Improving Clinician Workflow and Efficiency Overcoming IT Challenges at the Point of Care

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1 Improving Clinician Workflow and Efficiency Overcoming IT Challenges at the Point of Care November 2011 Dr. Michael Westcott CMIO Alegent Health 11/8/2011

2 Alegent Health Overview 6 Metro Hospitals 5 EDs 3 Rural Hospitals 3 EDs Lasting Hope 100+ Clinics & Outpatient Facilities 9,000+ Employees 1,200+ Physicians 2

3 The Pain of Moving from Paper to Computer Take off bottom line 3

4 New Interactions of Caregivers and Computers New Caregiver Workflow Requirements Paperless Chart Real-time Documentation Nursing Physician CPOE Allergy Verification Real Time Bed Board Updates Medication Administration Checking (future) 4

Documentation Nursing Physician CPOE Allergy Verification

5 Key Barrier to Change Finding a Solution That: Provides Fast Access to Information Estimated logons per day: 50 to 70 Delivers Consistency in Performance Enables Mobility Addresses HIPAA Concerns Standardizes the User Experience Most importantly, the caregivers like and will use the system 5

Performance Enables Mobility Addresses HIPAA Concerns Standardizes the

Wireless Issue Security / Losing the Device Virtual Keyboard Fixed Devices

6 Why What We Tried Did Not Work Work Station on Wheels (WOWs) Wireless problems Battery problems Space issues Ergonomic problems Costs Tablets Durability Battery Wireless Issue Security / Losing the Device Virtual Keyboard Fixed Devices Network Logon Latency Competition for Devices Passive- Aggressive Behavior Security Issues 6

7 The Denver Health Solution Denver Health Caregiver Experience Any place they moved, they access their complete desktop and applications in just a few seconds Doctors and nurses leverage dual-factor authentication every time Thought: a computing system designed for the doctors and nurses Team that created the solution are the founders of Aventura Aventura is a workflow company 7

leverage dual-factor authentication every time Thought: a computing system designed for the

8 Alegent Adopts New Solution Key Benefits of Solution 1. 2 to 3 Second Access From Anywhere 2. Enabled Application Adoption 3. Transforms Workflow 4. Reduced ER LOS 5. Clinician Satisfaction 6. Dual-Factor Authentication / Smart Card 8

Enabled Application Adoption 3. Transforms Workflow 4.

9 2 to 3 Second Logons 1. Transport Session Not Devices : desktop and application sessions follow the clinicians Logons a Day times 45 Seconds = Not Usable A. Anything over 7 or 8 seconds is not acceptable 3. Instant Logoffs (arguably more important) A. Locks session / clears screen B. Patient security C. Fast user transition 9

clinicians 2. 70 Logons a Day times 45 Seconds = Not Usable A.

10 Enables Application Adoption Emergency Department Case Study Desired future state: 1. Paperless chart 2. Real-time documentation A. Nursing B. Physician 3. CPOE 4. Real time bed board updates Aventura key in facilitating successful implementations 1. Efficiency in accessing information 2. Ease of use 10

11 Transforms Workflow 1. Timely data entry / timely data views at the point of care 2. Promotes device sharing among caregivers 3. Allows clinical information and image viewing with patient 4. Increased Collaboration 11

12 In Room CPOE / Documentation CPOE 1. Order Accuracy A. Right order / right patient 2. Timely Orders 3. Rapid Order Processing Documentation 1. Real-Time A. Much less writing on palm of my hand 2. Improve Accuracy 3. Load Patient Context Before Entering Room 4. Updating Comments are Simplified on Tracking Boards 12

Rapid Order Processing Documentation 1. Real-Time A.

13 Decrease Length of Stay Emergency Department Case Study Midlands Mercy Lakeside # of ED Rooms Average LOS (Treated & Released) - Before 249m 178m 255m Average LOS (Treated & Released) - After 152m 150m 111m 13

14 Clinician Satisfaction 1. Number 1 benefit of this solution is the increased satisfaction of our nurses and doctors. Ken Lawonn, SVP and CIO 2. Compliments, not complicates, clinician workflow 3. Nothing to carry or push 4. Makes EMR systems usable 14

15 Smart Card / Dual-Factor Authentication 1. Very little resistance if any to adopting smart cards 2. Dual Factor A. Something you have (smart card) B. Something you know (password) 3. Created Temp Card Process / Card Replacement Process 4. Multi-purpose cards 15

16 IT Benefits 1. Centralized management of desktop environment 2. Standardization of desktop environment 3. Strong security practices by doctors and nurses 4. Minimized wireless and battery problems 16

17 Summary 1. Clinical Satisfaction Starts with Usable Systems 2. Fast Roaming and Secure Access Ensures Success 3. Centralized Desktop Management Provides Significant ROI 4. Happy Clinicians 17

18 Thank You! Questions and Answers Contact Aventura:

Optimizing Workflow in the Face of Meaningful Use

Optimizing Workflow in the Face of Meaningful Use Michael L. Westcott, MD, FACEP Alegent Health, Omaha, NE Facilitator: T. Forcht Dagi, MD, MPH, DMedSC, FAANS, FACS, FCCM Chief Medical Officer, Aventura