Electronic Health Reporter

Who among us that spend time working in health IT don’t think about ways to use the technology in practices to create efficiency and make work life better? However, on the other hand, how often do we think about the technologies and technological strategies employed in healthcare that just don’t measure up to much except for waste of time and resources.

Stepping back for a minute, but using that concept as a launching point, I recently asked several people this very question and the responses I received were plentiful. They ranged from implementing new solutions to make life easier for physicians on rounds to techniques for streamlining the use of email.

You see, electronic health records and practice portals, for example, are not the only solutions and approaches that can make us more productive or create productive IT throughout the care setting.

Vincent S. Vitali, CIO, La Rabida Children’s Hospital

For our clinicians, especially physicians, the need to login and logout of workstations can cost them 15-30 minutes or more per person per day. Physicians moving from room to room on the outpatient side experience this most often. We have tried to address this issue in a couple of ways. We implemented wireless workstations on wheels (WoWs) for the nursing staff, one per nurse per shift, so they can login once and take the WoW with them to do rounds, administer meds, document, etc. We also added a couple of shared-use WoWs for physicians to use when they are rounding or seeing patient in the clinic  to minimize their need to login and logout.  We are looking at virtualized desktops and biometric devices to speed this process further.

A related example is password management. We have implemented rules re: password complexity and reuse to address HIPAA and other security concerns. Staff often forget these longer, more complex passwords, especially when they are forced to change them every 90 days and we do not allow them to re-use any of their previous five passwords. Calling the helpdesk during peak periods often resulted in delays that prevented staff from doing their work. To address this, we implemented an online password reset portal to allow staff to change their passwords themselves.

Communication among caregivers is also a huge time-waster. Nurses needing help from other nurses, nurses needing to reach the physician, physicians needing to reach the nurse covering their patients – all of these involve phone calls and callbacks, leaving messages and waiting, or sometimes physically having to leave a patient to go find someone. By one recent study we’ve seen, physicians spend only 45 percent of their time with patients. The other 55 percent is spent on administrative tasks and communications with others. We are looking at ways to streamline this communication while keeping it secure, including secure text messaging and real-time individual communication devices (e.g., handheld phones or wearable badges).

Abhay Padgaonkar, award-winning management consultant, author, and speaker

I have seen a tremendous waste of time manifest itself in the following three ways as it concerns Healthcare IT inefficiency:

1) Too many systems with the need to remember multiple, non-standard and expiring passwords coupled with slow response time because of poor IT infrastructure and architecture.

2) Partial migration status for years resulting in electronic and paper hybrid wastes a lot of time. Add to that lack of functionality or flexibility and lack of full, two-way access to key stakeholders (e.g. PCPs).

3) EHR systems designed by programmers without proper involvement from end-users results in “surgery was successful, but the patient was dead” syndrome.

Rick Brenner, principal of Chaco Canyon Consulting of Cambridge, Massachusetts

By now we’re so accustomed to email that we tend to forget how much time we spend using email clients. And many of us have stopped learning — we know the commands and techniques we use, and we get by, so we have little motivation to learn how to do things better.

True, the advantages of the more powerful methods are small, but since we’d use them so often if we knew how, we could save significant amounts of time and effort. Another way to look at this situation is that we’re wasting a lot of time doing things the way we do them now.

Here are two tips for using your email client more effectively.

Create folders and filters for categories of traffic

Instead of keeping all messages in one folder (usually the inbox), file messages in folders dedicated to particular projects or topics. And when you create such folders, also create filters that automatically file incoming messages there if they belong there. No more manual sorting.

Excerpt only relevant parts of the received message in your reply

Include only the parts relevant to your reply. When you include the entire received message in your reply, you compel recipients to scan through the whole thing to determine whether you commented on any of it.

And here are four tips for making the entire email system more effective.

Don’t reply all unless all need to see your reply

Think of a received email message as an interruption for the recipient. Interrupt people only if what you have to say is important for them to hear.

Check your email as frequently as necessary — not more

Some people have their email clients set to notify them whenever a new message arrives, or every five or ten minutes. Do you really need notifications that often? Some people do, but if you don’t, turn the darn thing off.

Don’t recycle subject lines

Use an appropriate subject line for your outgoing messages. Sometimes we reply to old messages just to get the addresses right, even though we’re sending mail about a new topic. When we do this, we make finding, filing, and grouping relevant messages more difficult, which wastes time for everyone. Use an appropriate subject line.

Make it easy for groups to establish global group email addresses

In many organizations, establishing a globally (but internal) accessible email group definition is difficult. Obstacles usually involve high bureaucratic hurdles that nobody has the time to figure out how to jump. Consequently, members of these groups are forced to manually type email addresses, or define and maintain their own nicknames at the email client level. Even if they do everything right (and mistakes do happen), the time spent far exceeds the time that would be spent if each group or department could delegate this responsibility to a single member. This is a tragic waste. Make list definitions easy for users to create and maintain. If Yahoo can do it, we can.

What techniques can you recommend to make use more productive? What have you used to bring your practice forward, even if not innovative just used differently.