About the Hospice
”Hospice Casa Speranței” was founded in 1992 at Brașov and is a non-profit organization, which has introduced the palliative care concept in Romania.
HOSPICE is the greatest charity in the country that provides this kind of specialized services free of charge. The organization has two centres with integrated services, in Brașov and Bucharest, and mobile teams in Făgăraș and Zărnești for the care of old people with incurable diseases. HOSPICE developed complete services of palliative care, which are provided in daycare, outpatient centres and own hospitalization units for admission in patient homes and in partner hospitals as well. In all its 25 years of existence, HOSPICE comforted and brought hope for more than 20,000 children and adults suffering from incurable diseases.
”HOSPICE Casa Speranței” develops the palliative care at national and international levels through information and education programs dedicated to professionals, patients and the whole community, and also through the improvement of the relevant legislation.
The technical and human resources were not optimally used within the ”Hospice Casa Speranței” charity, for it was not possible to create in real time for all the employees an overall view to the disposition and availability of information about the patients, and especially at the management level of the organization. That caused delays in data processing both by the interdisciplinary team of the institution, and by the administrative personnel.
The existent software applications did not cover all activities, and thus some of them remained non-computerized. The traditional patient chart system was also outdated due to low speed data collection, reduced accessibility to data (the patient chart was limited to one location and thus, unavailable to any other persons that needed to check it simultaneously).
Therefore, the objective was the implementation of ATLAS MED medical integrated information system that allowed the medical and financial data collecting, storing and processing. It was intended to increase the information flow and the security of access to information, respectively of the medical act. The implemented system would have to supervise all activities conducted by clinical services offered by the charity, the track and evolution of the registered patient, the clinical examinations, procedures, prescribed medicine, consultations in the specialty ambulatory and the home/hospital care services, interventions performed by the team members, and all episodes of monitoring/counselling by phone.
In addition to the common hospital workflows, the implementation of a specific module for palliative care was also intended.
In 2014 the project by which ATLAS MED information system started to be used in specialty ambulatory, in wards for admission and patient chart completion, in pharmacies and outpatient care was initiated.
Concurrently, in collaboration with the Hospice’s employees, a module specific to palliative care started to be developed to provide the electronic recording of the entire registered patient’s medical file and having the following functionalities:
- New patient registration at first admission or in any moment of the treatment for the patients registered before the module implementation;
- Allocation of a unique file number;
- Completion of patient ID form including the following details: personal data, attendants and their contact information, first diagnosis at registration, other chronical diagnoses, the actual diagnosis, the date of registration, allergies, alerts, medical devices, family physician, treating physician, findings, insurance information, medical information, national programs, disability certificates;
- Each patient can be registered with the existing healthcare service within the medical institution where he is admitted (outpatient, inpatient, home care, day care, etc.), with the pending and past healthcare services; visualization of the medical documents resulting from each healthcare service;
- Accompanying documents related to the medical record: medical documents, identity documents, documents related to patient’s social status, documents issued by the medical institution, etc.;
- Recording of patient’s evaluation according to multiple criteria: patient’s history, clinical evaluation, social evaluation, mental evaluation, etc.
- Recording of patient’s expectations (approach to disorder, approach to prognosis, adherence to treatment, etc.);
- Recording of patient’s problems (physical, social, mental, emotional), of health remediation and intervention objectives; recordings are displayed in two sections: current health problems and the history of patient’s health problems.
- Recording of patient’s treatment plans;
- The option of patient removal of the records by completing the following details: the removal date, the reason of removal, the date and place of death where appropriate;
- The option of searching any information through the patient’s file;
- All recorded medical files can be found in a specific register, which can be filtered by various criteria (period, doctor, department, patient’s name, number, etc.);
- The information in the patient file can be printed and used for reporting medical and research activities.
In 2015, this module has been extended, gaining other features for accessing information on mobile devices, such as tablets, so that the Hospice interdisciplinary teams could remotely access and fill out the electronic records (from patient homes, medical offices, public hospitals, charity’s bedded units).
The electronic medical file has also been developed for the palliative care, intended both for family physicians in partnership with the Hospice, and for doctors training to get their palliative care certificate.
This contributed to the growth of the quality and accessibility of palliative care services, by the implementation and development of a comprehensive service management system using the information technology.
Charity activity is directed in three areas:
- Free palliative care services for the eligible patients (adults with oncological disorders and children with incurable diseases and a limited life expectancy) at the patients’ home, in bedded hospital units, in ambulatory or day care centres, provided in Brașov county and Bucharest, including medical assistance, social and psycho-emotional and spiritual support for the patients and their families, with the scope of improving the quality of their life.
- Palliative care educational programs for professionals (doctors, medical assistants, social assistants, psychologists, clergy men).
- Advocacy for the developing and organizational, legislative and financial integration of the palliative care services in the Romanian health system and in other countries in the region.
Since August 2014, due to the financial help of Vodafone Romania Charity, HOSPICE Casa Sperantei has moved up to a significant substantial learning and organizational development phase through the integration of information and mobile technologies in the management of all services offered to our patients.
A major step in that direction was to digitalize the files of the patients that we treat. As a provider specialized in palliative care services, we realized that all software on the market are divided by certain services (inpatient, outpatient or home care), and the challenge for us was to find a company willing to develop in partnership with our clinical team an information system specifically designed to meet our needs, that would integrate all services, focusing on our patients.
GAMA IT accepted the challenge and for couple of months had been working to design and implement the system, a process that involved dozens of professionals from both organizations, and a continuous adjustment of requirements as the process went ahead. Now, in post-implementation stage, we enjoy a good partnership and permanent technical support.
Since 2015, we have started to use the patient integrated e-file, and now we have over 5,900 patients in the system. When we initiated the digitalization process we wanted to get: an increased access to information for the healthcare professional teams (from our headquarters or on-the-spot, using our tablets) and a limited one for other members of our team (e.g., pharmacy, research, administrative-management); a wholistic supervision of the patient throughout all our care services (starting with his first visit and up to our services offered post mortem to the family of the deceased patient); the possibility for the team members from different locations (e.g., at patient homes and in bedded units) to equally be able to access the patient files; support in the management of our care services through various reports that support the decision-making process of the charity. Presently, all these benefits are a fact and, moreover, the program provides us useful information, which we never thought we could get about our services. The use of electronic files and ATLASmed reports has become basic tools in the improvement of the quality of the HOSPICE services.
We would like to take this opportunity to thank the entire GAMA IT team for their openness and all their support!”