A Workflow Makeover
By Rich Temple, VP/CIO, Deborah Heart and Lung Center
Possibly the biggest system upgrade a healthcare system can go through today involves changing the currently used Electronic Health Record (EHR) system to a newer, technologically-savvier one. In Deborah’s case, its EHR has been in use for nearly 20 years. Our EHR upgrade provides the opportunity to leverage legacy systems with innovative technologies that are better suited to the modern world. It is also an inventive method to get rid of years of workaround on older systems and introduce fresher, better ways to get work done. Incorporating new technology supports better workflow, which is one of the more comprehensive goals of any organization. Installing new systems is not just about the technological aspect, but fundamentally considering all functions involved right from the scheduling process, all the way to checking patients in through clinical documentation and billing and posting third-party payments. Essentially the data flow cascades into a massive pile; but retrieving data and forwarding the same to the right place, at the right time is vital. Further, accountability of mechanisms is being focused on and built into systems, so as to spot general inconsistencies or outliers.
The version of the hospital-based product we use, MEDITECH, was first rolled out in 1998 and comprised sets of individual modules ranging from clinical to financial to materials management and a number of others. In 2007, Deborah rolled out an EHR from Allscripts for its ambulatory clinic practices. With these two systems, challenges were experienced with lack of seamless integration points with the data flow, given that data was often fed and documented either from separate systems or documented duplicatively, which was intrinsically inefficient. This was the focal point around which the upgrade revolved; essentially processing more patients with a higher level of quality, while minimizing duplicate data entry and mitigating as many manual processes as possible. Being a small, independent hospital in New Jersey, it is our responsibility to remain competitive, viable and ahead of the game. Deborah has managed to score among the highest in the state, both in terms of overall quality as well as patient satisfaction. Even so, there are numerous factors we can improve on. One such factor is finding innovative ways to constructively engage with patients from the very beginning to the very end of their interaction with Deborah, even after their discharge. All these innovations would not have been possible without the blessing of technology! Note that technology in itself is not the panacea in this scenario, but merely the enabler to promote optimization of processes and experiences, so as to generate efficient workflow.
"Automating processes and aiming to make the overall workflow frictionless is the ultimate goal"
Identifying Right Partnerships
Deborah Heart and Lung Center belongs to a Health Information Exchange (HIE) which is a network of hospitals and other health care providers, a hub that provides access to sensitive patient information from many different care settings across New Jersey. When a patient first comes to Deborah, the HIE permits us to perform a query and pull in their clinical information. This facilitates a fuller set of data to use while diagnosing the patient. While this HIE allows us to get access to external information, the effort that goes into retrieving this information is often time-consuming. Furthermore, the data doesn’t always necessarily provide value; often it returns the same information that we previously sent in. In our upgraded EHR system, we have worked around these issues. Automating processes and aiming at making the overall workflow frictionless is the ultimate goal.
Artificial Intelligence is rumored to be one of the most popular disrupters in this arena, even though it is really currently in its infancy in healthcare. Voice-activated electronic documentation is yet another budding disrupter. There are a number of different technologies that are at the cusp of exploding; the “cloud” being a good example. Many organizations have started to realize the convenience and ROI of hosting data in the cloud, whilst having access to resources whenever and wherever. Further, the consolidation of many small systems into bigger, collaborative systems is another disruptive approach, which has more of an industry-wide impact on the workflow of an organization. The result of this collaboration has changed the dynamics of various healthcare structures in the state today and will impact the competitive landscape massively.
The Success Quotient
The best advice would be to build relationships and stay people-focused. In other words, take the needs of the customer as paramount. Value your end users and be proactive in terms of reaching out to them. In any situation, don’t shy away from communication; either with your employees or customers. More than the technological aspect of the business, invest in the trusted relationship between two parties. Speaking with regard to the functionality of a CIO, the supreme goal lies in determining which technologies are best in solving current issues in the arena. This would involve being open to change and maintaining a positive outlook while exploring different technologies. Additionally, a CIO must comprehend business flows and the overall functioning of the organization so as to promote value.