around one-third of hospitals and other health care facilities have a CMIO.
Paul Devenish-Meares has been associated with Mater for the bulk of his 38 years in medicine, most recently as director of obstetrics and gynaecology. He still works as a part-time obstetrics staff specialist in addition to his three-tenths appointment as CMIO.
Devenish-Meares noted Mater executives' commitment to the importance of IT, as well as the significance of the teamwork and collaboration between staff in the IT and clinical areas of the hospitals.
He also pointed out the importance of wireless communications in the hospital setting, due to the need for access at the point of care.
Stephen Withers travelled to the Cisco Networkers conference as a guest of the company.