On October 15th, 2008 the Clinical Record by BMA went live at the Flevoziekenhuis in Almere. Half a year later BMA went back to learn more about the experiences gained at the hospital, and to share these with our customers. At the Flevoziekenhuis, gynaecologist Marcel van Alphen and registered nurse Inge de Lange devoted much time and energy to the implementation of the Clinical Record. They are full of praise for BMA, albeit that they now know just how complex and intensive the implementation of such a system really is.

Conscious strive for paperless
Marcel van Alphen: ‘At this hospital we already had all Mosos modules, except Mosos <HomeMonitoring>. We also work with STAN and Monica. We really made a conscious choice for a paperless department, just like it has been a conscious choice to act as an early adopter of the Clinical Record by BMA. Apart from this, we used the implementation of the system to extend the paperless concept across the department, where we still worked with old CTG appliances using paper. We now have Mosos <PatientView> on large monitors, which is a world of difference.’ So it is possible to achieve the paperless workplace. Inge de Lange: ‘Well in advance and together with all the departments and wards involved we made an inventory of the paperwork we thought we could do without. October 15th, 2008 was D-Day for the department, the day paper went overboard. The little paper we still use at present is for communication with other departments, including the financial department. Within the own department we are entirely paperless, thanks also to the new COWS (Computers on Wheels) and a wireless network. The enormous advantage is that now you have immediate access to patient records at any location. Records can no longer disappear.’

Assign someone to support implementation
But even if the Clinical Record is operational, there’s always something that needs to be done. Marcel van Alphen: ‘In fact, the entire department will have to go through quite a process before each and everyone is ready to exclusively use the computer instead of paper. For instance, it is essential to make good arrangements about what is entered where. How do you make the best possible use of colours and keywords, and in such a way that nurses can filter the correct tasks from your message? Just writing down something in free text is not the proper way, because people may not read it.’ This essentially meant that the staff at the department had to formulate in detail the way data go on record. All final arrangements were laid down in a book by Inge de Lange, who is therefore in a good position to offer a golden tip to anyone contemplating the acquisition of the Clinical Record: ‘The best way to go about is to fully free someone from the work at the department, someone who really knows all the ins and outs of Mosos. For the preparation and the implementation itself, including the making of the right templates, I spent four days a week for five months on end. The post-implementation period also calls for attention and time, e.g. for refresher courses and new employees, and just to have things run smoothly. If a hospital does not assign someone to do these tasks, the implementation will fail.’ On the other hand, within a foreseeable period of time the Clinical Record will save both on manpower and material cost. Now that the department has been working with the Clinical Record it slowly starts to become clear where there is room for improvement. Marcel van Alphen: ‘As was said before, we have made a conscious choice to position ourselves at the forefront, including the inevitable growing pains. As far as I am concerned, I would like to see the integration of all Mosos packages to be taken even further, so that I only have to open the Clinical Record to see it all, including ultrasound images.’