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Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center

  • Systems-Level Quality Improvement
  • Published:
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Abstract

Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS. This new version involved fundamental software changes to enhance clinical care such as real-time importing of laboratory data and total hardware exchange. The pre-implementation phase involved coordinated preparation over six months between multiple informatics teams along with local leadership. During this time, we conducted component, integration, and validation testing to ensure correct data flow from medical devices to AIMS and centralized databases. The implementation phase occurred in September 2014 over three days and was successful. Over the next several months, during post-implementation phase, we addressed residual items like latency of the application. Important lessons learnt from the implementation included the utility of partnering early with executive leadership; ensuring end user acceptance of new clinical workflow; continuous testing of data flow; use of a staged rollout; and providing additional personnel throughout implementation. Implementation of an AIMS at an ASC can utilize methods developed for large hospitals. However, issues unique to an ASC such as limited number of support personnel and distinctive workflows must be considered.

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Acknowledgments

I would like to thank the following individuals for their critical review of this manuscript: Mr. Tom Foerster, Vice President, Picis; Dr. Edward R. Mariano, Associate Professor, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine; and Dr. Todd Wagner, Director, Health Economics Resource Center, Veterans Health Administration and Consulting Associate Professor, Stanford University School of Medicine. I would also like to thank the team members of the Veterans Health Administration’s (VHA) Clinical Information System/ Anesthesia Record Keeper Program and Picis for their hard work on this implementation effort.

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Authors and Affiliations

  1. Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue (112A), Palo Alto, CA, 94304, USA

    Seshadri C. Mudumbai

  2. Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA, 94305, USA

    Seshadri C. Mudumbai

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  1. Seshadri C. Mudumbai
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Correspondence to Seshadri C. Mudumbai.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Mudumbai, S.C. Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center. J Med Syst 40, 22 (2016). https://doi.org/10.1007/s10916-015-0390-4

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