Health IT Summit San Francisco 2015 - Case Study "Taking Mobility Beyond Wireless Phones: A Work in...
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Transcript of Health IT Summit San Francisco 2015 - Case Study "Taking Mobility Beyond Wireless Phones: A Work in...
Taking Mobility Beyond Wireless Phones A Work in Progress
IHT2 San Francisco HIT Summit
March 4, 2015
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OUTLINE
1. ABOUT JFK
2. THE CURRENT STATE OF MOBILITY
3. THE VISION
4. CHALLENGES & LESSONS LEARNED
5. NEXT STEPS
Taking Mobility Beyond Wireless Phones
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1. ABOUT JFK
Taking Mobility Beyond Wireless Phones
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1. About JFK - Background
Taking Mobility Beyond Wireless Phones
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399 Bed Acute Care Medical Center
98 Bed Rehabilitation Institute
500 Long Term Care Beds (4 facilities)
Neuroscience Institute of New Jersey
Homecare, Hospice & EMS
Multi-Specialty Physician Groups
Accountable Care Organization (MSSP & Commercial)
Regional Health Information Exchange
Family Medicine, Rehab & Neurology Residency Programs
1. About JFK - Background
945 member medical Staff (127 employed, 85 contracted)
Competitive primary service area
Physician friendly culture
Preparing to undergo a major system replacement initiative
Chance to change workflow and culture
Focus on the 3 P’s – Patient Safety, Productivity & Provider Affinity
Taking Mobility Beyond Wireless Phones
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2. THE CURRENT STATE OF MOBILITY
Taking Mobility Beyond Wireless Phones
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2. The Current State – Infrastructure
Taking Mobility Beyond Wireless Phones
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448 cell phones* : 45 hotspot/mifi devices : 102 laptops : ### medical devices* : 1,100 pagers : 227 tablets* : 230 wireless phones
Mix of Android, iOS and Windows devices
BYOD policies exist but are not strictly enforced
VoIP enabled infrastructures from phone switch and network vendor
One primary cellular provider for majority of cellular devices
Mobile Device Management (MDM) environment being installed
2. The Current State – Mobility @ JFK
Taking Mobility Beyond Wireless Phones
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Cellular Phones : Voice; Texting; Email; Internet; Apps; Applications
Hotspots : Mobile Connectivity for EMS and other field staff
Laptops : Email; Applications (Med Administration; Documentation)
Medical Devices : Data collection
Pagers : Text Alerts
Tablets : Email; Internet; Apps; Applications
Wireless Phones : Staff Voice Communication
2. The Current State
Taking Mobility Beyond Wireless Phones
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Reactive approach to mobility with no cohesive strategy
Policies exist with limited enforcement of proper use, standards, etc.
Expense tracking for mobility based solutions is not well established
Increasing, unstructured, demand for mobile equipment and use cases
Need a more formalized process for overseeing mobility based initiatives
2. The Current State - Governance
Educate : What is the value of mobility?
Identify : Use Cases
Understand : Existing mobile capabilities
Evaluate : Requests for mobile solutions
Measure : What are costs vs. potential benefits
Vision : What’s on the horizon?
Taking Mobility Beyond Wireless Phones
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Taking Mobility Beyond Wireless Phones
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1. The Current State – Practical Questions
What are you trying to accomplish using mobility?
Who are the participants in this interaction?
What are the mobility tools to be used?
What are the anticipated volumes of interaction?
What is the expected outcome of the interaction?
How will success be measured?
Taking Mobility Beyond Wireless Phones
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1. The Current State – Practical Questions : ED Mobility Project
What are you trying to accomplish using mobility?
Who are the participants in this interaction?
What are the mobility tools to be used?
What are the anticipated volumes of interaction?
What is the expected outcome of the interaction?
Enhance clinician to clinician communication
ED Physicians, ED Nurses, Admitting Physicians, Ancillary Depts
Smart phones on plan, on wi-fi, VoIP wireless phones, apps
Limited use of cellular voice, extensive use of texting
Reduced ED LOS, Decreased use of unsecure texting, improved clinician satisfaction
Taking Mobility Beyond Wireless Phones
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1. The Current State – ED Mobility Project
Deployed a mix of Android and Apple phones to nurses and physicians
Physicians and manager received phones with cellular voice enabled
Nurses received phones that were wi-fi enabled only
Opted for individual devices, not shared
All phones were loaded with apps for secure texting, VoIP extensions to the phone switch, and a number of convenience apps
What was the experience?
3. THE VISION
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Taking Mobility Beyond Wireless Phones
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3. The Vision – Developing a Strategy
Map current state
Examine workflow & identify opportunities
Identify or create solutions
Visualize a future state
Assess outcomes and adjust if needed
Focus on a few key initiatives at a time
Taking Mobility Beyond Wireless Phones
3. The Vision – Examine the Workflow
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ACTOR will send INFO via METHOD(s) to ACTOR(s) ACTOR will receive INFO and view on MODALITY ….. ACTION ?….
Identify a communication opportunity:
V-Mail
Text Message
Secure Text
Robot Voice
Video
Real-time Chat
METHOD
Ancillary Dept
Community
Family Member
Nurse
Patient
Physician
EMR
ACTOR
Cell Phone
Hotspot
Laptop
Medical Device
Pager
Tablet
Wireless Phone
MODALITY
Result
Appointment Info
Order
Reminder
Alert
Verification
History
INFO
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3. The Vision – Identify Opportunities
Acute Care Setting
– Integration with hospital systems
Consults, Critical Labs, Diagnostic Imaging, Pathology results, Rounding lists, Dictation/Signature requests pushed to clinicians
– Patient-centered care-team communications
– EHR/HIE notifications of status changes to all providers
– Delivery of analytic alerts
– Nurse call integration
– Education & Training
Taking Mobility Beyond Wireless Phones
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Post-Discharge & Home Care Settings – Cohesive network of clinicians, nurses, care managers, patients, family – Monitoring, Reporting, and Responding to clinical status changes – Telemedicine
Patient & Community Applications – Provider directories – Facility directories – Way-finding – Procedure scheduling & appointment reminders – Marketing
3. The Vision – Identify Opportunities
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Back Office & Operations Bed turnover automation Service recovery team coordination - patient satisfaction issues Patient services - room service, entertainment Pager replacement Charge capture Facilitated dictation Emergency management
_ _ _ _ _ _
3. The Vision – Identify Opportunities
_
4. CHALLENGES & LESSONS LEARNED
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4. Challenges & Lessons
Taking Mobility Beyond Wireless Phones
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Developing a mobility strategy can be overwhelming – focus on a mobility philosophy
Proper governance is vital to ensuring a cohesive approach to mobility & to ensuring focus on value and organizational goals
Usability is not trivial – it is the key to adoption and must be given extensive attention in the planning process – Be wary of information overload
Try to remain device independent
4. Challenges & Lessons
Taking Mobility Beyond Wireless Phones
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Do not underestimate the effort to integrate back end systems particularly for bi-directional interaction
Security of mobile devices remains a concern that must be addressed and constantly reviewed
Establishing policies is important, however keeping them current & enforcing them is equally important
Find ways to stay current on the rapidly evolving technology landscape without compromising security & value
Find ways to give users choice without sacrificing control
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THANK YOU
Indranil (Neal) Ganguly Vice President & CIO
JFK Health System Edison, New Jersey