The use of low-code cloud databases in the design and implementation of a new surgical delivery system in an urban setting

Ira Kirschenbaum ikirsch@bronxleb.org

Abstract

In March 2007, two things happened related to surgical delivery systems in the Bronx, NY. The first was that a new Chairman was hired and the second was that the Chairman paid his first $22 dollars to an online cloud database to run the development of a surgical system.

The challenges of any information technology system is to: (1) Supply critical business intelligence to support decision making for all levels of the delivery chain and (2) Track quality parameters for patient care. The combination of physician and non-physician leadership with the powerful information technology tools of a low-code cloud database allowed for the successful and sustainable development of a high quality orthopaedic surgical delivery system in the lowest congressional district in the nation. The system originally supported approximately 200 operations and 3,500 clinic visits and was able to grow to 2,000 operations and 40,000 clinic visits with commensurate increase in gross revenue to the health system sustainable through the present time. Development of do-it-yourself data systems were successfully developed in surgery scheduling, coding acquisition, in-hospital rounding management, ER and floor consult management, imaging and physical therapy services analysis, management of episodes of care for bundled payments, and a novel system of referral management. These systems were successful enough to spin off two of the applications as the basis stand-alone apps for public use.
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