clinicians doing the care? That’s what all of our jobs are—to make that process as good, safe, and effective as it can possibly be. How do we lower the technology barrier between us and our patients? How do we fit into workflow?
In the old days, back before HIPAA, we used to literally hang charts in the patient room at the end of the bed. We’d come in, we’d do our work, we’d chart, we’d leave. We were caught up. Now what we do, because stopping and logging onto technology slows our workflow…instead of work, chart, work, chart, work, chart, we do work, work, work, chart. How much of that charting is coming out of memory? And not only that, that means the information is not in the records for the other clinicians—your physical therapy, your physician, your pharmacist. Somebody else might need that information, but it’s not where it needs to be, because it’s still in your head.
Q: What are some of the technologies that are being rolled out that are really improving patient healthcare and breaking down the barriers between the caregivers and patients?
A: One of the things that I’ve seen that’s most effective is technology that morphs—for example, the combination of a computer on a cart with a tablet. The tablet is actually the CPU for the cart, but can also be put into a bedside docking station with a keyboard and a mouse and a big screen. It can be used as a desktop.
These kinds of technologies that do different things, based on the needs of the workflow and based on the needs of the individual clinicians.
Q: What are your top two or three recommendations for healthcare organizations (large and small) that are developing an IT strategic plan to address these new requirements?
A: First of all, we need a clear understanding of our goals. Have some measurable data to show if we accomplished our goal. We also have to make sure that we’ve thought about things like education. Not only the “go live” education: Okay, we’re bringing in this new EMR package. We’re going to send everyone through X amount of training. Okay, training’s done. No, it’s not. We need to plan for remedial training, we need to plan to train all new people that hire into the organization.
We’ve got to have maintenance. I’ve seen some horrific examples of, “we bought the technology, we threw it out there, and then we never looked at it again.” There needs to be a good strategic plan. Is point of care documentation our goal? Then what do we need to accomplish that? And we can’t do a one size fits all. We can’t just say, “put a computer in every room.” That may work wonderfully in some areas and be horrible in others. We can’t just say, “give them a cart, or give them a tablet, or give them this.”
It needs to be a flexible solution that can last at least the life of the product.
Q: Having a strategic plan for the healthcare environment, how often should that be tested or reevaluated?
A: That’s something that needs to be looked at by each organization based on what their strategic plan is. There are two things that tend not to happen in healthcare—we tend to throw out a solution and we really never go back and optimize it. We really need to sit down and schedule, as part of our strategic plan, an optimization point— usually somewhere between three to six months after implementation. And then we need to look at it again in a year or two years, anytime there are some major regulation changes.
That’s the problem in healthcare right now. There are so many changes coming along in what’s required that we’ve really got to continue to look at our operations and say, with what we have right now… applications, hardware, security…are we still meeting all the regulations from the government, the requirements from joint commission? We need to make sure that we have not only testing plans to test that, but we need to make sure we’ve also got contingency plans for downtime, planned and emergency downtime. When all of our data lives on a server, what are we going to do if something happens? We really have to have a plan.
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