The Journey to Mobility Past, Present, and Future SoCal HIMSS Clinical Informatics 5.19.17
Why Mobility Frontline care teams demand ease of use and ease of access to data Proliferation of devices/apps increases maintenance complexity and context fragmentation 6.4 = avg number of mobile devices clinicians use per day 1 5 = avg. number of work-related apps on a clinician smartphone 1 Converging demands require cross-functional strategy for clinical mobility Security Productivity Clinical Quality & Safety Coordination 1. Wireless trends in healthcare netmotion 2
Elements of a Mobility Strategy People MD RN RX Ancillary IT Capture the right workflows Cross Functionally Process Clinical Workflow Comms Workflow Maintenance Vertical and horizontal integration Capability and Forward Compatibility Tech Apps Device MDM Middleware Network Start the design process from the user experience and work outward to the technology 3
Elements of a Mobility Strategy MD RN RX Allied Health Outcomes - targeted Workflows - enabled Horizontal Integration Right Workflow + Experience = Outcomes / Productivity Mobile Devices Telemetry/ Monitors Mobile Apps Middleware Nurse Call Systems Vertical Integration Interoperability Reliability Availability Manageability Infrastructure Clinical Network Telephony 4
Past
Mobility Strategy in the Past Reactive management, limited number of single-purpose devices, single-purpose applications Clinical Care: Single-Purpose Devices Communication: Single-Purpose Devices WoWs Motion C-5 Honeywell Dolphin 6
Elements of a Mobility Strategy Outcomes - targeted Workflows - enabled Mobile Devices Telemetry/ Monitors Clinical Mobile Apps Middleware Nurse Call Systems Infrastructure Network Telephony MD RN RX Allied Health Horizontal Integration End Result: Right Workflow + Experience = Outcomes / Productivity Duct-taped devices Break-fix Vertical burden Integration across a proliferation of devices Interoperability Reliability Siloed ownership: Biomed, IT Availability Manageability 7
Present
Mobility Strategy Today Reacting and adapting to smart devices while struggling to reconcile infrastructure readiness and fragmentation Smart devices enable a multi-purpose platform to build on Proliferation of disparate apps created a new tool belt the app tool belt Clinical Workflows Communication Workflows Reliability & interoperability across clinical and comms infrastructure becomes challenging 9
Infrastructure Middleware End-User Applications Transitioning from past mobility investment to present creates further fragmentation without a consolidated strategy RN focus, expanding to MD MD focus Transitions-of-Care Focus Integrated End-user applications: VoIP, text, alerts/alarm, (workflows/contexts) Purpose-Built Inpatient Barcode Devices Legacy VoIP or DECT handsets H/W Only Purpose-built Handhelds Next-gen H/W + broader capabilities Alert & notification management Enterprise Visibility Desktop Console Middleware Assignment Systems Nurse Scheduling System Nurse Scheduling/Assignment Comms Middleware (incl. alert mgmt, assignment functions) Monitored Device Middleware isirona Cardiopulmonary Capsule Patient Monitors Nurse Call Systems Monitors w/ Ports Nurse Call Network & Telephony Infrastructure: PBX, Wifi, LAN, WAN 10
Mobility Emphasis: Smartphone adoption, MDM investment, HIPAAcompliant communication app choices Outcomes - targeted Workflows - enabled Mobile Devices Telemetry/ Monitors Clinical Mobile Apps Middleware Nurse Call Systems Infrastructure Network Telephony MD RN RX Allied Health Horizontal Integration End Result: Right Workflow + Experience = Outcomes / Productivity Network reliability Proliferation of the app toolbelt Vertical Integration Limited workflow impact Interoperability No outcomes Reliability impact Siloed ownership: Availability IT, Telecom, Nursing, Manageability Physician 11
Future
Elements of a Mobility Strategy Outcomes - targeted Workflows - enabled MD RN RX Allied Health Reliable outcomes Horizontal are enabled Integration by system of interaction, engagement and action Right Workflow + Experience = Outcomes / Productivity Mobile Devices Telemetry/ Monitors Clinical Mobile Apps Middleware Nurse Call Systems Infrastructure Network Telephony Vertical Integration Mobility services are built on top of mature Interoperability systems of record Device-agnostic Reliability Availability Manageability Vertically & horizontally integrated infrastructure: EMR, Directory, Patient ID, Assets Tracking 13
An integrated ecosystem Clinical Information Systems Alerts And Monitors ADT CPOE Pharmacy emar Patient flowsheet HL7:ADT HL7:ORM HL7:RDE/ORM HL7:RAS/ORU HL7:ORM, Web Services Nurse Call Telemetry Patient monitoring Middleware Lab HL7:ORM/OML/ORU IT Infrastructure Care Team Web Service Telephony Wireless LDAP/AD 14
Clinical informatics leadership is critical to mobility strategy success It s 80% a people issue 15% a process issue Historical Mobility Challenges Siloed ownership Clinical initiative IT initiative Telecom initiative Unclear executive sponsorship Lack of strategic visibility Successful Mobility Strategy Strategy is well-defined Lead by CMIO + CNIO collaboration Consulted by CTO, sponsored by CIO Cross-functional stakeholders engaged: Workflow integration discovery Vendor consolidation requirements Clear, multi-year roadmap of purposeful evolution spanning infrastructure to middleware to end-user applications to outcomes 15
Successful mobile-enabled institutions are relentless about results CLINICAL COMMUNICATIONS CLINICAL WORKFLOW 86% of users experience improved response times 86% of users feel more connected to the care team 79% of users see improved communication of patient information 67% of clinicians experience fewer interruptions 50% improvement in response time to rapid patient deterioration 97% average compliance on any workflows 60 minutes per nurse per shift saved on documentation and coordination 20% reduction in duplicative lab orders 15% decrease in STAT order to lab time 15% improvement in HCAHPS per medication education to patients 16