Solutions Guide: Workflow

March 11, 2015
Secure Messaging
Trimming time and money
Hemant Goel, Chief Operating Officer,
Spok, Inc.

Treating patients with chronic conditions like diabetes is complex and requires large care teams, with members ranging from primary care physicians to nurses, endocrinologists, dieticians, physical therapists and social workers. As more people are added to a care team, treatment costs rise. In fact, the Robert Wood Johnson Foundation published in their 2010 Chronic Care report1 that 84 percent of all U.S. healthcare spending was for people with one or more chronic conditions – in other words, 50 percent of the population. But not all of this cost is because of human capital and medications. Costs also increase because of greater inefficiencies in the communications required to coordinate care among more and more individuals.

Researchers estimate2 that U.S. hospitals waste more than $12 billion annually from communication inefficiencies, or about $4 million per year for a 500-bed hospital. Of that amount, increased length of stay accounts for 53 percent. The researchers conclude that “information technologies … may help alleviate some of this burden.” Technology is available that can help hospitals cut this waste by reducing unnecessary wait time between points of contact for care providers.

In a recent study of physician communications from Spyglass Consulting Group3, 61 percent of physicians said they have a hard time accessing colleagues and specialists. And I’ve talked with a physician who spends over an hour each shift just trying to track people down. There’s a big opportunity here to make the coordination of patient care more efficient. Quick communication to share information and get answers to questions can reduce lengths of stay and improve patient outcomes, as well as positively impact hospital finances.

One way to do this is to give providers access to the hospital’s employee directory and on-call schedules through their mobile devices. Providers rely on mobile devices for much of their interaction with other care team members, and having a readily available, single source of information for contact and scheduling information is vital to efficient communications.

In the Spyglass study, 96 percent of physicians also reported using unsecured texting to support patient care. Standard texting relies on people already being in the contact list, doesn’t help providers identify who they need to talk to, doesn’t filter texts to identify the most critical messages and potentially violates federal privacy laws.

Giving clinicians an easy-to-use, secure texting solution that can pull up-to-date on-call schedules and contact information gives hospital staff a valuable communication tool to trim unnecessary time from treatment planning, speed the delivery of patient care and help save money.

References
  1. www.rwjf.org/content/dam/farm/reports/reports/2010/rwjf54583
  2. Agarwal, R., Sands, D.Z., Schneider, J.D. (2010). Quantifying the economic impact of communication inefficiencies in U.S. hospitals. Journal of Healthcare Management, 55(4), 265-82.
  3. Spyglass Consulting Group. (November 2014). Healthcare without Bounds: Point of Care Communications for Physicians.
Analysis
Three tips for conducting comprehensive workflow efficiency assessments

By Becky Quammen, CEO, Quammen Health Care Consultants

Communication is an essential element in clinical workflow and one where habits die hard. Not surprisingly, when you try to automate routines in a medical practice, you’re likely to draw the ire of physicians. In fact, attempts to convince physicians that care is enhanced and workflow is improved when verbal communication is replaced with the latest technology, software or device is a daunting and humbling endeavor.

However, the task is worth the trouble, as these tools can improve workflow considerably. Here are a few tips that can enhance the journey:

  1. Really observe the workflow. It is important to capture the subtleties of communication among physicians and other medical staff members through observation that zeros in on the innate rhythm and critical sensitivities associated with work processes. A physician who performs an exam and then walks out of the room with verbal orders to the care team (“Stop this medication, add this medication, order this test …”) is leveraging the human processes that have surrounded care delivery for decades. Careful observation of these processes over days, not hours, is needed to capture the nuances that not only support the workflow but render it effective.
  2. Let peers observe peers. Nobody understands physicians like physicians. Indeed, nothing trumps first-hand knowledge to gain respect, credibility and effective adoption of technology. As such, whenever possible, physicians should be intimately involved in workflow process mapping to ensure that physician needs are adequately met. “Each member of the patient care team is an expert at mapping out their workflow process in the new EMR system,” says Pratip Kumar Nag, M.D., Ph.D., Pediatrics, Katherine Shaw Bethea Hospital, Dixon, IL. “Adoption of a new EMR system by physicians is always more credible, effective and seamless due to peer involvement in the development and implementation phases.”
  3. Acknowledge the art and science of medicine. Process flow diagrams, however elaborate and detailed, are not the complete answer. While there is much to be gained through such standardization of processes, the practice of medicine relies heavily on gut and instinct as well. Always ensure workflow analysis captures the “artful” nuances.
Records and Messaging Synthesis
Secure texting integrated with EHRs
TigerText recently announced integrations with major electronic health record (EHR) platforms including Cerner and PointClickCare, markedly increasing the number of organizations that can extend their records platform capabilities beyond the desktop by securely sharing patient information from the EHR to smartphones and tablets.

One recent adopter is Waterbury Hospital, a 357-bed facility in Connecticut with nearly 15,000 inpatient visits a year and more than 2,000 employees. By integrating TigerText with their existing Cerner platform, Waterbury’s EHR users can now easily route notifications and patient alerts through TigerText, saving time and accelerating response times – all while maintaining HIPAA compliance.

“Our community physicians do not carry hospital-issued beepers, so we needed something more mobile and intuitive,” says Don MacMillan, Assistant Director of Information Systems at Waterbury Hospital. “We’re now able to instantly notify care teams of a request for consult, critical lab results, completion of imaging and other studies ordered stat, and vital sign thresholds indicative of a septic infection. With TigerText linked to our EHR, staff can better engage our community physicians and improve patient safety and throughput.”

TigerText encrypts EHR data including protected health information (PHI) and eliminates security risks. Additionally, TigerText accelerates communication between physicians and nurses by delivering instant alerts so care teams can coordinate and react to patient needs faster and more effectively.

Source: TigerText

Telemedicine
Optimize your telehealth approach
Critical access hospitals and rural communities looking for guidance in implementing telehealth services to improve outcomes and generate revenue can find answers in the new “Telehealth Start-Up and Resource Guide” available from HealthIT.gov. The 53-page downloadable resource, created by Telligen and the Great Plains Telehealth Resource and Assistance Center (gpTRAC), puts links to all the latest telemedicine studies at your fingertips and provides a treasure trove of valuable reference materials, including: policy considerations (licensing), step-by-step best practices, a product and services directory, funding opportunities, and toolkits and information for program initiation. Get the guide at healthit.gov/sites/default/files/
telehealthguide_final_0.pdf
.
Staffing
Top five 2015 workplace trends

Top five 2015 workplace trends

Members of The Workforce Institute at cloud solutions provider Kronos name the top issues they believe will impact the world of workforce management in 2015:

  1. Regulations shake up the workplace. With todays regulations administered not only at the national and state levels but down to the city, municipal and individualized union levels, new compliance requirements will shake up processes for organizations while adding another layer of complexity for national and multinational organizations.
  2. Employees are an asset. Employees – especially the front-line, hourly workforce – should be seen as an asset, not a cost. As competition tightens, successful organizations will invest more in their workforces to increase employee engagement and create a virtuous cycle that leads to happy customers.
  3. Seismic shift in generational workforce dynamics. Talent retention and career development will be key as organizations train new managers while working to simultaneously shrink the skills gap and hold onto the knowledge assets of a retiring baby-boomer workforce.
  4. Analytics for evidence-based decision making. Industry-specific solutions, visualization technology and new applications from specialized consultation and services vendors will utilize existing workforce management data to create actionable insight and deliver analytics for evidence-based decision making.
  5. Consumer technology infiltrates workforce management. Mobile devices and social media have transformed the way employees and employers communicate, while gamification and wearable technologies are expected to win in the workplace. For workforce management software suites, look for an increased focus on the user experience (UX), responsive design, flat OS functionality, and drag-and-drop and touchscreen performance.

Source: Kronos

Workflow Solutions
Integrated IT, EHR solution 
Paragon Community Plus is tailored to help community hospitals make a strategic shift from their current application to a modern, affordable solution that includes clinical, financial and document management capabilities. It combines the Microsoft-based Paragon EHR with implementation, remote hosting and post go-live services. The Paragon EHR features a single, fully normalized database for simplified data management and implementation services that leverage prebuilt content and recommended practices from similarly sized hospitals. Remote hosting services are included.McKesson
Cancer center chooses Omnicell Rx suite
Memorial Sloan Kettering Cancer Center (MSK) has selected Omnicell medication automation and analytics solutions to improve workflow and coordination of care between pharmacy and 2,000 nursing professionals and help increase drug storage capacity in all its locations. MSK’s choices include: OmniRx automated medication dispensing cabinets with integrated medication label printer, Anywhere RN remote medication management software (shown on the Savvy mobile medication cart) and the WorkflowRx server-based pharmacy inventory management software program. Omnicell
Wireless solutions available to Amerinet members
STANLEY Healthcare recently signed multi-year agreements with Amerinet to provide its members with access to a broad range of its solutions, including RTLS, Hugs Infant Protection and Bed-Check Fall Management. Amerinet collaborates with over 75,000 healthcare providers, including hospitals, surgery centers, long-term care facilities, clinics and doctor offices. The agreements cover all of STANLEY Healthcare’s AeroScout Real-Time Location System (RTLS) solutions, which have been chosen as KLAS Category Leader for RTLS for three consecutive years. STANLEY Healthcare
ClinicalKey gets valuable user updates

Incorporating extensive feedback from clinician users, the new enhanced version of ClinicalKeyfeatures intuitive topic pages, a design easily viewable on any mobile device and multi-layered search functions (including doctor search history in reverse chronological order). This point-of-care clinical resource provides both a general topic view and specific answers to help clinicians rapidly access evidence-based, peer-reviewed information for accurate diagnosis and treatment. Access to more than 2,900 drug monographs from Gold Standard is also provided. Elsevier

Extend your operational reach

TeleTracking Technologies has an array of new solutions that reach beyond hospital walls and into the cloud, including the Web-based Community Access Portal that allows community care teams to exchange information with hospital transfer/placement personnel; a link to health system-owned outpatient clinics, imaging centers and invasive ambulatory areas; an RTLS automated discharge system and a hand-hygiene monitoring system. The company also has updated its ServiceTracking application to be a real-time centralized request-and-tracking system with auto-dispatching. TeleTracking Technologies

A revolution in access control
Carstens’ new line of WALLAroo wall-mounted workstations includes powerfulISONAS access-control technology that allows an authorized user to open locked cabinets and access points throughout a facility with a single swipe card. WALLAroo workstations provide convenient, secure storage to help streamline daily activities, create workflow efficiencies and improve interaction. Using a patented PowerNet reader-controller, ISONAS offers network-based “Pure IP” technology that eliminates the need for a separate power supply, control panel and dedicated hard wiring. Carstens
Integrated hardware, software at the POC

The Metro AccessPoint Mobile Computing Workstation and the Metro AccessPoint Rx MD Mobile Medication System, the first solutions in the new Metro Access platform, provide advanced medication management, configurability and integration. The workstation, which meets Cornell University Healthcare Cart Ergonomic Standards, features a Li-Nano power supply and a universal laptop tech tray. The medication system interfaces with the HIS to promote secure medication management from the automated dispensing cabinet or pharmacy to the patient bedside. Metro

Control off-site physical records

Iron Mountain Inventory Governance builds inventory validation, retention and audit capabilities right into the normal physical records management chain-of-custody process. Data Validation ensures metadata is attached to newly created boxes sent to off-site storage. Data Integrity ensures metadata is attached to legacy information already in storage. Inventory Audit provides options for tracking and auditing inventory stored securely offsite using physical scanning or radio frequency identification (RFID). Iron Mountain

EHR-integrated Rx prior authorization

According to a Health Affairs report, physicians spend an average of eight hours each week to process prior authorizations. Surescripts and Epic are working together to improve the accuracy and efficiency of the prescribing process by offering Surescripts CompletEPA for medication prior authorization to Epic EHR users. Surescripts CompletEPA is a real-time electronic prior authorization (ePA) solution fully integrated into a physician’s EHR workflow that enables immediate information exchange between providers and pharmacy benefit managers (PBMs). Surescripts

Dashboard reports for audit management
AudaPro Dashboard Reports is a new module for HealthPort’s comprehensive audit management solution. This tool provides technology and workflows to help healthcare organizations streamline their government and health plan audit requests and appeals management tracking. Users get new and enhanced visual dashboards with drill-down and exporting capabilities for insight into the financial impact of audits on their bottom line. More than 80 detailed reports are offered to analyze financial impacts and begin root cause analysis.

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