Point of Care Mobility Solutions Clinical Data Access in the Real World

1
Point of Care Mobility SolutionsClinical Data
Access in the Real World


2

• We help rural and community healthcare providers
  put information technology to work.

3
Change Happens

• David Brailer in the Federal Times on the
  barriers to technology use in healthcare
• "One is cost. In health care we pay by the
  piece. If you were my patient, I would be paid
  for seeing you, depending on how long I saw you,
  and I would be paid the same amount if I made a
  mistake or if I didnt. Theres no incentive for
  quality or incentive for efficiency. Health IT
  increases quality and efficiency, but it doesnt
  increase the doctors bottom line. The other one
  is know-how. These systems are complicated, not
  just technically. Theyre about changing the way
  practices operate, changing the culture of
  practice, changing the way people communicate,
  the way decisions get made, the role of the
  patient. And that requires a lot of change
  management and organizational re-engineering
  know-how."

4
E.H.R. - Defined

• The Electronic Health Record (EHR) is a
  longitudinal electronic record of patient health
  information generated by one or more encounters
  in any care delivery setting. Included in this
  information are patient demographics, progress
  notes, problems, medications, vital signs, past
  medical history, immunizations, laboratory data
  and radiology reports. The EHR automates and
  streamlines the clinician's workflow. The EHR has
  the ability to generate a complete record of a
  clinical patient encounter, as well as supporting
  other care-related activities directly or
  indirectly via interface - including
  evidence-based decision support, quality
  management, and outcomes reporting.
• www.himss.org

5
When to go mobile

• Go mobile when
• Stay tethered if
• When does a touch screen or a PDA make sense and
  who decides?
• PatientKeeper, iScribe, ePhysician, LogonHealth,
  PocketScript

6
How are we doing?

• 33 of hospitals currently have implemented PACS
• Only 12 of ambulatory clinics associated with a
  hospital have implemented EMR.
• Less than 10 of all health organizations have
  successfully implemented CPOE.

7
Is This As Good As It Gets?
8
(No Transcript)
9
(No Transcript)
10
Different Strokes

• No one size fits all even though we in IT would
  love to set it up this way
• News flash nurses are very different from
  physicians
• Specialty groups have unique needs for mobility
• Internal Medicine is different from Family
  Practice

11
Security Protection or Productivity?

• It should NOT be an either/or decision.
• It can be about compliance AND efficiency.
• Single Sign-On and / or HotDesktop / HotDesking
  should be part of your total plan.
• This could be the key to bringing the two
  together
• Remember CIA
• C Confidentiality
• I Integrity
• A - Accessibility
• Only 18 of all healthcare organizations are
  completely HIPAA Security compliant.
• (According to Pheonix Health Systems annual
  survey www.hipaadvisory.com)

12
Some Real Mobility Solutions

• Xyloc Proximity Solutions
• www.ensuretech.com
• Citrix Smooth Roaming Wyse Winterms
• http//www.citrix.com/English/ps2/segments/v/featu
  re.asp?contentID21056
• Tarentella Sunrays from Sun Microsystems
• http//www.sun.com/software/sunray/
• Ergotron Styleview Carts
• http//www.ergotron.com/3_products/carts/sview/def
  ault.asp
• Imprivata Single Sign On Appliances
• http//www.imprivata.com/

13
Why Now?

• Two Important Trends Pushing Adoption of
  Information and Communications Technology
• Exponential Increase in Medical Knowledge many
  new drugs, new devices and interventions. Too
  much for one mind.
• (Decision Support Tools, Rules Based Logic, EMR)
• Life expectancy has been increasing, leading to
  an increased need to manage chronic conditions
• Interesting Fact Individuals with multiple
  chronic conditions see an average of 6 clinicians
  per year, often in multiple settings
• (Health Maintenance Tools, Patient/Clinician
  Clinician/Clinician Communication, EMR/EHR)

Source IOM Quality Through Collaboration The
Future of Rural Healthcare. (2005)
14
IOM on Future of Rural Health
Items that involve IT directly Resource - Rural
Wisconsin Health Cooperative www.rwhc.com
15
Bad News 6 Sigma Comparison
16
Good News - I.T. Works!

• Press Releases - Meinodes Medical Center NY
• 68 decrease in medication processing times
• 55 decrease in medication discrepancies
• 20 decrease in duplicate ancillary orders
• 48 decrease in duplicate Lab orders
• 31 reduction in average length of stay
• CPOE seen as a catalyst for quality because
• 49 of errors occur during ordering
• 26 of errors occur at bedside administration
• 14 of errors in pharmacy dose checking

17
Action Items

• Assess
• Validate current investments if junk admit it
  and move on. Do a complete assessment include
  a true wireless site survey.
• Consider the work flow make your clinical folks
  part of the solution.
• Think Enterprise-wide
• Need a cohesive solution that includes PACS,
  Physician EAR/EMR, Nursing POC, Bar-coding, E-Rx,
  etc.
• Implement Train
• Remember training isnt just for the application
  knowledge of the tools is also required for
  success.

18
Thank you.

• Questions?
• Phil Stravers
• Brenda Kloewer
• ICE Technologies, Inc.
• 877-754-8420
• PhilS_at_icetechnologies.com
• BKloewer_at_icetechnologies.com