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Mother & Child Care

The synchronized system for obstetrical care

By Philips, The Medical Center Leeuwarden ∙ 2017 ∙ 5 min read

Patient monitoring

Women's and maternal health

The Medical Center Leeuwarden (MCL) made the strategic decision to replace its outdated electronic medical record with the Epic EMR. When the hospital implemented a new EMR system, they chose to add IntelliSpace Perinatal (ISP) from Philips, their long-time patient monitoring partner, which could interface with the EMR.

 

ISP is used to monitor obstetrics patients throughout the hospital because of its interoperability, adaptability and coverage of the obstetrical care continuum. As a result, the clinical staff at MCL say the Epic/IntelliSpace Perinatal connection has enhanced the quality of care for patients in labor by reducing the potential for errors from working in different patient files at the same time.

Case study at a glance

Partner

The Medical Center Leeuwarden (MCL) is one of the largest non-university teaching hospitals in the Netherlands. This modern, quality-driven hospital consistently receives high patient satisfaction ratings. The hospital’s Gynecology and Obstetrics Department delivers about 1,850 babies a year.

Challenge

When the hospital integrated a new Epic EMR, they looked for a perinatal information system, which could work with it.

Solution

The MCL chose the IntelliSpace Perinatal information system from their long-time patient monitoring partner Philips. It is used to monitor obstetrics patients throughout the hospital because of its interoperability, adaptability and coverage of the obstetrical care continuum.

Results

With a new, state-of-the-art EMR, clinical staff at the MCL Gynecology and Obstetrics Department say the EPIC/IntelliSpace Perinatal connection has enhanced patient care and staff confidence. It has fostered communication across the hospital, and is easy to maintain and operate.

Clinician looking at a screen showing medical measurement readings

A complex project

Creating a connection between Epic and IntelliSpace Perinatal was complex because it required supporting the flow of information across many locations of the hospital.

“Our staff felt quite anxious about making this change because our department has a high-risk factor. We are dealing with babies, families and mothers, and the impact of an error can be huge. It’s like an emergency department in that respect.” 

Arie Zomers

MCL, Manager Gynecology and Obstetrics Department

Arie Zomers, MCL Manager Gynecology and Obstetrics Departmen

Enhancing OB patient care 

Patient safety is the priority for all staff members on the maternity ward, especially when things become stressful. “Our work can be very chaotic with lots of surprises, so it’s important for us to have a perinatal monitoring system that we can blindly trust. We have to know that we are putting the right data from the right patient in the right file,” said Lida Flapper, MCL Clinical Manager of IntelliSpace Perinatal.

 

To provide a current and unified record for each patient, Epic and IntelliSpace Perinatal use context synchronization, which keeps the patient or user focus in sync between the two systems. When a user selects a patient in the Epic system, IntelliSpace Perinatal automatically also selects the same patient. Both applications can be accessed via the same workstation.

 

In the department’s previous perinatal system, staff might sometimes work in two different patient files at the same time, meaning they could inadvertently enter data from patient A into the folder of patient B.

“Now, because Epic and IntelliSpace Perinatal synchronize with each other live, we can click on a patient’s CTG in Epic, and IntelliSpace Perinatal follows so we know we are always working in the right file. IntelliSpace Perinatal also reduces our keystrokes when entering data. It only takes a few seconds for changes to be updated to either system, so we know we are always seeing the latest information.”

Lida Flapper

MCL Clinical Manager of IntelliSpace Perinatal

Lida Flapper, MCL Clinical Manager IntelliSpace Perinatal

Fostering communication across the hospital

IntelliSpace Perinatal allows staff members to monitor the status of all patients in labor at the hospital: in display screens in the maternity ward, intensive care, outpatient clinic and surgical recovery room. Flapper said she recently saw a child with a bad CTG on her IntelliSpace Perinatal screen in another room and could bring that to the attention of her colleagues in the outpatient clinic.

 

“IntelliSpace Perinatal is beneficial not only for the mother and child, but it also supports us as medical staff by alerting us to potentially dangerous situations. In our case, it fosters better communication between staff on the maternity ward and different hospital locations,” says Flapper.

 

The department’s obstetricians can log into the system from home and view everything in the application. This allows them to consult with a physician’s assistant who is on the ward. Flapper says, “This capability is extremely important for our process. A mother in labor is going through an extremely fragile process, and we want to do everything we can to make it go smoothly and to intervene immediately if the patient has an issue.”

“IntelliSpace Perinatal is beneficial not only for the mother and child, but it also supports us as medical staff by alerting us to potentially dangerous situations. In our case, it fosters better communication between staff on the maternity ward and different hospital locations.” 

Lida Flapper

MCL Clinical Manager of IntelliSpace Perinatal

Staff in in a room with the patient

Flexible planning

IntelliSpace Perinatal is designed to simplify maintenance and updates for IT departments. “If there is an update for an application, we can plan it in. That is important, because when we are doing an update, we switch to the emergency protocol and the nurses have to go back to pen and paper. Fortunately, we can do a lot remotely and we can first test an upgrade offline so we know exactly how long it will take and what issues we might have. That allows us to limit our downtime as much as possible,” said Thony van der Veen, MCL Technical Application Manager.

“IntelliSpace Perinatal is a stable product. Very little goes wrong. But if there is an issue, we received dedicated training and tools from Philips that help us quickly figure out where it’s going wrong. We can then usually resolve the issue ourselves.” 

Thony van der Veen

MCL Technical Application Manager

Staff in several locations can easily monitor the status and alarm indications for all patients

Excellent Teamwork

Many parties worked intensively to implement the connection between the IntelliSpace Perinatal system and Epic: the MCL applications, ICT and medical technology specialists, Philips distributor – GrafiMedics, Philips IT specialists and the Epic engineers. Colleagues from the MCL Medical Technical Department were involved from the start in the project and played a significant role in successfully implementing Philips hardware in the hospital infrastructure.

“Philips understands how the care process works in obstetrics departments, with the mother and child. That is an advantage. We received a lot of support from Philips and had a real lifeline with them when we were making the switch and that continues today. I trust Philips. They have sound expertise, and they are not hesitant to share their expertise with us.” 

Thony van der Veen

MCL Technical Application Manager

Case study

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Footnotes
 

[1] Lawton J. et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization. JACC. 2022;79(2):e21-e129.

[2] Gotberg M, et al. Instantaneous wave-free ratio compared with fractional flow reserve in PCI: A cost-minimization analysis. Int J Cardiol 2021 1;344:54-59.

[3] 2018 ESC/EACTS Guidelines on myocardial revascularization: The task force on myocardial revascularization of the European society of cardiology (ESC) and European association for cardio-thoracic surgery (EACTS). Eur Heart J. 2018;00:1-96. Japan guidelines

[4] Jeremias A et al. Blinded physiological assessment of residual ischemia after successful angiographic percutaneous coronary Intervention: The DEFINE PCI Study. JACC Cardiovasc Interv. 2019 Oct 28;12(20):1991-2001.

[5] Patel M., et al. 1-Year outcomes of blinded physiological assessment of residual ischemia after successful PCI. JACC Cardiol Interv. 2022;15(1):52-61.

[6] FDA 510k (#K173860). The iFR modality is intended to be used in conjunction with currently marketed Philips pressure wires. In the coronary anatomy, the iFR modality has a diagnostic cut-point of 0.89 which represents an ischemic threshold and can reliably guide revascularization decisions during diagnostic catheterization procedure.

[7] Gotberg M. et al. iFR-SWEDEHEART: Five-Year Outcomes of a Randomized Trial of iFR-Guided vs. FFR-Guided PCI. Late-breaking clinical Trial presentation at TCT on November 4, 2021.

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