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When civic leaders and county government officials decided to reopen a shuttered inner-city Los Angeles hospital, they rebuilt within the outer shell of the old building while opting for the highest tech health IT inside.
Smartbeds, teleneurology services and sophisticated wireless and wired networks were just a few of the advanced technology features built into the Martin Luther King, Jr. Community Hospital when it formally reopened in one of the city's poorest neighborhoods in November 2015.
"We had a blank slate. The only boundaries we had were time and money," Sajid Ahmed, CIO and chief innovation officer, said. "We didn't want to do a refresh. We had new people and a new infrastructure, and we took a look at how we were going to build a hospital for the future."
Old hospital defunct
The original Southeast General Hospital opened in South Los Angeles in 1972 after the Watts riots of the 1960s, and the county government determined that the poorest residents of the area were underserved by healthcare.
That 461-bed facility was shuttered in 2007, after losing its accreditation from the Joint Commission and its certification from the Centers for Medicare and Medicaid Services. This left the surrounding communities without local medical and surgical care and emergency services.
Enter the new MLK, Jr. hospital, funded with $70 million from the county and staffed by the University of California. It reopened in November 2015 as a nonprofit, much smaller hospital -- only 131 beds -- but with big dreams.
"It's probably one of the most sophisticated hospitals" technologically, said Brad Armstrong, senior partner and co-founder of Top Tier Consulting (T2C), a healthcare management consulting firm that helped guide the rebirth of the hospital and install its networks.
Sajid AhmedCIO and chief innovation officer, Martin Luther King, Jr. Community Hospital
Armstrong served as acting CIO as the original building was being gutted and retrofitted, before the hiring of Ahmed, a veteran of several telemedicine and health IT ventures, to lead a technology-centered approach to care typified by teleneurology and other telehealth services.
High-end network spine
T2C worked with medical leaders to install the kind of high-end hardware infrastructure usually found in bigger hospitals, including a Cisco network, VMware workstations and storage from EMC.
As for the smartbeds from Hill-Rom Holdings, Inc., which are equipped with fall-risk software and customizable alerts among other features, the hospital is still trying to understand how best to use them, Ahmed said.
For now, nurses manually enter into the EHR information from the beds such as patient movement and weight, but eventually hospital officials hope to have that information flow automatically from the beds to the EHR, Ahmed said.
Armstrong said an interesting facet of the rebirth is that the new hospital was designed from the start with an EHR system from Cerner Corp. that connects every department and is available on all clinicians' mobile devices.
By contrast, many older, existing healthcare systems have had to switch from paper to electronic health records, or have been forced to work with an unwieldy array of different EHRs and billing systems before ripping them out and replacing them with a new EHR.
Teleneurology helps cut costs
Another key point of emphasis was providing videoconferencing technology for teleneurology consults after hours and with practicing specialists in greater Los Angeles, which relieved the small hospital from having to spend too much on those expensive services. The hospital also offers inpatient radiology and neurology services.
Meanwhile, MLK, Jr. has invested in modern staff-based healthcare approaches such as care managers for all patients and full-time hospitalists and intensivists.
The hospital also is focused on population health management for patients with chronic pulmonary obstructive disease, diabetes type 2 and obesity, and it has plans for a remote patient monitoring system.
"We felt like we were being great stewards, getting the best equipment for people who hadn't been getting the best," Ahmed said.
Urban populations benefit from videoconferencing and telemedicine visits
Telestroke treatment, other telemedicine services displayed at conference