Preparing for tomorrow’s challenges today, with automation
By Margaret Mayer, Boston Software Systems, August 2011
Automation technology gives hospitals the ability to streamline processes, reduce costs, increase accuracy and ensure the deliverability of data from one system to another.
Bombarded with requirements from many constituents, healthcare technology managers are becoming master jugglers. They are faced with implementing sweeping governmental mandates, constant financial pressures and technical innovations. While deadlines for new initiatives swirl around them, they need to maintain their organization's systems and processes, keeping them as efficient as possible with little or no increase in staffing. For these executives, business as usual is not an option.
Under pressure to connect systems for improved care and increased efficiency, hospitals are implementing automated workflow to achieve a wide variety of goals within the facility and as a means of sharing critical information with clinics, labs, insurers and others. From automating data entry to multi-step processes involving decision making, automation can make a huge difference.
Breaking down the process
The first stated standard for meaningful use is that 30 percent of all unique patients have at least one of the meds on their medication order be entered using computerized physician order entry (CPOE). Implementation of CPOE is often the first hurdle IT departments have to cross in satisfying meaningful use. Successful CPOE implementations include a great deal of personnel buy-in and training, including an understanding of the benefits of improved accuracy and accountability.
IT objectives must line up with those of the physicians and take into account the needs of the clinical staff. In order to more easily integrate the medication order system into existing operations, a floor-by-floor review of existing processes will help make the transition easier. In this review, many hospitals discover that workflow methodology for the same process differs from one department to another. The move to CPOE often necessitates the examination and improvement of the steps staff takes to achieve particular tasks.
It is by breaking down a process and understanding the exact way staff deals with information that automation can be most effective. Automation tools can reliably handle data by reading, writing and reacting to the data on a screen just as a human operator would. The primary advantages of automation over manual processes are increased speed and accuracy. Automation can also be an effective tool when upgrading or migrating systems.
Tactical application of automation
During the tactical planning of its CPOE implementation, Catholic Health East (CHE) needed to standardize procedure names in its MEDITECH system so physicians could use a pull-down menu to locate a procedure and send the instructions into the system. In addition, the team planned to amend each procedure with a prefix of the common category code to make it easier for physicians to find the procedure they wanted. Manually reformatting and accurately keying in thousands of categories would take weeks and severely delay the deadline. In addition, a concurrent upgrade of CHE's MEDITECH system meant that all data involved with the CPOE implementation had to occur in both versions of MEDITECH to maintain both environments.
CHE chose to automate this critical portion of its CPOE implementation using automation software. Donna Karver, manager of MEDITECH's financial and administrative applications, notes, "It's easy to take for granted the tactical steps involved in executing a major technology initiative which has the potential to change the way healthcare is administered. It makes sense to stop and think about how we can accomplish these projects more efficiently. Automation has played an indispensable tactical role in our larger strategic initiative."
Having successfully saved man-hours by automating this CPOE project, the CHE team is constantly looking for areas where automation can reduce time and provide accurate results. As part of the MEDITECH upgrade, the team needed to remove site codes on more than 5,000 procedures as part of a reconciliation process. Automating the task allowed staff to build 280 procedures in only two hours, and all of the procedures in about 35 hours.
Workflow automation is being used throughout hospital operations to relieve the bottlenecks encountered when implementing major new initiatives, or systems upgrades, or expediting the day-to-day business of the hospital. Wherever staff is manually keying in information from one application to another, automation tools can enter that data faster and more accurately, and allow staff to address more strategic demands that make a significant difference for the organization and