Clinical Mobility CSOHIMSS 2011 Slide 0 October 21, 2011 Health Care Quality, Security and HIE Synergy 2011

Transcription

1 Clinical Mobility CSOHIMSS 2011 Slide 0 October 21, 2011

2 CSOHIMSS 2011 Slide 1 October 21, 2011 Clinical Mobility Mobile Computing Secure Wireless All we need to enable clinical mobility right?

3 CSOHIMSS 2011 Slide 2 October 21, 2011 Clinical Mobility Most mobility strategies are still in their infancy. Source: Billian Health Data and Porter Research Aug 2011

4 Clinical Mobility CSOHIMSS 2011 Slide 3 October 21, 2011

5 CSOHIMSS 2011 Slide 4 October 21, 2011 Clinical Mobility - Drivers CPOE emar/bcma PPID Patient Transfer PPID Specimen Collection Respiratory POC RFID Telemedicine Many Drivers to clinical mobility HIE Patient Discharge Admissions PatientScheduling RTLS eprescribing Patient Monitoring Voice Home Healthcare Document Mngmt

6 Hospitals are aggressively moving toward level 4, CPOE. A new state law in Massachusetts will require hospitals and community health centers to adopt CPOE systems by 2012, and EHRs by 2015 CSOHIMSS 2011 Slide 5 October 21, 2011

7 Colubris N E T W O R K S TM Everything Depends on Mobility Video Surveillance Medical equipment Tracking Electronic Prescription VoWiFi Mobile kiosks Personnel / Patient tracking Asset Tracking Digital Signage in the lobby Mobile Point of Care Secure Guest Internet Access Patient Terminal Hot-desking for ad-hoc personnel outdoor CSOHIMSS 2011 Slide 6 October 21, 2011

8 CSOHIMSS 2011 Slide 7 October 21, 2011 Clinical Mobility Current State Most clinical workers are frustrated with current deployments. Many combinations of technology have been tried unsuccessfully. New clinical technologies are highlighting weaknesses with current strategies.

9 The daily workflow associated with the clinicians job function, and patient flow should drive the overall solution. Most CNO s report they do not have decision making power for final solutions. CSOHIMSS 2011 Slide 8 October 21, 2011

10 Clinical Mobility - Current State A study conducted by the Robert Woods Johnson Foundation identified 327 workflow issues for nurses and 766 unique processes requiring improvement to enable nurses to spend more time delivering patient care. Many of these issues would be addressed by not only applications but the underlying technologies utilized to access these applications We must make it attractive for doctors to enter the digital world. Financial incentives would help, but the most important factor is to reduce acquisition and running costs (of technology). We must also simplify the EMR and make it easier for doctors to learn and use. IT and Primary Care Discussion Paper Harvard Pilgrim Healthcare Inc. Reliable, transparent, simple hardware and software lowers the cost of adoption, maintenance, and use while simultaneously increasing the likelihood that providers will purchase and employ them. Wide spread adoption of sophisticated handheld devices and the development of technologies and systems for making interoperability simple, straight forward and reliable will increase the attractiveness of HIT among physicians and hospitals. - Health Information Technology in the United States: The Information Base for Progress CSOHIMSS 2011 Slide 9 October 21, 2011

11 Case Study UCSF Medical Center, Motion Computing, Intel CSOHIMSS 2011 Slide 10 October 21, 2011 Has technology eliminated paper or writing on gloves? Nurses would take vital signs using the GE DINAMAP, collecting blood pressure (B/P), pulse (P) and oxygen saturation (O2Sat). Temperature was taken separately, and respiratory rate observations were done manually. All data elements were then written down on paper and carried by the nurse until they were entered into the EMR system.

12 Case Study UCSF Medical Center, Motion Computing, Intel CSOHIMSS 2011 Slide 11 October 21, 2011 nurses can log in as many as 50 times per shift Logon latency? = 20 seconds Source: USFC Medical Center

13 Case Study UCSF Medical Center, Motion Computing, Intel CSOHIMSS 2011 Slide 12 October 21, 2011 Reduced the chance of transcription errors from 12 down to 2. Source: USFC Medical Center Vitals process went from 5min to 1min.

14 CPOE Implementation Device Selection Workflow Study CPOE Software Encryption Change Management & Education Application Availability Wireless Network Performance CSOHIMSS 2011 Slide 13 October 21, 2011

15 CSOHIMSS 2011 Slide 14 October 21, 2011 Clinical Mobility Strategy Mobility Strategy: Clinician workflows and work areas for care and documentation Patient and information flow patterns for each clinical area Space constraints, facilities, Fire Marshall and Joint Commission requirements Infection control and prevention protocols Staffing models and ratios by discipline and shift User device preference Clinical Application Access Hospital Owned Non-owned devices Support for affiliated staff Wireless network Security Encryption Theft protocol PHI BioMedical Devices Medical Applications

16 CSOHIMSS 2011 Slide 15 October 21, 2011 Over 8,000 devices are registered by the FCC in the same spectrum as a/b/g n has much higher capacity and less interference The majority of wireless networks are installed incorrectly. Full spectrum wireless assessments are needed.

17 Clinical Mobility - Wireless CSOHIMSS 2011 Slide 16 October 21, 2011

18 CSOHIMSS 2011 Slide 17 October 21, 2011 Massive changes or design considerations are needed for a multi-service wireless network Data Only Multi-Service

19 The majority of wireless networks will not support VoWLAN. CSOHIMSS 2011 Slide 18 October 21, 2011

20 Clinical Mobility Application Access Handhelds Ultra Mobile Specialized Tablet Cvrtbl Laptop Motorola MotionCL900 MotionC5v HP 2760 HP Elitebook & Probook ipad MotionJ3500 Panasonic T8 Intermec Panasonic H1 Fujitsu Lifebook Client devices need to paired with the overall mobility design. CSOHIMSS 2011 Slide 19 October 21, 2011

21 CSOHIMSS 2011 Slide 20 October 21, 2011 How you access the medical application drives the device Special App Full Client Virtual Desktop

22 Clinical Mobility - Workflow Study CSOHIMSS 2011 Slide 21 October 21, 2011

23 Accessories CSOHIMSS 2011 Slide 22 October 21, 2011

24 CSOHIMSS 2011 Slide 23 October 21, 2011 Clinical Mobility Customer Knowledge is based on traditional client server computing PC/Client Services Non supported devices Clinical Departments want improved support, and find mobile experience tedious Senior management knows mobile device solutions are key but uncertain in how to proceed Help desk services are bombarded with mobile device support issues

25 CSOHIMSS 2011 Slide 24 October 21, 2011 Clinical Mobility - Telemedicine Broad Band Considerations remote locations and roaming specialists WAN Design MPLS Wireless roaming performance Quality of service multi-service design

26 CSOHIMSS 2011 Slide 25 October 21, 2011 Clinical Mobility Integrated Strategy Network Devices Workflow BioMed & Emerging Technologies Applications Support System Security & Compliance