I recently read an article in the New York Times titled “Undercover in a Hospital Bed.” It describes how hospitals and medical centers are contracting with “secret shopper” consultants. Being a secret shopper at a fast-food restaurant or a retail clothing store is fairly straightforward: walk in, pretend you’re a customer, observe how you’re treated and if employees are complying with company standards, make a purchase, and walk out. When it comes to being a secret shopper in a hospital or emergency department (ED), the stakes are a bit higher.
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Electronic Health Record (EHR) (2)
There is a well-known concept in computer science called Garbage In, Garbage Out (or GIGO for short). You need not be a brain surgeon to figure out what it means. If you enter bad data into a program or an algorithm, you’ll get bad data as output. No duh. Seems self-evident to me. That said, I’m not sure everyone has adopted the GIGO way of life, and it’s making me sad.
Healthcare IT is such a foreign language to people who don’t think about the intersection of health and technology every day. Before I entered the field, similar to other healthcare newcomers, I thought nothing of the nurses’ or doctors’ notes, aside from whether the blood pressure number they told me was normal. We are not too far removed from the days of paper everything, but I now find it interesting to see the magic behind the technology curtain.
I recently read an article in Wired magazine about what sound design is with respect to information technology (IT) and why sound design is so important. I admit that I’ve rarely thought about this field of software development, but it really is important. What exactly is sound design? The author introduces the concept this way: “How do you know whether Siri heard you? Just as in human interaction, good communication is about the flow of conversation, the ongoing exchange of information.” Sound designers try to ensure that the two-way communication between humans and technology works, intuitively and naturally.
Two weeks ago, I had the pleasure of attending the 2019 Cerner CommunityWorks Summit in Kansas City, MO. Avaap was honored to be included as one of a few select vendors to exhibit at the summit. It was a whirlwind week full of education, networking, and happy hours hosted by Cerner. We had great conversations with hospital executives, clinicians, operations leaders, and IT liaisons about the challenges rural, community, and critical access hospitals face. At the same time of the summit, Avaap announced the Columbus Regional Health System go-live with Cerner CommunityWorks after a year-and-a-half long partnership, beginning with system selection through go-live. Seeing their journey and comparing it with stories from other sites in their same domain, whether currently implementing or live for several years, led me to a few key takeaways from the week:
I recently attended the second annual KLAS Arch Collaborative meeting in Salt Lake City. If you’re not aware of the Arch Collaborative, it’s a group of hospitals, healthcare systems, and clinics which survey their clinical users about the technology they use to do their jobs. The Collaborative members then benchmark against peer institutions to see how they’re doing. Some crazy Arch Collaborative findings:
You probably recall the child folk song Dem Bones. The song helps children learn and remember how bones in the human skeleton system are connected to each other.
In my last post, I described the Last Mile Problem in healthcare information technology (IT). To summarize: The Last Mile Problem originated with supply chain and delivery. It is relatively easy to get a manufactured good from the factory to close to the purchaser (note the word relative!). That last mile – from the post office or local storage depot – is by far the most difficult. Are the roads big enough for the truck? Will the driveway support heavy equipment? Will the customer be there when you deliver? Will the object fit through the door? You get the picture.
I was recently speaking with a friend about a new endeavor that he is exploring, and he commented that no one has solved the Last Mile Problem – that’s what he’s working on. If you’re not familiar with the concept, the Last Mile Problem describes how it’s relatively easy and cheap to get a product from a far-away factory to very close to a consumer’s house, but getting that delivery to the front door of the purchaser takes a lot of effort and costs a relatively large amount of money. Even though the distance from a local distributor to a home may represent 2% of the journey, the costs may consume 25% of the potential profit.
Rural acute care and critical access hospitals face similar obstacles as their larger healthcare counterparts, but they also face unique challenges. Impediments range from aligning services to their communities’ needs and trying to stay independent amid heavy merger and acquisition activity to addressing value-based care and creating more efficient processes that optimize resources, lower costs, and support patient safety and quality of care goals. Most hospitals use some form of EHR technology to improve clinical efficiency, but dissatisfaction with current EHRs are leading many healthcare organizations to consider EMR/EHR replacement. Providers will often seek third-party consulting partners to collaborate with the EHR vendor and key stakeholders to conduct a rapid, efficient and streamlined implementation.