When hospitals think information technology, the 100-million-dollar gorilla in the room is electronic health records (EHR). While the adoption of these systems is meant to improve healthcare and create cost savings, EHR software systems are sprawling, their implementation complex and their price tags can run in the millions to hundreds of millions of dollars. At the high-end there are places like Boston-based Partners HealthCare, which went live with Epic (the EHR market-share leader) to the tune of $1.2 billion, after a three-year implementation process.
When speaking with hospital leaders on this subject, we've heard them use phrases like “IT pressure”, which is to say, beyond budget constraints, not having the IT staff bandwidth to deal with more on-site hosting of software systems, or complex implementations, especially after the move to EHR. There is of course cloud-based, healthcare technology that fits into departments' budgets and isn’t a large capital expenditure. These agile, cost effective software solutions can be accessed from workstations on wheels or mobile devices, and the implementation of this technology and return on investment is measured in months instead of years. When you talk about the interoperability of these software systems, it’s more often the rule than the exception.
Fast Implementation, Immediate ROI
From initial workflow analysis to hospital-wide implementation, it took approximately three months for University Hospital in San Antonio, a 700-bed academic medical center and level-I trauma center, to deploy an automated equipment workflow solution to manage 7,000 medical pumps using RTLS (real-time location system), at a cost of less than $100,000. The hospital saw relatively immediate return on that investment, by avoiding the need to purchase extra pumps at a cost of almost $200,000; something they thought was necessary before the new workflow and software streamlined their equipment distribution process, and freed up their existing inventory of pumps.
Fast implementation of new software and technology also means minimal strain on staff time and resources. SUNY Upstate University Hospital, a 420-bed, level-I trauma center in Syracuse, New York implemented a service request software solution for nurses (enabling them to easily request equipment delivery) while the hospital was also rolling out Epic. Nurses were successfully trained in tandem on both pieces of software, in large part because the service request software was easy to use and easy to train on. “We rolled out the iGotIt application, within about a month we were hospital-wide, which was about two months faster than we had initially thought,” said Brian Reed, Manager of Central Equipment.
It took Reed and his department just two twelve-hour days of giving tutorials to the first nursing units before they were live and his department had requests coming in through the software. With the average response times for equipment delivery dramatically improved — from an hour to 15 minutes — within a week five other nursing units who weren’t part of the initial rollout wanted in. The ease of use and immediate benefits of the software created an environment of easy adoption among the nursing staff, who were initially skeptical of new software.
Medical University of South Carolina (MUSC) deployed an equipment tracking solution with RFID (radio-frequency identification) at their Medical Center and Children's Hospital buildings, taking two weeks to install about 110 read points throughout the hospital, and six weeks for tagging 6,000 pieces of equipment — 4,500 of which were new infusion pumps being changed out by the manufacturer. The hospital has now expanded its asset tracking efforts to more areas of the hospital on some 20,000 pieces of equipment. MUSC’s improved equipment workflow enabled the hospital to free up bladder scanner availability, and avoid purchasing extra scanners at the cost of over $200,000.
Getting the Message
The move to EHR was a government mandated one. Hospitals needed to comply or face penalty. The new paradigm for healthcare information technology, like these success stories, is one where hospitals have a choice. The choice to fix broken processes and procedures with the help of new technologies to become more efficient, provide better care and save money. We’ve come to a place with technology where we don’t have to accept the status quo; whether it's booking a hotel, waiting for a taxi, or delivering infusion pumps to patients.
Across this disruptive environment, the opportunities for hospitals and healthcare providers has never been greater. It seems like the government is starting getting the message as well. At the recent J.P. Morgan Healthcare Conference in San Francisco, CMS Acting Administrator Andy Slavitt spoke of ending, or at the very least altering the Meaningful Use program in 2016. "The focus will move away from rewarding providers for the use of technology and towards the outcome they achieve with their patients, said Slavitt. "Providers will be able to customize their goals so tech companies can build around the individual practice needs, not the needs of the government. Technology must be user-centered and support physicians, not distract them."