Siemens unveils intelligent IT to integrate all aspects of patient care

Siemens Medical has introduced Soarian, a Web-enabled software-based product that connects discrete databases, including medical images, patient records, and billing, to the daily processes of caring for patients. This all-in-one product, which debuted Oct. 23, orchestrates all aspects of medical workflow, addressing administrative, diagnostic, clinical, and financial matters individually and holistically.

Each component is a compilation of best practices, compressed into algorithms that streamline and interconnect day-to-day tasks throughout the healthcare enterprise. Operators are guided by a “smart” user interface (UI) programmed to anticipate the needs and processes of individual users.

The interface was modeled on the syngo operating system, which has been a part of Siemens imaging equipment for the past two years. The UI allows navigation across clinical, financial, and administrative information that affects specific patients. These data are presented on a single screen, allowing operators to check a patient’s medical history, display medical images, track patient care status, and issue orders for the next step to be taken. Soarian assembles these steps into work lists that enable staff to sequence and prioritize patient care while communicating among themselves.

Soarian may be the IT equivalent of computer-assisted healthcare. Its embedded analytics personalize all phases of medical practice and administration, tracking a patient’s progress and proposing appropriate actions based on guidelines that conform to healthcare best practices.

“Embedded analytics make sure that tasks are executed in parallel, rather than the common serial form, which takes much longer,” said Dr. Wilfried Baldauf-Sobez, Siemens vice president of clinical systems. “These analytics serve as agents or tools that ensure nothing falls through the cracks.”

The execution of tasks from patient admission to discharge is organized according to “best industry practices,” Baldauf-Sobez said. If they are not completed in a timely manner, Soarian issues an alert to the user. If the problem persists, Soarian contacts the next level of management.

“This provides an excellent opportunity to the user to make the work environment effective,” he said. “It is also an excellent tool for communicating tasks within a large team environment, which is today relatively fragmented among nurses, physicians, clerks, and referring physicians.”

Before making final decisions, staff can navigate through Soarian databases to the required level of detail. Graphic field descriptions, drop-down boxes, and icons simplify the discovery process. These capabilities extend through clinical processes as well as administrative and financial procedures. In the financial area, the patient record is expanded to encompass billing processes, including eligibility, claims, and reimbursement.

Embedded analytics even monitor Soarian itself, measuring the system’s effectiveness and generating reports that can be used to improve and enhance operation.

PACS is a major component of the new product. The transition of PACS to Soarian was made easier by the incorporation of syngo. The Web is a native part of the product, allowing ease of use and simplifying the implementation process, Baldauf-Sobez said.

The goal is to synchronize the numerous processes that occur across the healthcare enterprise. Access to the data is distributed to every department a patient comes into contact with. Rules governing administrative tasks, patient management, and payer-specific reimbursement are built into the system. Common master files, embedded in the system, serve as centralized repositories of information describing all the changes that occur in each patient’s case.

“The current hospital environment often manages 30 to 40 different applications (when providing healthcare). It is a full-time task for several employees to keep this up to date,” Baldauf-Sobez said. “Soarian can make all this more manageable and significantly improve productivity.”

Siemens executives believe Soarian can attain these goals based on clinical experience at four beta sites where the processes and capabilities of the system have been validated. These facilities are Carilion Health System in Roanoke, VA, and three sites in Pennsylvania: Susquehanna Health System in Williamsport, Universal Health Services in King of Prussia, and Chester County Hospital in West Chester. None of these sites, nor any other, has implemented Soarian in its most advanced form, however. Siemens will begin delivering this latest software to the beta sites early next year. Five additional customers have contracted to implement Soarian when it becomes generally available, although that will not occur until the first quarter of 2003.

“To declare general availability, we need to have more than just the product,” Baldauf-Sobez said. “We need to have the processes in place; to have the quality assurance documentation. And all the downstream services need to fit the product to make a solution. That is what our beta sites here in the U.S. are for.”

FDA clearance will not be required for product marketing in the U.S., he said. The processes composing Soarian, however, have been certified by the International Organization for Standardization (ISO) and the system is compliant with the Health Insurance Portability and Accountability Act. It is configured to allow single-user sign-on with user authentication and information authorization. Passwords can be configured and access is audited.

Soarian can run on servers controlled by the institution or can operate remotely using hardware at Siemens Information Services Center.

Implementation at a site should take nine to 12 months, about half the time needed to install a conventional IT system, Baldauf-Sobez said. Soarian implementation typically involves networking hardware and software, training, and launching a project assessment program.

In the changeover to Soarian, facilities will have to preserve the data and files of existing IT systems. The conversion will be streamlined using tools and wizards, as well as the master file toolkit developed by Siemens. Staff familiar with Siemens medical equipment, such as its CT and MR scanners, will have less trouble adapting to the system, Baldauf-Sobez said, as they will probably be familiar with syngo.

Relatively little new hardware will be required because Soarian is designed to use a Web browser. Any computer-desktop or server-that can communicate with the Web is compatible with the new Siemens IT system. This was an essential requirement, considering that many of Siemens’ customers are large institutions with thousands of personal computers spread throughout the enterprise.

“Trying to install software on all those PCs would be very complicated, particularly since they are often used for other things,” he said. “We avoid this by using browser-enabled software.”