Rapid Integration

Apple’s iPad has made tablet computing a reality, easy and cool. The list of touch-screen tablets is constantly evolving and growing, i.e. Apple iPad, Samsung Galaxy Tab, BlackBerry Playbook, etc.

Not only have they become the must gadget to have, there’s a good collection of useful applications that are making life easier for both physicians and patients. Knowledge Networks reported in March 2011 that 27% of physicians in the United States had a tablet-style computer which is about 5 times the general public’s adoption rate.

This rapid adoption rate by physicians requires for healthcare IT professionals to be able to integrate these devices rapidly with their enterprise IT landscape. Long gone are the days where corporate infrastructure groups could take years before allowing new platforms into the enterprise. For instance, in 2006 a Fortune 100 company initially only allowed RIM’s BlackBerry mobile devices onto their corporate platform. As the iPhone grew in popularity, and apps, more employees and executives begin requesting to have the iPhone as part of the IT enterprise. Almost 4 years later, the infrastructure group finally granted approval to allow Apple’s iPhone and OS as part of the IT enterprise landscape. The problem is that Google’s Android mobile devices are now growing at an outlandish rate, so as you would probably guess, a significant amount of employees, and executives, are now clamoring to have Android devices approved. So not only is the company playing catch up with developing and integrating Apple OS apps with enterprise applications, they are also behind with Android development and integration.

In a healthcare IT setting, this slow speed of integration could very well be life or death for a patient. Particularly in the case of physicians in remote areas, where a significant amount of mobile apps have been developed to assist with providing more efficient and timely care. The bottom line, tablets and similar mobile devices have enough processing power to rival that of desktop computers. Because of open development, new apps are literally released everyday and are being developed to do what was once unimaginable. The impact and benefit of apps, and the high rate of adoption of tablet devices by physicians, requires healthcare IT organizations to make streamlining and integrating these new mobile technologies at a much more rapid pace than most other industries a top priority..

EMR Implementation Training

One of the things that always surprised me was the level, or lack thereof, of basic computer skills that existed within most providers’ offices. This low level of computer skills existed not only with office personnel, but also with doctors and nurses. Therefore, when implementing new computer software a lot of time was spent providing basic computer training in addition to software specific training.

With EMR implementation it’s highly critical that both medical and office personnel are trained on EMR systems. If they are not properly trained they will become frustrated, and possibly, unproductive. An unproductive doctor and/or nurse in a clinical setting is not a good thing. If that happens it could sabotaged the best of EMR implementation projects.

Keep in mind that no two providers are alike and work flow processes differ from one provider to another, here are a couple of training recommendations when providing EMR training that are applicable across the board. First, access the computer skills of everyone that will be using the new system. If basic computer training is needed, include it in your training curriculum. When providing basic computer training take nothing for granted, heck, you may have to teach keyboarding, how to operate a mouse, etc., just be prepared to get the users up to speed on the most basic of computer skills. Secondly, provide one-on-one training when feasibly possible. I found one-on-one training works best for this set of users, especially for smaller to medium sized providers. If this is not possible, try to have at least one experienced (or a well-trained user) to support every two doctors during the initial days of “go live.” And thirdly, require ALL medical personnel to attend training, even if it means night and/or weekend training sessions. This may require flexibility on your part to accommodate everyone’s schedule, but it will be time well spent to have trained doctors/nurses using the system on day one of “go live” versus doctors/nurses doing OJT on the day of “go live”...

Remember the best way to eat an elephant is one bite at a time, so save yourself a headache by implementing EMR in phases. Implement only one process at a time before turning up the next process. Because if glitches are caused by implementing an EMR system, i.e. billing, clinical, prescriptions, etc., the emergency system just may get activated (see cartoon)...

EMR Costs, Just Like Hens in a Hen House

On the heels of my last post, EMR APP for iPhone, I mentioned the cost of the EMR iPhone app was less than $200. Keep in mind EMR deployments can cost millions. In a report by the Free Library, “EMR: one hospital that got it right,” Dr. James Leo, associate chief medical officer for Long Beach (Calif.) Memorial, stated "EMR [systems] can cost hospitals $20 million to $200 million due to implementation, vendor and hardware costs, staff training, and upkeep." Smaller providers’ can expect to spend from $25,000 to $60,000 per physician to deploy an EMR system. For smaller providers this projected cost doesn't cover consulting, training, add-on-software, and upkeep.

Despite the availability of EMR iPhone apps, EMR deployment is still a costly project. For this reason, a good case can be made for EMR implementations to hire an external EMR consultant, which is not employed by the vendor, is money well spent. Go ahead, laugh. Coming from an IT professional, this is like the rooster telling the farmer he needs more chickens in the hen house, right? But for a project of this magnitude, whether it’s for a small provider’s practice or a large hospital institution, having someone on board that’s not affiliated with the vendor but has rolled out one of these systems is money well spent.

Just like the farmer will be ecstatic with the additional hens in the hen house once all of his hens are producing more eggs, providers will be happy that a set of non-partisan eyes are part of the project team when implementation challenges are encountered. As IT professionals, we know that implementation challenges will be ecountered.

Click here to read the entire article from Free Library.