Spanish Hospital Boosts Access to Medical Data

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1 Customer Son Llatzer Hospital, Palma de Mallorca, Spain Industry: Healthcare The Son Llatzer Hospital The Son Llatzer Hospital, which opened in 2001, is pioneering healthcare services in Spain It is located in Palma de Mallorca (Balearic Islands) and serves 240,000 patients Part of the Balearic Island Health Service (Ib-Salut), the hospital is operated by the Health and Consumer Protection Office of the Balearic Island Government Network solution A Medical-Grade Network providing vital, real-time access to hospital records and patient data and images An Electronic Patient Record (ERP) system that stores records digitally, enabling medical staff to update patient and hospital information efficiently and cost effectively Wireless capability ensuring potentially life-saving network access is available from anywhere within Son Llatzer Hospital Business value 48-hour notice of appointments with specialist medical professionals A 10 per cent fall in missed hospital appointments 12,000 more people receiving medical care every year Better follow-up treatment from outlying healthcare centres Improved personalised patient care Greater patient monitoring More than 1,000 health and non-health professionals work at the hospital Business challenge Make Son Llatzer a worldwide model for healthcare services using industryleading Internet Protocol (IP)-based technology HAVING THE SUPPORT AND TECHNOLOGICAL ADVICE OF A COMPANY SUCH AS CISCO SYSTEMS IN A PROJECT OF THIS MAGNITUDE IS VERY SATISFYING FOR THE HOSPITAL. THANKS TO THIS ASSISTANCE WE CAN SAY THAT OUR EXPECTATIONS HAVE BEEN MET. WE HOPE TO CONTINUE WORKING WITH CISCO TO START NEW PROJECTS IN THE FUTURE. JOSÉ MARÍA CAMPUZANO, DIRECTOR, SON LLATZER HOSPITAL

2 The Son Llatzer Hospital, which opened in 2001, is managed by a foundation and forms part of the Balearic Island Health Service. With 323 beds and a 1,000-strong professional workforce, the hospital delivers healthcare to 240,000 patients. The hospital's trustees are adopting leading-edge technology as they realise greater accessibility to hospital and patient information means better healthcare and patient services. Son Llatzer, working with Cisco Systems, has implemented a world-class Cisco Medical- Grade Network, enabling all data and images (digital radiology, endoscopies and digital electrocardiagrams) to be stored in a single EPR. Furthermore, the network's wireless connectivity is allowing staff with Personal Digital Assistants (PDAs) and Tablet PCs to access hospital files anywhere on the Son Llatzer campus. The infrastructure's capabilities extend to 24*7 links with local primary care centres for sharing patient information, and with other hospitals for Telemedicine. There is also the ground-breaking ability to send Short Message Service (SMS) messages to remind patients of appointments and give them hospital information. Innovative Healthcare The new infrastructure is improving patient care and the personalised nature of Son Llatzer's health services - making staff seem more human and cordial. Indeed, the amount of time dedicated to patients and monitoring their progress is increasing thanks to the labour-saving move of switching clinical and administrative processes to the network. Having the support and technological advice of a company such as Cisco Systems in a project of this magnitude is very satisfying for the hospital. Thanks to this assistance we can say that our expectations have been met. We hope to continue working with Cisco to start new projects in the future, explains José María Campuzano, Director of Son Llatzer Hospital. The infrastructure at Son Llatzer has benefited from two new solutions: Cisco Medical- Grade Network Assessment and Cisco e-radiology. The Assessment is a three-part evaluation of the network's capacity and capabilities, carried out by Cisco and the hospital's Information Technology teams and clinicians. The solution is based on analysis of best practice in 12 of the world's leading hospitals, and leads to a network blueprint that will support whatever the future may hold for medical services. The e-radiology solution is a suite of offerings that includes Picture Archival Communication Systems (PACS), a very demanding filmless radiology application. It also includes other first-class applications enabling crucial, real-time diagnostics and prescriptions. The pioneering network at Son Llatzer has three key features: Universality Integration Accessibility

3 Universality The Hospital Information System (HIS) handles almost 98 per cent of the hospital's former paper-based processes. Its role is vital in managing the contents of the Electronic Clinical History (ECH) - the electronic library for patient documentation and images (digital radiology, endoscopy images, digital electrocardiograms) - giving doctors instant access to medical results. Integration The ERP manages a clinical portal which, through its control panel, enables medical staff to add notes to patients' files, consult laboratory analyses, order new examinations, consult patient release forecasts, edit medical reports for prescriptions, or view X-rays. All applications are based on international technology standards such as Health Level 7 (HL7) for data exchange between healthcare applications, and the Distributed Component Object Model (DCOM) which ensures reliable, secure, and efficient communication between software over a network. Accessibility It was essential that access to patient files be as widely available as possible to both medical staff and patients. Not only has the hospital deployed 700 computer terminals around the hospital, it has also built-in wireless connectivity allowing PDA and Tablet PC connections from bedsides and anywhere in the hospital. In addition, the network extends to 35 outlying primary care centres, providing them with waiting lists, test and laboratory results, and administrative information - raising the standard of medical service across the island. Boosting the level of personal services for patients and improving channels of communication with staff has been a priority. As a result, a mobile platform has been developed for SMS. The messages deliver: Real-time hospital statistics for the management team Clinical requests and results Appointment reminders for patients 48 hours in advance. The platform consists of servers for both voice and SMS. Its voice recognition technology can convert text to speech, and it offers web-based applications. System stability and robustness, as well as software simplicity were some of the basic principles and fundamental aspects that were pursued when developing the platform, notes José María Campuzano. Safety and Security is guaranteed A major factor in the network's design has been the guarantee that vital medical equipment will not be disrupted by wireless connectivity. Radio frequencies and electromagnetic fields could disastrously interfere with medical equipment, causing false diagnostics. Great care has been taken to meet the international standards for medical equipment protection: in the case of radio frequencies standard IEC and for electromagnetic fields standard IEC The Wi-Fi capability has also been extensively tested to meet the globally recognised b wireless standard.

4 An equally crucial design factor was data protection and security. All national and European legislation and guidelines governing data protection have been observed, and security devices such as passwords, automatic log-out, access, encryption, firewalls, back-ups have been built in. Cisco also created multiple security levels making use of Extensible Authentication Protocol (EAP) and the 802.1x standard. There are three levels of protection, each appropriate to security needs: VLAN 1 (highest) for devices (laptops, Tablet PCs and PDAs) that support EAP and allow access to all resources and applications at the hospital. They require EAP verification with a client and server certificate, as well as Wired Equivalent Privacy (WEP) encryption and session key VLAN 2 (intermediate) for devices not supporting EAP but which have very restricted access protocols and require 802.1x authentication by the Radius server when access is attempted using a static WEP key VLAN 3 (low) are patient and family member devices that do not have access to the network Missed appointments plummet Vast improvements in communications with patients have seen the number of missed appointments plummet by 10 per cent. Driven by features such as the link between Son Llatzer and the primary care centres, the huge windfall should mean that an additional 12,000 patients receive medical care each year. The greatly improved level of efficiency is leading to upgraded healthcare services overall. Medical staff from anywhere on the campus can make accurate decisions quickly through access to databases holding hospital and patient information. Technology to save more lives The huge benefits from the network are currently being consolidated and the hospital's Information Technology Department is already working towards extending the reach of its Telemedicine service. The hope is that through telemedicine more health services will be on offer and response times of its healthcare teams will be cut. To help raise healthcare throughout the Balearic Islands, staff at Son Llatzer are currently advising other hospitals, with the support of Cisco Systems, on how Medical-Grade Networks can revolutionise medical services.

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