These can be confusing times for anyone who has invested in an electronic medical record (EMR) system. Several recent reports raise doubts about the return on investment (ROI) from EMRs. Most prominently, RAND admitted that its widely disseminated 2004 study, which helped to inspire the federal meaningful-use program, significantly overstated the projected ROI from national adoption of the technology.
Yet there’s little doubt EMRs are necessary. Digital patient records are table stakes for the mandated technology-driven makeover of healthcare. The question facing health systems today is not whether EMRs represent a good investment. Instead, the question is, “How can you maximize the value of that investment, which can represent the equivalent of a full year’s operating expense for some organizations?”
One answer: Give your EMR eyes and ears.
Despite their vast capabilities, EMRs lack the ability to orchestrate care via resource and context awareness. Real-time location system (RTLS) technology has the ability to “sense-enable” an EMR by tracking interactions between caregivers and patients, providing the location of equipment and other assets, identifying the causes of extended delays and automatically feeding this data into the EMR without manual intervention. By RTLS-enabling the EMR, organizations can truly maximize their EMR investment.
The analogy for this concept is GPS (global positioning system) technology. Just as GPS revealed a whole new landscape of possibilities when combined with computers and smartphones, hyper-accurate RTLS combined with EMRs and advanced analytics can transform clinical workflow. Using real-time locating technology and advanced business rules and clinical workflow engines, the latest RTLS systems are able not only to track but also interpret location, movement and interactions across departments to draw conclusions about the current state of patients, appropriate next steps and the personnel required to take those steps.
A good example is the optimization of patient flow. A large heart and vascular interventional radiology department in the Northeast (part of a 1,100-bed network) had struggled for years to uncover the cause of bottlenecks in patient flow. Milestones in patient care, such as physician site-marking or prep completion, were difficult to identify and rectify in a timely manner, and completion often went unnoticed by prep staff who had moved on to the next patient. Without a bird’s-eye view of all patients, rooms and personnel, floor managers had to solve bottlenecks on a one-off basis, wasting further time making phone calls or accessing the EMR to seek a solution.
Today, RTLS provides that bird’s-eye view via a dashboard and map that visualizes the location and status of radio frequency identification (RFID)-tagged patients, clinicians and rooms throughout the department in real time, and intelligently automates workflow to streamline communication, care coordination and patient throughput. For example, the system can:
- Automatically note milestones in care against patient-specific plans of care or procedure-based best practices, as they are achieved in real time;
- Automate physician and ancillary provider paging to accelerate the removal of common roadblocks and room turnover;
- Leverage predictive analytics to notify caregivers of potential bottlenecks, such as a patient prepping for an OR suite that lacks a history and physical or case cart; and
- Use smartphone, email or pager to notify staff of milestones, such as a room or bay that has been vacant for more than five minutes and requires cleaning.
RTLS-enabling your EMR also can eliminate all sorts of mundane documentation and efficiency roadblocks. The system can auto-assign an emergency department (ED) nurse to a patient if they spend more than 120 seconds in a room, and then sends a message to the ED information system. Or it could alert an anesthesiologist that a patient has just arrived in Bay 6 and is ready for evaluation, without the pre-op nurse having to call. RTLS can even log users onto the information technology network, merely by their proximity to the computing device.
Furthermore, an RTLS-enabled EMR can support your organization’s effort to meet clinical quality measures under health reform. Whether it’s ED throughput, the timeliness of acute myocardial infarction treatment, or how quickly prophylactic antibiotics are administered prior to surgery, RTLS can track activity in real time, queue the EMR and assist organizations with compliance and reporting of key value-based care metrics.
In conclusion, the RTLS-enabled EMR supports the orchestration of care within and across departments, facilitating the coordination of caregivers, assets and patients. Hospitals and health systems that want to make the most of their investment in an EMR may want to consider the synergistic effects of RTLS on caregiver efficiency and patient throughput, resulting in lower cost and improved patient satisfaction.
About the author
Jay Deady is president and chief executive officer of Awarepoint. For more on Awarepoint, click here.