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Workflow Roundup Three ways to

orkflow: We hear it now all the time, in almost every imaginable context. And as hospitals and physician practices continue to try and do more with less, workflow can easily transform itself into an all-pervasive, omnipotent bane of their existence. For if workflow is significantly impeded, it likely supersedes everything else, including implementing an electronic health record (EHR), meeting meaningful use and jumping through all the hoops required to be considered for incentive payments.

workflow. He knew the importance of putting in the extra time up front to give his readers a smoother, more efficient experience down the line.

“The dignity of movement of an iceberg is due to only one- eighth of it being above water,” Hemingway famously said. The above-the-surface part of the iceberg, for our pur- poses, is the front-of-the-house aspect of workflow – readily apparent to patients, while most of what’s really important takes place behind the scenes, below the surface. Here, we will examine three scenarios and their effects on productivity; specifically, how medical device integration, mo- bile technology and virtual card payments impact workflow.

1. Restore clinical efficiency with MDI

Mary Carr is CNO of iSirona. For more on iSirona: www.rsleads. com/210ht-217

How can hospitals resuscitate clinical efficiency after an EMR change? Consider medical device integration (MDI), which automates device data collection by sending patient data directly to the EMR – reducing clinician documentation duties. “The clinical improvements promised to the hospital that becomes a ‘meaning- ful’ user of EMRs are great: better patient outcomes, increased efficiency,” says Mary Carr, chief nursing officer of iSirona, which specializes in medical device connectivity. “But the truth is that implementing an EMR

represents an enormous change in clinical workflow. And this change can hurt … a lot.”

Carr cites a recent UC Davis study, which estimates that EMR implementations result in an initial reduction in pro- ductivity of 25-33 percent. “Naturally, productivity inches back up through clinician training and adjustment,” she says.

6 October 2012

increase productivity W

By Phil Colpas The great American writer Ernest Hemingway understood

“Still, the change hits the hospital’s bottom line awfully hard.” Field studies indicate that MDI not only alleviates the initial negative impact of implementing an EMR, it takes clini- cian efficiency to levels surpassing those experienced before the implementation. According to MindGent Service Center, which specializes in business workflow solutions, MDI can save a 150-bed hospital more than 2,000 nursing hours a year. Another study projects a reduction in charting time up to 50 percent for support staff and 20 percent for physicians. “These improvements in clinical efficiency through MDI keep clinicians happy; the less frustrated the caregivers in your facility, the less likely they are to leave,” Carr says. “Perhaps more important, though, is what clinicians consistently do with the hours that MDI frees up: deliver direct care.”

2. Assess mobile technology’s changing impact In today’s high-tech age, medical apps and mobile devices have become almost ubiquitous. But an extended array of choices also means more diligence is required during the selection process. “A word of caution is advised when embracing the influx of apps and medi- cal devices,” warns Robert Hitchcock, M.D., FACEP, vice president and CMIO of T-System, which produces emergency- department solutions to facilitate better patient care, boost workflow and maximize revenue. “We must use them for what they are intended – augmenting care, not replac-

Robert Hitchcock, M.D., FACEP, is VP and CMIO of T-System. For more on T-System: www.rsleads. com/210ht-218

ing clinical judgment.”

There is no doubt that the right mobile tool in the right situation can increase quality of care and change outcomes for the better. But the novelty of first impressions often diminishes with time.

“Once the euphoria fades, step back and take into account workflow implications, balancing the usefulness and produc- tivity impact,” Hitchcock says. “The tools can be designed to help solve complex problems, but should not supplant good, solid clinical training and decision making.” Hitchcock suggests questioning the methodology and information the app uses to arrive at a conclusion, estimating the ramp time necessary for adjusting to your new workflow and inquiring if your hospital has proper mobile security


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