Health IT Summit San Francisco 2015 - Case Study "Taking Mobility Beyond Wireless Phones: A Work in Progress"

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


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1. About JFK - Background


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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


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2. THE CURRENT STATE OF MOBILITY


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2. The Current State – Infrastructure


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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


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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


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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?


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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?


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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


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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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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


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:

E-Mail

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


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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



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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

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4. CHALLENGES & LESSONS LEARNED

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4. Challenges & Lessons


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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


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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

[email protected]