In case you were wondering why my posting had dropped off, I was getting ready for the 12th Annual Healthcare Internet Conference and my vacation I'm taking after it.

The first day of the conference Community Health Network won the Greystone.Net Best In Class Innovator’s Award.  I was very surprised that we won this award.  In the past we have received the redesign and clinical content integration awards which we unfortunately didn't win this year.  When you're working on these projects from day to day, it can be hard to step back and see the innovation involved.

Community Health Network won based on our new mobile site, new find a physician application and the myCommunity card program.

Here is the text that was submitted:

We recently created a mobile site for eCommunity.com at http://mobile.ecommunity.com. The mobile site includes content and several applications that were redesigned for usability on a mobile interface, including Find a Doctor, Online Prescription Refill, Pregnancy Text Messaging program sign-up, health library, medication guide and facility contact information. Redesign considerations included the length of content pages to avoid scrolling and constraint of content to a narrow screen size. Small images were used sparingly to assist with page layout and download. Applications were also redesigned to require few date entry fields. 

Our most important consideration was (and is) "Does this content make sense in a mobile format?" For example, the mobile site could house the full-featured version of our Find a Doctor application, including the ability to compare physicians and request appointments, but we realized that a patient would likely not be doing that on a mobile phone. Instead, a patient is probably more apt to need to look up a doctor’s phone number, location, office hours, and so on. Moving forward, we will continue to keep users in mind during evaluation of the usefulness and presentation of various content types on our mobile site.

We created a new version of our Find a Doctor application. This application is an excellent marketing tool for physicians and health care organizations. Our application provides a service to patients and physicians by offering various search options, physician comparisons, and search engine optimization along with a Google maps mash-up.

myCommunity cards were issued to all current myCommunity members earlier this year and are issued to all new members from now on.  The card entitles the member to receive discounts at area retailers and will be used to identify myCommunity members who use it for express check-in at select locations within the network. The card also facilitates linking between patient data in the EMR and personal health record data (patient-created) to minimize the repeated completion of forms collected by various network entities.

http://mobile.ecommunity.com

http://www.ecommunity.com/physicians/

http://www.ecommunity.com/card/

When I was nearing the end of my third year as a medical student I spent a month in Kingman, Arizona for a rural family medicine rotation.This was “full spectrum” family medicine with more OB than most formal rotations. I liked the responsibility, had a call pager, would come in to the hospital at all hours of the night for deliveries. Usually beating my preceptors there. Disconcerting, sitting gowned and gloved in front of a crowning baby inching its way to the first cry. Once I made the mistake to ask the nurse if the attending had showed up yet. I was so nervous it would just be us in the delivery room. She went to check–then it was just me, mom, and and an imminent birthday party.

One of the scariest moments, however, was over before I could fully appreciate the seriousness of the situation. I was delivering yet another baby in the wee hours of the morning when awkwardly, the baby stopped in mid-delivery. The preceptor, usually sleepily coaching, sparked to life. In a flash he was angling and maneuvering the baby and the mother’s legs. The baby came out normally after that, it seemed to me. “That was shoulder dystocia!” he exclaimed in unfamiliar exasperation. The baby was positioned with the shoulder pinned behind the mother’s pubic bone and would not budge. Life threatening to mother and baby, knowing what to do in this situation is essential.

This and other nightmare scenarios were drilled into us for two days at The ALSO course for high risk obstetrics. As FM interns we have two months of OB and our continuity patients to care for as well so the training was much appreciated.

The lectures were presented at a fast pace at the beautiful Valle Vista country club, with its spacious lecture halls and home to an impressive golf course. While this was unexpected, the atmosphere was reminiscent of the floor (where the hospital transforms into a cozy, floral environment). Another pleasant surprise was that most of the FM residencies in Indianapolis and one from Terra Haute (with my AZCOM classmate as a new intern) all attended the training together. Everyone got along very well, especially over the lunch break. I haven't laughed so hard in a very long time - thanks to Chris, Anna, Katie, Laura, Rachel, Kelly, Adrian, and Amy. Not only did we get the firsthand experience of the Community attendings, but the attendings from the other programs as well. It was an impressive bunch.

Along with the lectures, we had numerous workshops including forceps training, vacuum extraction, post partum bleeding, shoulder dystocia (remember suprapubic pressure), and laceration repair training on real cow tongues!All of this increased my comfort level with OB, and I will definitely still keep the “phone book” handy. The culmination of the course is the “Mega delivery” where we apply everything we learned during one unfortunate scenario on a plastic mom and baby model. Everything that can go wrong does. Before the exam, the halls were filled with studious residents reviewing their notes.

I’m grateful for running through it all on models – it was stressful and tense situation where seconds count. The entire experience was so practical and helpful, if and when the real situations arise.

For all of you prospective Community FM interns, once certified, you will be eligible to train as a course instructor. The ALSO course is taught worldwide and provides much needed skills and information, especially for providers in developing countries.

Community Hospital South’s emergency room expansion project has been awarded LEED NC Gold Certification by the U.S. Green Building Council (USGBC). LEED is the USGBC’s leading rating system for designing and constructing the world’s greenest, most energy efficient and high performing buildings. Community Hospital South is the first hospital to receive gold certification in the state of Indiana.

The emergency room construction, which was completed in August of 2007, expanded the facility from 11,000 to 30,000 square feet, including  26 all-private patient rooms equipped with the most advanced emergency technology; trauma rooms for the most critical trauma needs; a comfortable waiting area; and an enclosed bay that can accommodate four ambulances. It was designed by Schmidt Associates to achieve LEED certification for energy use, lighting, water and material use.

What made the Community Hospital South emergency room project eligible for LEED certification? Here is a quick rundown:

• A heat recovery process using approximately 22 percent less energy than the baseline established by the American Society of Heating Refrigeration and Air-Conditioning Engineers (ASHRAE)
• Pollutant removal process for storm water
• Water-efficient landscaping
• Reduced water usage through automatic fixtures, low-flow lavatories and dual-flush toilets
• Refrigeration systems that use no ozone-depleting refrigerants
• Daylight harvesting, combined with use of dimmable compact fluorescent light bulbs and occupancy sensors
• Spaces and fixtures for collecting and storing recyclables
• Bike racks and nearby bus lines that create alternative transportation options
• Use of regionally produced construction materials, including brick, steel, glass, and hardwood veneers, to reduce cost and energy consumption associated with shipping
• More than 10% of construction products created from recycled and sustainable materials
• Recycling more than 50% of the construction waste

Visit our Web site to learn more about Community Hospital South's green initiatives.

Mitch Breeze, director of general support services at Community Hospital South, shared some photos he recently took of the construction on that campus. The expansion project, The Next Evolution of Community Hospital South, includes a new five-story, all-private room patient tower, expanded operating suites and convenient outpatient services for residents on the south side of Indianapolis and in Greenwood.

The first picture (left) was taken inside one of the concrete stair towers, looking up. There are three of these structures, all of which are part of the patient tower. With the stair towers complete, the steel frame of the building is now being installed between these structural elements.



In the next image, contractors are working on the formwork of the new 20,000-gallon underground water tank, which is part of the new chiller system that will serve the entire campus. The water tank is one example of the hospital's ongoing green initiatives, allowing the hospital to save and recycle thousands of gallons of treated water per year.

The last photo shows a crane moving some reinforcing bars (rebar) for use in the foundation walls of the patient tower.

In addition to the patient tower and utilities, work is also progressing on the hospital's new operating suites. The steel framework for that part of the project is complete, and contractors are now working on the interior layout.

For more photos of The Next Evolution of Community Hospital South, including renderings of the completed facility, visit our Web site.

The second annual Heartoberfest was held at The Indiana Heart Hospital on Saturday, October 11. The event attracted more than 200 guests to the lobby and across the front drive.

The Sleep/Wake Disorders Center at Community Hospital South is moving to an off-site location, effective October 27:

521 East County Line Road South, Suite G
Greenwood, Indiana 46143
317-887-7079
See a map

The new sleep center is approximately two miles east of Community Hospital South, in the Indiana American Office Park. It has all the technology and comforts of its former hospital location but will offer easier access for patients. Please make a note of the new south location if you have an appointment for a sleep study on or after October 27, 2008.

Not from the south side? Community Health Network has four more Sleep/Wake Disorders Center locations for patients who live in other parts of town.

To see if you might have a sleep disorder, take our online test at eCommunity.com/sleep.

When a maternity patient at Community Hospital North asked if her husband, a soldier in Iraq, could witness the birth of their child via Webcam, members of the IS department, concierge team and nursing staff pulled together to make it happen.

The videoconference was hosted by Freedom Calls Foundation, a non-profit organization that provides a satellite network to connect deployed troops in Iraq with their loved ones at home free of charge. In the week leading up to the mother’s delivery, members of the IS department worked with Freedom Calls to set up the connection.

“It was our first time working with Freedom Calls,” says Susan Dine, R.N., IT site director at Community Hospital North. “It required a lot of collaboration within IT, and we learned a lot of valuable lessons in bringing this experience to the patient.”

The setup included a bedside table with a laptop that had a Webcam on top. Both video and audio were transmitted, so the mother and father could see and talk to each other throughout the delivery. “I was in the room when the dad first came up on the screen,” says Dine. “There was a gasp, and then a lot of tears. It was very memorable for everyone involved.”

The nursing staff was instrumental in creating a meaningful experience for the father. Jeannie Amoroso, R.N., was present for the entire birthing process and controlled the position of the camera. “At delivery I made sure dad got a good shot at seeing the delivery as he wanted,” she says. “After delivery, I took the camera to the baby and showed him all the neat little things about his son.”

One week later, IT staff at Community Hospital South coordinated a Webcast so that Taunya Staley-Middleton could have her husband “by her side” during the birth of their second child. The baby’s father, James Middleton, is serving in Iraq as a MP with the 38th division of the Indiana National Guard. According to Desiree Tarter, patient concierge at Community Hospital South, “I was so impressed to see that everyone worked so well and so fast to make this happen for this family. It was very rewarding to come in later after the baby was born and see dad on the computer screen, smiling from ear to ear.”

Using Freedom Calls and other Webcast technologies, Community is able to provide an exceptional experience to families who are separated by 8,000 miles. Community North has a second Freedom Calls video conference scheduled for another expecting military family in November.

Construction of the Next Evolution of Community Hospital South is underway. The new facility, which includes a five story, all-private room patient tower, expanded operating suites and convenient outpatient services will create en exceptional experience for patients, families, physicians, nurses and employees. But did you know it's also being designed with the environment in mind?

“We are incorporating as much energy efficiency as possible and doing what we can to optimize indoor air quality,” says Mitchell Breeze, director of facilities at Community Hospital South.

Following environmentally friendly standards involves registering the project with the Green Guide for Health Care and the U.S. Environmental Protection Agency’s Energy Star program. A similar approach was taken with the recent expansion of the hospital’s emergency department, which received gold certification from the Leadership in Energy and Environmental Design (LEED) Green Building Rating System™.

According to Breeze, the guidelines for the Next Evolution project are difficult to achieve, particularly for a hospital building. “We’re building on the lessons learned from our last LEED project,” he says.

The list of goals for the environmental component of the project is lengthy. Among the items on the checklist:

• At least 75 percent of the equipment purchased will be EPA Energy Star or Enerlogic rated.
• At least 75 percent of the construction waste will be diverted away from landfills through recycling and reuse.
• Water consumption in the new facilities will be reduced through the use of low-flow and hands-free technology.
• Finishes and paints that are low in odorous or irritating contaminants will be selected to ensure the comfort and well-being of patients, families, employees—and those involved in the construction.
• Every effort will be made to keep sound disruptions to a minimum, throughout the construction and beyond.
• Native or adapted plants requiring little or no irrigation will be used for the outdoor landscaping.

Taking the extra steps to achieve Green Guide and Energy Star certification is a win-win for the environment and for the occupants of the new facilities. In particular, patients and visitors will benefit from the reductions in noise and air pollution, which will contribute to the healing environment.

Learn more about the Next Evolution of Community Hospital South at eCommunity.com/south.

Please visit the newest site designed by our team to support health care services provided by Community Health Network.

Indianapolis Endoscopy Center may now be found on the Web at www.indyendoscopy.com

The Indianapolis Endoscopy Center is a licensed surgery center dedicated to the diagnosis, treatment and follow-up of gastrointestinal disease. Founded in 1994, Indianapolis Endoscopy Center is committed to providing quality care to all patients.

Community Health Network, in partnership with Healthcare Performance Improvement (HPI) hosted the 2008 Safety Summit this week. The conference theme, Navigating toward Safer Outcomes, provided an opportunity for more than 250 health care leaders from around the country and the network to gather and discuss ways to advance the culture of safety. Speakers shared best practices and lessons learned at this two-day conference from their safety culture journeys.

“With the annual safety summit taking place right here in Indianapolis the network had the opportunity to send many leaders, safety coaches and others, who have been and continue to be instrumental in the culture of safety journey,” shared Trudy Hill, network safety officer.

“Topics included integrating human error science into process improvement methods; internal transparency; a system approach to culture transformation; giving new meaning to rapid response teams; and inspiring behaviors for a culture of safety.

“I know all those who attended are inspired to continue on this transformational journey with renewed urgency,” said Trudy. “I have been humbled by the commitment of all who participated and look forward to the continuing journey of the entire network.”

In accord with Community North Hospital’s desire to offer regular Pediatric Grand Rounds, another session is scheduled for November 5th, 2008.  Our next speaker is Chris Belcher MD, with Infectious Disease of Indiana.  Dr Belcher is a pediatric infectious disease specialist, who supports physicians in our area on childhood infectious disease matters.  He will be providing a lecture titled “Vaccination Update 2008”. 

Again, these sessions are provided monthly and are eligible for CME.  We will provide these offerings on the 1st Wednesday of each month at 7:30 am, in the multi-service conference rooms on the 3rd floor of the professional building.  Breakfast refreshments will be served.

If you have any questions about this, you can contact Dr Robert Lindeman at Community North’s pediatric unit 317-621-5474.

Last week Community Health Network hosted our annual Best In Class Showcase, featuring exceptional and innovative work being done across Community Health Network.

Representatives from all parts of the network gathered to share their latest ideas and best practices, hear operational updates and a motivational address from former local news anchor Anne Ryder. And they honored winners of the network’s first annual Leadership Excellence Awards.

Check out this episode of "Community News" for more.

There has been a lot of news recently about a national health record being able to display a patient record for the clinicians if someone appears in a hospital.

The example that is cited the most is someone appears unconscious at an emergency room at a hospital when they are out of town.  The system pulls up their medical records even though they haven't been there before.

This scenario depends on three factors occurring:

1. The patient is out of town.
2. The patient has an event that causes them to go to the emergency room.
3. The patient arrives unconscious and without family or without some sort of medical information on them.

While I’m sure this example does happen, it would not be the norm; it would be an aberration.  I would think that patients who have serious conditions like heart problems would take some medical information with them when they travel in case something happens.  Or at least they would be with family members who know what their medical issues are.  They would probably have their medications with them when they travel even if they don’t have them in the emergency room.

This scenario is very dramatic and compelling but would not occur often enough to justify the expense the time and effort to create these systems.  The scenario that should be targeted to improve would be the day to day flow of medical data in a health system.  Patients are asked to complete similar paperwork with similar pieces of data each time they visit a new location in a health care system, physician office, emergency room, surgery, etc.  Fixing this problem would save more expense and improve more patient care than the unconscious patient appearing in a out of town ER.

Community’s first eCycling event was a partnership involving the network’s green team, Computer Experts Inc., Keep Indianapolis Beautiful, Virtual Scavengers and 1-800-GOT-JUNK. A team of volunteers processed donations during the 10-hour event in the Community North parking lot.

The event sought old electronic products—such as used computers, VCRs, DVD players, cell phones and televisions. Disposing of such items through regular trash pickups is not considered safe, due to hazardous materials they may contain. Equally important, in many cases these used electronics still have some good life left in them.

Virtual Scavengers, for example, reconditions old PCs, printers and monitors—or disassembles them for parts—and helps provide low-income families with low-cost technology and training. Donated items that were determined to have no potential for reuse were taken away for safe disposal by partner 1-800-GOT-JUNK. The preliminary weight total of objects that were e-cycled at the September 5 e-Cycling event was 27,292 pounds.

“I want to tell you how wonderful the whole event was for us. You work with an incredible group of people. The volunteers worked long, hard hours with enthusiasm and humor. We were also deeply touched by the enthusiasm of your donors; they were obviously genuinely excited by the knowledge that their ‘babies’ were going to remain in use and benefit other families," says John Crooks, executive director of Virtual Scavengers.

To see a video of the day's events, click here.

Looking for something to add flavor -- and a little kick -- to your salads, sandwiches, and grilled chicken? Nilima Mondal, cook at Community Hospital East, shared her recipe for spicy tomato ginger chutney:

1 c + 2 T cider vinegar
1 c + 2 T sugar
¾ c red wine vinegar
¼ c fresh ginger root, peeled & minced
1 T whole mustard seed
2 tsp Kosher salt
¾ tsp black pepper
1 tsp crushed red pepper flakes
¼ tsp ground cloves
1 ½ pounds plum tomatoes, diced ½ inch
½ pound fresh red peppers (sweet), seeded & diced ½ inch

In a heavy bottom non-reactive pan over medium high heat, bring all ingredients except tomatoes and diced red peppers to a boil. Let boil 8 to 10 minutes. Add tomatoes and fresh red peppers. Bring back to a boil. Reduce heat. Simmer 45 minutes to 1 hour, stirring often until most of liquid is evaporated and sauce coats the back of a spoon. Cool. Store in refrigerator covered for up to 3 weeks. (Makes 2 cups)

The chutney is a nice complement to ham, turkey, grilled chicken, or grilled portobello mushrooms. To make a salad dressing, whisk some additional oil and vinegar into the finished chutney. Bon Appetit!

If you don't want to do the cooking yourself, you can enjoy Nilima's creations at the Community Hospital East cafeteria daily, 7 a.m. to 7 p.m.

Community Health Network will host a bike rodeo for kids ages 7 to 12.

Saturday, September 27
10 a.m. to noon
Community Hospital North

The rodeo will be held in the parking lot on the south side of the hospital campus, just east of Community Regional Cancer Center. Participants should bring their bicycle and a helmet, if they have one. The event will include a helmet fitting station to ensure riders are receiving maximum benefit from their safety gear. Kids will also have the chance to visit three skill stations that will teach them how to stay safe, while having fun, on their bike.

“We are offering this free event as a public service to our local community,” says Tom O’Daniel, bike patrol coordinator and field training officer. “Young cyclists are encouraged to join us, rain or shine.”

Quality indicator data for Q2 2008 has been posted at eCommunity.com/quality.

The data reflect Community's high quality patient care for indicators in three categories:

• Heart attack
• Congestive heart failure
• Pneumonia

Community's quality data are compared against national hospital averages and are provided for all network hospitals: Community Hospitals North, East, South and Anderson, and The Indiana Heart Hospital.

More information, including national averages for hospital quality data, can be found at http://www.hospitalcompare.hhs.gov