Published: 2015-03-16

Cambio COSMIC is to be implemented in a carefully prepared ”Big Bang”

At 03:00 on March 18, a carefully prepared “Big Bang” will take place in Region Jämtland Härjedalen. At this time, Cambio COSMIC R8.0 will be implemented throughout the region’s healthcare facilities The change will affect approximately 2500 users, a hospital and nearly 30 health centres.

– By moving over to Cambio COSMIC, we gain access to a modern and technologically sturdy IT solution that effectively supports work processes in healthcare, says Marit Nilsson, IT Manager at Region Jämtland Härjedalen.

The region has chosen to carry out a single implementation instead of gradually introducing Cambio COSMIC to the organisation – hence the name “Big Bang”.

– We believe that recording information in two parallel systems would involve a lot of extra work and hassle. Therefore, all activities will cross over to Cambio COSMIC at the same time, explains Marit Nilsson.
It is not a coincidence that Cambio COSMIC is to be implemented at 03:00. The time has been chosen to facilitate the transition.
In practice, this means that the emergency, ICU, surgical and main wards at Östersund Hospital will be the first to log into the system, followed by the clinics and health centres, who will access the system in the morning when business starts for the day, explains Marit Nilsson.

Detailed planning
The transition constitutes a major change and there are many pieces that need to slot into the right place at the right time. This is probably the first time in Sweden that a whole healthcare information system has been replaced in a “Big Bang”, but Marit Nilsson is feeling relaxed.
– Work has been ongoing since autumn 2013, and everything is planned down to the smallest detail. We have received very good support from Cambio throughout the process, including the implementation of a live pilot at the child and adolescent medical clinic in May 2014, she says.
Kristina Edman, Cambio’s project leader at Region Jämtland Härjedalen, is also full of confidence.
– I feel that the organisation is well prepared and that the staff are ready and waiting in their starting blocks. Representatives from Cambio are in place, as are staff from the IT-operations provider, she says.

250 superusers
Along the way, 250 superusers have been trained in the new IT system, including doctors, nurses and many others. Superusers have subsequently trained their respective colleagues in the workplace. In every healthcare unit there are also interdisciplinary implementation groups. It is the responsibility of the business manager within the unit to ensure that Cambio COSMIC is implemented in a way that is safe for patients. Marit Nilsson highlights that the healthcare staff did a great job. Without this engagement, the implementation phase would take considerably longer, she says.

Starting from a clean database
– The reason for the change is that our current IT system was becoming obsolete, having been introduced back in 2005. Modernisation work was started, but gradually we came to the conclusion that it was more advantageous to buy a whole new system. We also chose not to migrate data from the old system, but instead start with a clean database, explains Marit Nilsson.

A clean database means that data must be transferred manually during the patient’s first contact with the healthcare services after the transition to Cambio COSMIC. Amongst other things, this includes data on infection or disease that affects the care that can be provided.
Afterwards, a summary of past illnesses and lifestyle habits are recorded for each patient in the shared document “Basic information”.
– This is a measure introduced to reduce the current problems surrounding document duplication. Other data that is manually entered into the new system includes, for example, waiting lists and unanswered referrals, says Marit Nilsson.

High quality from the start
Various professional groups are involved in this work and additional personnel have also been deployed to help out. Some tasks can only be handled by a doctor, such as tasks involving the medicine list where obsolete medicine should be removed during the transition.
– Because we are starting from scratch, the quality of the information in the health information system will be high. This is a great advantage, highlights Marit Nilsson.
To begin with, the former IT support service will be available through a window on the computer screen or on a monitor next to it. Eventually it will be moved to the region’s e-archive, which will also be accessible via Cambio COSMIC.

Residents have been informed
Right now the very last preparations are being made before the transition to Cambio COSMIC. The region’s residents have also been informed that a new health information system will be introduced on March 18, and that this may result in reduced output and availability during the first few weeks.
Region Jämtland Härjedalen expect that it may take up to six months before everything falls into place and the new procedures are fully functional.
– But right now we are 100% focused on “The Big Bang”, and hope that the changeover goes as planned, says Marit Nilsson.

Quick facts about Cambio COSMIC R8.0
• Cambio COSMIC R8.0 is the next generation of healthcare information system Cambio COSMIC.
• Cambio COSMIC R8.0 is based on a modernised technology platform. It features a wide range of practical improvements such as more filter functions, a new printing system and device overview.
• The new version also includes enhanced support for referral management. The new referral module, Cambio COSMIC Referral, makes it easier to follow the referral as well as exchange and add information throughout the healthcare process. Support is also provided for managing electronic referrals with other healthcare providers in Sweden.

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