Posts Tagged with efficiency

posted by adgrooms on May 24, 2019

A trip to the hospital can be a stressful and overwhelming experience. While the patient is already unwell and concerned, they are also receiving information and guidance about their current and future care from physicians and therapists. Upon discharge, the patient or caretakers must take this information and continue self-treatment at home. But how is the patient to keep track and apply all of the advice and instructions - some spoken, some printed?

Patient portals may contain notes about the visit, but often don’t have detailed information that a patient was given in person. Many patients lose printed discharge information and reasonably resort to looking for the information online. However, this is lacking the specific input from the various specialists and therapists that all provided direction.

An ideal solution would be an after-visit summary that consolidates information from all points of care and a patient could access at any time in their portal. Of course, producing these notes for every patient in language that they could understand would be extremely time-consuming for a physician. This is another area that could be helped by dictation systems. Capturing the instructions as each care provider speaks them to the patient and providing both the audio and transcribed text would help a patient remember what was conveyed.

Additional information could be automatically supplied with libraries of information tied to medical coding. Instead of asking patients to remember to ask for key information and keep track of the answers, these formats could become electronic templates and filled with specific details. This could be further enhanced with the ability for physicians to include additional instructions as needed. The information library could be made take into account the specifics of a patient such as prescription information, health numbers to monitor and aim for, and dietary instructions/goals.

Outcomes can be improved with better patient discharge information. Providing the information in an understandable and accessible way can benefit communication and help a patient take an active role in their recovery.

posted by adgrooms on May 23, 2019

The partnership of medicine and technology has generated solutions for problems across the healthcare landscape. As more problems are solved, the number of software systems and apps that use the same data, but have different or overlapping purposes, continues to increase. At a point, it becomes difficult and time-consuming to manage redundant information across different systems. That is the time, or ideally just a little sooner, to look for integrations.

Software integration is a process of connecting two or more systems so that they can work together, sharing the same data, and possibly, some functionality. One related term you will hear is "API", short for Application Programming Interface. An API is a connection that one system provides so that other systems can communicate and exchange information. The information can travel either one way (either in or out) or both ways (both in and out) allowing smooth communication between the two systems.

Once the systems start working together, the data will synchronize and you have integration. There are many ways that integration can be beneficial in health care. For example, a mobile app could be used to capture data and deliver it to a larger system that doesn’t provide mobile support, such as a time tracker that reports hours to a hospital management system. A mobile dictation system could integrate with the EHR system. Or the other way around, a physician could use a mobile app for chart viewing that could download charts from the EHR system to provide greater convenience and access when a desktop computer isn't available.

Schedules are another area where integration could be beneficial. Physician scheduling and patient scheduling are typically handled by separate systems, and some are even still managed on paper. One possible integration could be the patient scheduling system providing an average number of patients per day or defining busy times of the day where staffing levels need to be adjusted to reflect patient volume. Or simply integrating a physicians schedule into their personal calendar in a secure way can increase visibility and convenience.

It is sometimes hard to know where your software needs will take you. APIs and integrations provide new possibilities and capabilities. In the best cases, they make a whole that is greater than the sum of its parts. Software companies that support integration are likely forward thinking and will continue to expand integration capabilities in the future. If you become aware of redundant work or manual data shifting, contact your software partners. A good partner will want to integrate with other products to provide you with more value. If they are unwilling, it may be worthwhile to look for a company that is.

Integrations can help reduce the rising tide of solutions, reduce effort and consolidate information. With the right integrations, your data management should become a lot easier.

posted by adgrooms on May 3, 2019

In my last post, I talked about a bill I received from a lab in error. The mistake was resolved, but not without some effort on my part. According to an article in Huffpo one researcher found that 30-40 percent of bills have mistakes and another researcher found the occurrence to be much higher than that. That lends the question, where do the billing mistakes happen? Who bears the cost? What can we do about this enormous problem?

A lot of mistakes are user error entering data. Judging from the poor UX of the patient portal I was using, I’m sure that the interface used for billing is equally clunky and obstructive. I decided to poke around and see for myself.

Looking at some of the screenshots of the EHR systems being used, it’s no wonder that there are so many mistakes. There is a lot of information on each page, navigation is not organized and some of the color schemes made it all look like mush.

These complex systems take months of training to be able to use and there are plenty of people in healthcare that are not computer savvy that may never be comfortable using one. That seems like a recipe for mistakes.

Good UX/UI practices shouldn’t be reserved just for the big consumer-based interfaces (Facebook, Google, Amazon). And they are not, do you think the folks in finance or sales would tolerate a less-than-stellar interface? Medical software needs these techniques and tools now more than ever, as the systems become more complex. EHR companies need to invest in usability and their clients need to demand better, or maybe take a page from Hertz's playbook...

posted by adgrooms on April 26, 2019

Pagers, laptops, desktop computers, rolling mobile desktops, printed sheets, handwritten notes, flash cards…. It really boggles the mind how anything is kept straight in the massive constant flow of information and communication around a 770 bed hospital serving almost 30,000 inpatients per year between 550 physicians.

We had the opportunity to watch a residency program in action. From handoff and morning report to rounds, the EHR system was being used. The cutting edge of health records! However, it seemed more like an artifact from another generation of software. The interface was cluttered and required many clicks to get from one place to another. Perhaps this will evolve into a more streamlined layout.

What we would like to see: typeahead lookup, voice input, hotkeys, macros, de-cluttered interface, better use of data visualization, quick tagging/list building. Wouldn't it be cool if the doctors could "flag" and order the key records that they want to present?

The pressure is on for doctors to see as many patients as possible, communicate to various departments, and make sure all of this is logged in the EHR system. Many doctors are toting their own laptops, running from room to room, scribbling notes, and pausing to use fold down wall mount stands to catch up on their data entry. It almost seems as though doctors need their own personal scribe to take in data as they communicate with the patient (and of course actual and virtual scribe solutions are available - but what another possibility of miscommunication!).

The tough part of observing all of this is actually grabbing a busy doctor and asking them how they really feel about the EHR and why....Because they are too busy typing in the EHR!