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1 Advancing)Technology:)) Point)of)care)documenta7on)op7ons. David Tapia, MBA, FACHE Presentation Objectives The&learner&will&be&able&to&iden6fy&at&least&two&benefits& and&two&barriers&to&point&of&care&documenta6on&in&their& prac6ce. The&learner&will&be&able&iden6fy&at&least&two&different&point& of&care&devices&that&may&be&appropriate&in&their&prac6ce.&& The&learner&will&be&able&to&demonstrate&how&to&u6lize&a& decision&making&path&focused&on&key&considera6ons&for& choosing&a&point&of&care&device&for&their&prac6ce. POC Documentation Benefits of Using Technology in the Home " Real-time information " Documentation " Interdisciplinary communication " Coordination of care " Efficiency " Reduce mileage " Employee satisfaction TAPIA,&DAVID&&1&

2 POC Documentation Barriers of Using Technology in the Home " Patient interaction " Clinician resistance " Cost/affordability " Learning curve/training/support " Loss/damage " Extra piece of equipment to carry " Incorrect notion that it hinders productivity Optimal Decision Making Path Step 1: Analyze Your Current Situation " What types of devices are you using for POC documentation? " What type of system (MR/EMR) are you currently using for documentation? Are you still on paper? TAPIA,&DAVID&&2&

3 Step 2: Identify the Opportunity or Problem Step 3: Establish Your Goals Example: To select a device that will help you to remove these barriers and experience the benefits of improved POC documentation. Step 4: Research / Identify Your Options " Internet research " Web demonstrations " Networking " Employee feedback " Test devices " Get references site visit TAPIA,&DAVID&&3&

4 POC Devices Optional Financing Models " Employer sponsored " Employee owned " Hybrid " Mobile Device Management model " Option to Lease tablets vs buy " Remote lock & wipe tablets in case lost or stolen " Control data usage per user to avoid expensive overages " Use geo-fencing and GPS for security measures What s Out There? Step 5: Evaluate Your Options " Notebook/Laptop " Netbook " Tablet PC " New tablets " Other (e.g., handheld/smartphones) TAPIA,&DAVID&&4&

5 What to Look for in a POC Device POC Software Compatibility Client-server Solution: Web-based Solution: " Notebook/Laptop " Tablet PC " Notebook/Laptop " Tablet PC " Netbook " New tablets What to Look for in a POC Device Prioritize this List " Compatibility (Software & Flash) " Affordability " Portability " Ease & speed of use " Display (size) " Multi-functionality " Connectivity** " Battery life " Camera " Performance " Storage " Apps/other software " Accessories** Comparing POC Devices Best in Each Class Laptop Netbook Tablet PC Tablets Initial Investment Monthly Access Portability Web-based EMR Web-based & Client-Server Flash Compatibility Intuitive (Less Training Req.) Speed of Use Ease of Documentation Reduced patient barrier Battery Life Camera Storage Maintenance TAPIA,&DAVID&&5&

6 POC Devices New Tablets " Apple ipad 4 " Asus Vivo Tab " Dell PS " Microsoft Surface " Other Tablets: Sony peria Tab Z Google Nexus 7 Samsung Note 8 New Tablets Key Benefits " Easy to carry " Easy to use " Cost effective " More efficient " Reduces common barrier " Useful applications " Other usage opportunities Tablets Key Differences " Screen size (7-10 in) " 3G/4G connectivity " Wireless carriers " Compatibility (EMR & Flash) " Operating systems " Storage options " Cameras " Apps/other software " Accessories TAPIA,&DAVID&&6&

7 ipad 4 & ipad mini Advantages) Both&are&lightweight&and&portable& Powerful&processors& Great&reputa6on&and&brand&recogni6on& Intui6ve&Opera6ng&System& Op6on&between&7.8 &or&9.5 &screen& Disadvantages) No&external&storage&or& memory&expansion& Opera6ng&system&is&very& restricted& No&Flash&compa6bility&& Pricing) ipad&mini s&start&at&$329& ipad&4&starts&at&$499& Asus Vivo Tab Advantages) Large&screen&12 &with&docking&keyboard& Powered&by&new&Windows&8&OS& Digital&stylus&easily&integrates&wri6ng&func6on& External&expansion&and&media&slots& Pricing) Star6ng&at&$799& Disadvantages) New&Windows&8&OS& &some&learning& curve& Might&be&too&large&for&some& clinicians& Price& Dell PS New class of devices called Convertibles Advantages) Large&screen&12.5 && Powered&by&new&Windows&8&OS& Serves&as&both&a&tablet&and&laptop& External&expansion&and&media&slots& Pricing) Star6ng&at&$1199& Disadvantages) New&Windows&8&OS& &some&learning& curve& Isn t&this&just&a&big&superfast&laptop?& High&price& TAPIA,&DAVID&&7&

8 Microsoft Surface RT & Pro Microsod&Surface&RT& Disadvantages) New&Windows&8&OS& &some&learning&curve& Keyboard&on&Surface&RT&feels&cheaply&made& Surface&Pro&is&more&clunky&and&larger& High&price&for&the&Pro& Advantages) Both&are&lightweight&and&portable& Large&10 &screen& Created&specifically&to&compete&with&iPads& Docking&Keyboard&op6ons& External&slots&for&media&&&storage&expansion& Pricing) Surface&RT&starts&at&$499& Surface&Pro&starts&at&$999& Microsod&Surface&Pro& Google Nexus 7 Advantages) Latest&version&of&Android&4.1&JellyBean& Great&bafery&life,&fast&processor& Above&average&screen&resolu6on& External&slots&for&media&&&storage&expansion& Rated&the& Best&$200&Tablet&you&can&buy & &by& Engadget& Pricing) Starts&at&$199& Disadvantages) Screen&size&7 &might&be&too&small&for&poc& Only&has&a&front&camera& Few&expansion&slots& No&3G/4G&op6ons& Samsung Galaxy Note 8 Advantages) Latest&version&of&Android&4.1&JellyBean& Powerful&processor& New&Stylus&features&electromagne6c&proper6es& External&slots&for&media&&&storage&expansion& Watch&On &feature&serves&as&a&universal& remote&and&media&hub& Pricing) Starts&at&$399& Disadvantages) OS&loaded&with&features&might&not&be&easy&to& navigate&for&a&new&user& Price& TAPIA,&DAVID&&8&

9 Sony peria Tab Z Advantages) Latest&version&of&Android&4.1&JellyBean& Large&10 &screen&near&re6na&display& External&slots&for&media&&&storage&expansion& Water&resistant&and&dustiproof!& Pricing) Will&be&released&in&Q2&2013& Overseas&pricing&around& $899& Disadvantages) Sony&is&s6ll&new&to&the&tablet&market& Brand&new&models&typically&need&at&least& one&genera6on&to&work&out&kinks& Price& Optimal Care Tips " Flexibility is key " Remain open to better opportunities " Utilize the benefits of technology advancement " Tech excellence contributes to clinical excellence! " Have a backup plan " Anticipate anxiety " Mutually set a realistic learning curve " Invest in device accessories " Try new ways of using your device Thank You For Attending. We have devices available for demonstration Questions? Ask now or contact us via . Dave&Tapia,&MBA,&FACHE& Managing&Partner& Exegete&Healthcare&Interna6onal,&LLC& davetapia@exegetehealthcare.com&& TAPIA,&DAVID&&9&

10 Addendum Case Study Optimal Care s Mission To provide the highest quality care with compassion and respect for each person through personal, clinical and technological excellence. Optimal Care Case Study& Timeline Census started at 20 patients and grew rapidly to a census of 200 in first year " 2006: Paper documentation standardbased forms " 2008: Transitioned to client-server system using Tablet PCs " 2010: Transitioned to Web-based system using ipads and multiple devices Optimal Care in 2008 Client-server Software + Tablet PCs Initial Investment $300,000 Monthly Costs $5,000 License Fees User $3,500/User Host $4,000/Host HHA $3,000/HHA License Laptops/Tablet PCs $2,000/Each PDAs HHA Documentation Security Software Licenses $50/Mo Activation $120/Tracking TAPIA,&DAVID&&10&

11 Client Server Software Solution Weaknesses Administrative: " Cost for growth " Device " License " Dependence on IT " Training 40+ Hours " Theft HIPAA concerns Clinical: " Device limitations " Delayed documentation " Lengthy sign-on time Tablet PC Software program " Employee dissatisfaction Tablet PC Weaknesses " Larger, more difficult to carry " Battery life " Internet access " Updates " Requirements Web-based Software Solution Opportunities Administrative: " No upfront costs or for growth " Billing/financial integration " Real-time QA " Reporting capability " Replace IT " No HIPAA concerns Clinical: " More oversight " Coordination of Care " Improved communication " Survey-ready " Improved documentation " Process improvement TAPIA,&DAVID&&11&

12 Optimal Care in 2010 Goals for New Software + Devices " To find a mission-driven solution for both administrative and clinical care needs " Employee satisfaction " Administrative oversight " Real-time documentation Optimal Care Case Study Web-based Software + ipads Initial Investment $35,000 Monthly Costs (Maintenance + Web) $5,500 License Fees $0 Tablets $600/Each Web Connection Fees $15-25/Month Apple ipad Opportunities Administrative: " Affordable pricing & plans " Dependable " Less training needed " Works with EMR Clinical: " Easy to use & carry " GPS " Performance " Patient education tool " Compatible keyboard cases TAPIA,&DAVID&&12&

13 Optimal Care Results " ipads provided to all clinicians " True Point of Care " >90% of actual POC documentation " Improves work/life balance The ipad is Wonderful! I no longer go home and spend the evening with a laptop on my lap. My work is already done. Optimal Care Results " Quality assurance oversight " Survey/record audit-ready " Real-time interdisciplinary communication " Using the latest technology to deliver the highest quality care With the ipad, I can now play my patient her favorite music as part of her dementia care! TAPIA,&DAVID&&13&

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