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The American Hospital Association (AHA) recently issued an RFI focused on IT solutions for perioperative workflow. In the aftermath of EHR implementations, hospitals are facing the harsh realization that, following great expense and organizational pain, EHR’s actually add to the complexity of clinical workflow. This is evidenced by lower patient throughput and increased costs. Thus, hospital executives are starting to search for more robust “workflow” assistance, especially in areas, like surgical services, that can account for 40%-60% of hospital revenue.

The AHA request begins by stating:
“Clearing patients for a surgical procedure is a lengthy process that involves managing several logistics. It requires coordinating members of the care team, allocating the necessary staff and equipment, reserving a room/ space for the procedure, preparing the patient physically and mentally prior to the procedure and administering the necessary medication and drugs for the procedure. Hospitals that effectively manage these logistics can avoid delays and cancellations of the patient’s procedure, prevent clinical errors and reduce readmissions.”

The RFI goes on to say: “Perioperative care management solutions can improve care coordination and achieve greater efficiency in resource utilization and workflows. Therefore, AHA Solutions is engaged in the process of identifying a partner who will provide the AHA and its associated hospitals with a perioperative care management solution.”

Furthermore, in an article written for EHR Science, Jerome Carter writes: “According to Google, “clinical workflow analysis” is the most popular search term that brings visitors to EHR Science. I am not surprised. Workflow disruptions are increasingly being recognized as workarounds, usability issues, safety concerns, and CDS problems. The first step to solving any problem is recognizing that it exists.” Follow this link for the entire article: https://ehrscience.com/2014/12/15/a-place-for-everything-clinical-workflow/

Optimium Health applauds both EHR Science and the AHA decision to open an RFI and has submitted OPTIMI$ER as a candidate to fulfill its perioperative workflow solution goal. The time has come, now that the dust has settled on EHR implementations, for hospitals to see for themselves that EHR’s are not the Holy Grail to fix systemic clinical workflow inefficiency that costs time, money, and patient safety and satisfaction.

If you would like more information on how Optimium Health can help your organization improve IT interoperability while lowering operational costs and enhancing care delivery, please contact: heather@waohi.azurewebsites.net

One of the elephants in the room regarding health technology is that in spite of all the talk, a meaningful level of interoperability has yet to be achieved in the 5700 hospitals across the country. A recent report to Congress from the Office of the National Coordinator (ONC) shows that provider efforts are being held up by reasons beyond just financial ones. Here are the five major roadblocks to more widespread data sharing among caregivers, according to the ONC:

1. Lack of universal standards-based EHR systems’ adoption
2. Impact on providers’ day-to-day workflow
3. Complex privacy and security challenges associated with widespread HIE
4. Need for synchronous collective action among multiple stakeholders
5. Weak or misaligned incentives

Point #2 is Optimium Health’s sweet spot. Providing clinical workflow technology that seamlessly interfaces with EHR, scheduling, and practice management systems is at the heart of what we do. So we want to highlight what the ONC goes on to say about the need to incorporate workflow technology into a hospital’s interoperability strategies.

“Technology has reached the capability of making interoperability possible, but process innovation has yet to catch up. Existing processes must be redesigned to incorporate new technologies – a more prominent problem in the healthcare arena, mostly due to a lack of standardization.”
Included in the same report are ONC recommendations for processes to establish over the next six months in order to foster better interoperability. And things to watch out for: 1)Hospitals can have hundreds of IT systems, vendors have built proprietary databases but not everyone follows the same standards and 2) health systems fear sharing data with competitors and policymakers have not focused on health information exchange or EHR usability.

Click on this link for the full article: https://www.healthcareitnews.com/news/onc-cites-security-incentive-woes-among-5-biggest-interoperability-roadblocks

If you would like more information on how Optimium Health can help your organization improve IT interoperability while lowering operational costs and enhancing care delivery, please contact: heather@waohi.azurewebsites.net

OHI started following “The Health Care Blog” (THCB) which the Wall Street Journal considers the leading online forum covering the business of healthcare and the new ideas that are changing the health care industry. THCB is read by a daily audience of 4,000 – 5,000 healthcare professionals across a spectrum of roles. These include executives at healthcare networks and organizations, policy makers on the state and federal level, decision-makers, doctors and nurses, med students, investors and entrepreneurs and consumers trying to come to grips with the changes impacting the healthcare system.

A recent post “The Low Hanging Fruit is Lying on the Ground” caught our eye since the topic reflects the transformation of approach we’ve seen in our hospital clients over the past couple years. And this in only one of dozens of thought provoking blogs THCB features. After reading the excerpt below, OHI would welcome the chance to speak with you about how your organization can improve its processes and gather up some of that “low hanging fruit”.

“With hospitals and doctors under tremendous pressure to improve costs and quality fast, clichéd calls to “aim for the low-hanging fruit” are ringing in every boardroom and bedpan from Sarasota to Seattle. But medical providers should set their sights a bit lower. Why? Because “in health care, the low-hanging fruit isn’t just low-hanging fruit; the fruit is lying on the ground, and we have to be careful not to trip over it.”

That’s the axiom that Indiana University management professor Mohan Tatikonda repeats regularly to the physicians in an MBA program for MDs started in 2013 by IU’s Kelley School of Business in Indianapolis. His students, who hail from around the country and have been practicing medicine for an average of 20 years, shortened the phrase to simply “watermelons on the ground.”

It means that first-year MBA concept employed decades ago in most other industries can yield huge results among health care providers. “On average, the state of operations in health care delivery is primitive. Fundamentally primitive,” Tatikonda said. “Just the basic understanding of patient flows, materials flows, information flows. Having them documented and diagrammed. This kind of thing until very recently was just not very common.”

It’s not that things such as Six Sigma or Lean are unknown to health care leaders. Consultant Chip Caldwell estimates that about 75 percent of hospital systems are using Lean in some way, compared with 53 percent identified by a 2009 survey by the Association Society for Quality. Only about one in 10 hospital systems is using Six Sigma currently, Caldwell estimates, down from a peak of popularity in the 2000s.

Some hospitals, such as Virginia Mason and Barnes-Jewish, have employed these techniques to wide acclaim. What few health care provider organizations have done, Tatikonda said, is make a regular, sustained habit of using process improvement concepts, so that all the people in their organizations became used to thinking that way.

For the full article, please follow this link: https://thehealthcareblog.com/blog/2015/07/29/the-low-hanging-fruit-is-lying-on-the-ground/

Health Data Management wrote a brief set of top level tips to be considered to improve EHR interoperability.

Tip #3 (“Embrace user centered design”) is critical to the success of any guided workflow. Quoting the tip, “Most of the criticism and dissatisfaction with EHRs stem from enforced workflows and user interfaces. Healthcare organizations will need to invest in providing flexibility that reflects actual care processes rather than institutional ideas of how care should be delivered.”

Our experience at Optimium Health is that this particular piece of advice is the most important of the series. Whether the application is from the EHR vendor, an ISV such as ourselves, or an in-house developed application the overall success will be determined by the level of engagement with the “front line” staff during the specification and development process.

By embracing the end user, one can create a workflow that is natural and very easy to in-service. The workflow can then create a standard of care that requires no “work arounds” that are so often seen in applications built without the experience of the end user. Of course, blindly implementing an existing workflow without consideration of the “why” of certain steps/flows is also problematic. Creating an assisted workflow of a bad or sub-optimal process just results in a bad or sub-optimal electronic form of the same. Changing a workflow and adding best practice steps can get you to a more elegant and sustainable endpoint.

One addition to the tip is to be on the lookout for the following: Adjunct spreadsheets, colored sticky labels, colored file folders, and sorted piles of folders. These are all indicators of a workflow that is crying out for additional help. Of course, this means that you have to be out and about with the front line staff to get this close to the care experience; but this is a topic for another post…

Optimium Health has had numerous discussions over the past 6 months with hospital administrators and unit managers who all seem to highlight the same issue: while EHR’s promise to improve workflow and productivity, they more often than not do the opposite. A recent feature in iHealthBeat appears to back this up.

“According to survey conducted by Software Advice, and reproduced in iHealthBeat, slowed productivity is the greatest challenge cited by electronic health record users. Other key challenges cited by EHR users include integration with other EHR systems, customizing the EHR system, importing existing records and learning to use the EHR system.”

For a full view of the Top 10 Challenges for EHR Users survey findings, please follow this link: https://tinyurl.com/lxkrvpe

Given what we have heard from the people on the frontlines of providing patient care, Optimium Health could not agree more with these findings.  Our mission is to help health organizations get more value from their existing IT systems by providing overlay software that optimizes clinical workflow orchestration and facilitates timely, accurate communication between caregivers. The net result: improved overall staff productivity, patient throughput, and quality of care.

If you would like more information on how Optimium Health can help your organization improve IT interoperability while lowering operational costs and enhancing care delivery, please contact: heather@waohi.azurewebsites.net

 

The 26th annual HIMSS Leadership Survey showed consistency with prior year priorities, but with increased focus on improving patient satisfaction and the quality of care, which now occupy the top two spots. No doubt the guidelines and regulations set forth in the Affordable Care Act have health IT leadership fully engaged in their organizations’ pursuit of compliance and avoidance of penalties. Sustaining financial viability comes in next, while improving care coordination and operational efficiency/lowering costs round out the top 5.

While these may not be particularly surprising, what is surprising is the apparent lack of understanding about inter-dependency of all these priorities. There is still a tendency to address each priority area as its own problem, with its own IT solution, and not to unpack the “cause and effect” relationship one priority area has on the other. To do this, IT departments must involve front line clinicians, not just the C-Suite, in problem identification, best practice, and corrective action. By doing this, IT can better understand the intricacies of clinical processes, the bottlenecks that occur, and the communication failures that lead to errors, omissions, and duplications of effort that waste time, money, and compromise outcomes.

Below is an excerpt from the 2015 HIMSS Leadership Survey and the top hospital IT priorities:

“While a majority of respondents to the 26th annual HIMSS Leadership Survey reported an increasingly higher stature for IT within their organizations, information system departments will be supporting new initiatives in the years ahead, as healthcare organizations focus on changes in reimbursement. HIMSS released results of its survey during its annual conference and exposition in Chicago. Results are based on responses from 330 respondents. Data showed increased reliance on healthcare IT to achieve improved care delivery.

Some 87 percent of respondents said improving patient satisfaction would be a top priority for their organization in the next 12 months. Improving patient care, quality of care or outcomes ranked second as a top priority, followed closely by sustaining financial viability, named by 86 percent of respondents. Rounding out the top five are improving care coordination (75 percent) and improving operational efficiency and lowering operating costs (72 percent).”

For more survey details, please follow this link: https://www.healthdatamanagement.com/gallery/top-IT-concerns-issues-from-the-HIMSS-survey-50282-1.html?utm_campaign=daily-apr%2017%202015&utm_medium=email&utm_source=newsletter&ET=healthdatamanagement%3Ae4205767%3A3694212a%3A&st=email

Optimium Health brings over 25 years of clinical process and Health IT expertise to this discussion. Importantly, we ensure both hospital staff and patient satisfaction scores improve and that operational efficiency will lead to lower costs. Our clients consistently achieve a break-even on investment in less than 3 months. If you would like to learn more about how Optimium Health can help your organization, please contact Heather Guild at heather@waohi.azurewebsites.net