Tips for structuring a successful device pilot

One of the most common mistakes hospital systems make when implementing a mobile device strategy is choosing the wrong devices. Problems like devices not roaming well from access point to access point, or even simple manufacturer quality issues, can sabotage a strategy’s success.

It’s easy to assume that if a device costs upward of a thousand dollars it would meet almost any need a clinician could have, but many hospitals have found out the hard — and expensive — way that a high-dollar price tag doesn’t guarantee the best device for their user groups.

The best way to avoid this risk is to pilot any device before making a big purchase.

The importance of end-user input

The most important thing to keep in mind when piloting a new device is to conduct the pilot in real-world situations. There is a greater chance of a successful pilot if the devices are put right into the hands of end users and are used throughout the day within normal workflows.

Most end-user groups in hospital settings are very mobile by the nature of their jobs. Clinicians must be in many different places throughout the facility at many different times of day. And it’s necessary to make sure their devices roam effectively throughout your facility, without falling off the network.

For example, be sure to test the user experience at somebody’s desk, in a patient room, and in common areas of the hospital such as hallways, cafeterias and conference rooms. Don’t forget about areas outside the hospital, if personal devices are going to be included in your strategy.

Also, have a variety of end-user groups — e.g., nurses, ER directors, residents — test the devices. Apply as many variations as possible to the pilot process to increase the probability of finding a deal-breaking oddity. This will help you avoid purchasing and deploying expensive devices that aren’t going to work well within your hospital’s workflows.

Consider maintenance needs along with functionality

When it comes to workflows, test the devices against IT’s own needs. Think about the IT team’s ability to maintain the agreed-upon devices and policies, as well as manage them. The devices and the device strategy need to work just as well for IT as they do for the end user.

Another critical but sometimes overlooked element of the pilot experience is to test installation of commonly used applications. The goal here is to avoid any showstopping surprises after the devices are purchased and in the hands of hundreds, maybe even thousands, of end users. There are application limitations that are common to certain operating platforms, and if these limits are not tested before a device is selected and purchased, a breakdown in workflows and strategy adoption is likely.

For example, there’s a common assumption that by purchasing an Android device, end users will be able to run any app from the Google Play Store. The reality, though, is that some of these devices are on old versions of Android — i.e., 4.9 or lower — or they are heavily modified versions of Android that don’t support the Play Store or don’t support Google Cloud Messaging.

Since Google Cloud Messaging is used for push notifications, that’s the default push notification mechanism. If devices don’t support this feature, then extra work will be required.

You want to be as informed as possible about what you’re buying and how it’s going to work in real-life scenarios within—and beyond—your hospital walls.

 

 

Higher MIPS scores and positive CMS adjustments

Technology helps us do so much more than we used to be able to do on our own. If there’s anything we’ve learned in the last decade of technological innovation it’s that “there’s an app for that” when it comes to just about any goal you want to accomplish.

This absolutely includes the financial goals you’ve set for your practice, which you’ve probably had to re-evaluate recently due to the uncertainty surrounding CMS payment adjustments under MACRA.

Healthcare IT (HIT) will play a major role in your MACRA compliance efforts. In addition to automating some of the more tedious processes the new regulations require, HIT can help physicians score high under the Merit-based Incentive Payment System (MIPS), which is necessary to receive positive payment adjustments from CMS beginning in 2019.

Here’s how HIT, especially tools that enables efficient and timely care team collaboration, can boost scores in each of the four weighted MIPS performance categories:

Cost

The processes and treatment plans used by clinicians to deliver patient care are directly tied to costs. In the face of potentially negative payment adjustments, it’s more important than ever to realize cost savings, a feat that will be heavily impacted by providers’ ability to manage chronically ill populations. Success in population health management is highly dependent upon efficient communication, collaboration and care coordination across all care team members and care settings. Communication workflows and unified communication tools need to be assessed and implemented to improve the speed and efficiency with which disparate care team members can communicate with each other to coordinate care.

Quality

Clinicians have a lot of personal freedom when it comes to the quality of the care they deliver. One of the more manageable ways to improve the quality of healthcare is to overcome communication obstacles that have long degraded and delayed care. Obstacles such as not knowing who to contact for a given situation; searching for and struggling to find contact information and leaving messages with intermediaries; never knowing if the right message will be delivered to the right recipient, thus suspending and disrupting care, etc., are easily overcome with the help of intelligent communication routing and automatic escalation tools.

Advancing Care Information (ACI)

EHR functionality is a key component of ACI, but an EHR’s capabilities to support care coordination are limited. Care team members in a physician’s network may or may not share the same EHR, and the need to seamlessly communicate with them — and those outside of the network who are even less likely to have the same EHR — is equally important. There’s an increased need to implement a system of secure communications that transcend disparate EHRs to ensure timely bilateral exchange of patient information. Interoperability is an important factor for the ACI performance score.

Improvement Activities

Clinicians who utilize patient-centered approaches to achieve better, smarter and healthier care will perform well in this category. Implementing tools that enable patient-centric communications is one step toward achieving a high score in the Improvement Activities performance category.

More than 600,000 clinicians will be responsible for reporting MIPS performance criteria for at least 90 days this year. MIPS reporting is complicated, complex and extremely important to understand because it will impact CMS payment adjustments beginning in 2019.

The threshold to receive a positive payment adjustment has been set very low for 2017, so there’s less financial risk for eligible clinicians in the first year. The clinicians who want to cross the low composite score threshold to receive the maximum positive adjustment possible in 2019 need to score high in the performance measurement areas of Quality, Advancing Care Information and Improvement Activities. Reporting in the Cost category will begin in 2018.

Care team collaboration and communication platforms like PerfectServe® help clinicians decrease costs and improve quality by eliminating inefficient and time-consuming communication processes that delay treatment. Our cloud-based architecture allows clinicians to transcend the communication capabilities of the EHR and securely coordinate care with disparate interdisciplinary providers regardless of their location; and the patient-centered communication capabilities neatly fulfills all of the criteria for the Improvement Activities performance category.

The top 5 things you can do with PerfectServe

A day in the life of nurses and physicians is fast-paced and full of decisions. Clinicians receive an overwhelming amount of communications each day.

What if there was a way to streamline and consolidate those clinical communications? And make sure you’re contacting the person you need to reach, rather than searching and struggling to find them?

Watch the above video to learn about the top 5 things you can do with PerfectServe.

The impact of a unified communications initiative on a health system

Listen to the podcast here, or read the transcript below. 

Introduction: You are listening to Health IT voices. Broadcasting live from Chicago, Illinois, and direct from the HIMSS15 exhibition. HIMSS – transforming health through IT. Today’s show is brought to you by Health IT Outcomes, bringing you the latest on the technology and people driving health IT. And now here are your hosts, Todd Schnick and Kelly Riggs.

Todd: All right, good afternoon and welcome back to the show. I’m your host Todd Schick, joined by my friend and colleague, Kelly Riggs. Good afternoon to you sir. They have saved the best for last.

Kelly: Oh yeah, we’ve put a little pressure on him as well, but I’m looking forward to a great interview.

Todd: It’s going to be a great conversation. Before we go there, Kelly, a quick shout out to Health IT Outcomes for making this great day possible.

Kelly: You bet. Really appreciate them having us as a part of the show, and you want to make sure you check them out. HealthITOutcomes.com.

Todd: All right. Let’s get to this great conversation. We’re now joined by Terry Edwards, the CEO of PerfectServe. Terry, welcome to the show.

Terry: Thank you. Glad to be here.

Todd: Glad to have you. Thanks for carving out some very valuable time at the end of a long day. I’m sure it’s been a good day for all of us. Before we get into our conversation, take a quick second. Inform the audience a bit about you and your background, and then give us the 10,000 foot view of PerfectServe. What do you do? How do you serve your market?

Terry: Sure, sure. Well, I’ll maybe start with a little bit of a story here. I got involved in interactive voice response technology back in the 1990’s and when I got involved in that industry, my wife is a registered nurse, and she went to work for a solo practice pediatrician, and I used to observe how she would manage the call process. She would take calls for this doctor on the weekends occasionally, and I would observe how the process worked with patients needing to connect with her around an urgent situation, and how convoluted it was. And so, that led to an identification of this problem around communications in healthcare and me then founding PerfectServe. So today, PerfectServe is a pretty meaningful company in the space. We essentially are a communication and collaboration platform that’s focused on uniting the care team members – the physicians, nurses, and other providers.

Todd: We talked a little bit before the interview and you were explaining to me it is an enterprise resource type of application. Clearly, it has to be very extensive to begin to mold so many different disparate pieces into one arena. How do you implement?

Terry: Yeah. The heart of the platform is its ability to enable what we refer to as a communications-driven workflow. And so, let me explain what I mean by that. Let’s say that you were to show up in an emergency department, and the doctor thinks that you might be having stroke symptoms. So, they’re going to then kick off a workflow that’s based on stroke diagnosis and treatment. And that involves reaching out to the neurologist who’s covering that emergency room at that time. There might be a whole stroke team who has to get in to perform a CT scan for you. And this is important, because there’s a drug that arrest stroke called TPA, and there’s a certain time window when that drug has to be administered. And if it’s not administered in that time window, bad things happen. So, an example of the communications part of that is contacting the on-call neurologist and mobilizing that team and getting them to come together to provide the care that’s necessary. So, PerfectServe would automate that kind of a communications process, for example. So that’s what we do.

Todd: You said earlier that your role is to unite the care team members. Now I think the average consumer out there would say, ‘Well, wait. That’s not happening already?’ I mean, how big of a problem is that?

Terry: It’s a big problem. In fact, we conducted a Harris poll survey that we released this week, and we surveyed nearly 1,000 providers. I believe about 750 were actual clinicians. The others were administers of large practices or hospitals. But of the clinicians, 54% of them, or 53% of them, often times don’t know who the right care team member is in a given clinical situation, and that’s because the workflows are complex. So much of healthcare is role-based communication, and who is in this role. Like, I talked about the neurologist. Who is in the role of the neurologist providing care at this hospital right now? Because that changes.

Todd: Well it’s interesting that you use the phrase communication and collaboration, because basically what we’re talking about is a variety of silos that, if they don’t hand off and transition well, you can lose a lot of valuable information along the way.

Terry: That’s right. That’s exactly right. So, communication to me and to us is a part of collaboration and this notion of collaboration is really more important as the industry shifts to value-based care models, and it’s not about the doctor or just the patient anymore. It’s about the whole care team. And so we’re really focused on trying to bring the care team tools that will allow them to be effective at collaborating with each other.

Todd: Well, you were reading my mind – the value-based delivery. That becomes a significant aspect of this. It’s really difficult to even drive that without the collaboration.

Terry: Yes, yes. Under a fee-for-service model, there’s not an incentive for providers to communicate with each other in many cases. But, if you have multiple providers who are all under, say, a risk-based sharing contract for a population of patients, then that’s going to drive new communication work flows and youth cases that aren’t occurring today. And there, you know, like contacting the neurologist. Some of them are very difficult to implement in an efficient way.

Todd: Absolutely. Well, lest you think I missed it, I did pick up on your secret weapon that Mrs. Edwards is a registered nurse. How critical has that been? Because they’re a critical link between the patient and the doctor. How valuable has her insights been to help you understand what really needs to happen here?

Terry: Well, she’s not practicing anymore, but she was integral to allowing me to, you know, to see the problem. But even as she describes it, within healthcare, I remember somebody asked her the question, ‘How bad was it?’ It’s kind of like, well, you don’t really know how bad it is until you have a solution, and then it’s like, how did we live without this before?

Todd: Hey, I want to get a little bit specific with you Terry. Let’s talk a little bit about PerfectServe. Talk about some of the features that you offer healthcare providers in a unified communication platform that other vendors may not.

Terry: Sure. Well, I’ll start maybe just talking about texting, because it’s been a segment that’s been emerging and it’s being driven by the rise in smartphones and, you know, we’ve all adopted it from a consumer perspective, and we incorporate those capabilities, but a true platform to really be comprehensive has got to bring in voice, it needs to bring in voice messaging, it needs to be multi-mobile. You’ve got to be able to initiate a communication via the phone, via a mobile app, via the web. It’s got to connect up to the primary clinical systems, so we receive data out of different systems, for example, and we’ll route that data accordingly. Say, a lab result, for example, or a new admission notification. So the other thing is, as you think about all these different modes, and then you have to do the various routing, you have to make sure that they’re all secure. So the issues around security aren’t just secure text messaging. It’s secure communications. And that, you know, in addition to the workflow capabilities that I talked about earlier, the ability to secure all the communications at an enterprise level is, we think, distinctive to the PerfectServe organization.

Todd: IT departments hyperventilate when you change their worlds, the finances of provider are very sticky and tricky and they’re limited with resources. How do you overcome some of those challenges?

Terry: Well, you know, within the hospital enterprise or large integrated delivery networks, you know, IT organizations, you know, they have their own way of buying and things like that and the buying processes and evaluation processes can be very, very challenging, but we have been able to work with some of the largest and most prestigious systems in the country, like Advocate, for example, here in Chicago. One of the leading health systems in the country – a leader in value-based care and we’re deployed across that entire system, and we’re employed across the entire system because we’ve been able to meet their needs, both from an IT security standpoint, and as well as a workflow standpoint.

Todd: So here’s an interesting question for you. We talk about outcomes. What physicians care about, ultimately, is outcomes. Is that the perfect metric to validate the efficacy of a system like yours or is there something else that we can measure and understand?

Terry: Well, what we’re doing is we’re enabling clinicians to speed the time to treatment, ok? So if you speed time to treatment, that will have an impact both on quality, as well as on operational efficiency. Now, there are a lot of other things that can contribute to both of those factors, but we’ve been able to do studies, for example, from an operational efficiency standpoint, where we’ve been able to improve throughput for example, in emergency room. We’ve been able to see hospitals see a reduction in code blue events. That stroke example that I gave, St. John Hospital and Medical Center, part of the Ascension health system in Detroit, when they implemented the process that I described, they were able to administer TPA to three times more patients who presented with stroke than they did the previous year even though the patient population was the same. So, by improving that communication-drive workflow, more patients walked out of that system alive who presented with stroke.

Todd: Sure. Speed becomes a very interesting metric. I agree.

Terry: Yes, yes. And we’ve been able to prove, we’ve done studies where we’ve definitely proven a reduction in cycle time. I had the opportunity to give a presentation earlier today here at the event with Memorial Care, and we did a before/after time motion study of nurse to physician communication cycle time, and they experienced a reduction in average cycle time by about two thirds. From 45 minutes on average down to just under 15.

Todd: Wow. Wow.

Terry: And the thing that’s interesting is these kinds of communications are occurring hundreds or thousands of time every day in a given hospital. So in Memorial Care’s case, I believe they’re probably about five to six hundred times a day.

Todd: Wow. Unbelievable.

Terry: And this is all about the care delivery process, and it’s the interaction that occurs in those communications that determines the, you know, the action that needs to be taken to provide treatment.

Todd: Well we’re here at HIMSS15. Is PerfectServe making any key announcements we should be aware of?

Terry: Yes, yes, yes. So we just announced our broader product development strategy and we’ve introduced that under the PerfectServe Synchrony brand identity. And that effort is about expanding from the communication-driven workflow for doctors to the entire care team, like we’ve described. So, we’re going to be rolling new capabilities out next quarter, and then those capabilities will be available by the end of the year or early the first of next year. And Memorial Care, who I talked about earlier, will be one of the first systems in the country to deploy this comprehensive solution. There’s not another one like it. Fantastic market. So, we’re excited.

Todd: Yeah, congratulations. We look forward to talking about that next year.

Terry: Great, great.

Todd: Terry, we’re out of time. Before we let you go, how can people get in touch with you should they have questions and where can they learn more about PerfectServe?

Terry: Sure. Well they can learn more about PerfectServe at www.perfectserve.com. I can be reached directly at 865-212-5700 or terry.edwards@perfectserve.com.

Todd: Terry Edwards, the CEO of PerfectServe. Terry, real pleasure to have you. Thanks for stopping by and joining us.

Terry: Thank you.

Todd: All right. Well that wraps our day one coverage here from HIMSS15. This has been Health IT Voices broadcasting from HIMSS live from Chicago. On behalf of myself, my cohost, Kelly Riggs, and all of us at Health IT Outcomes, this is Todd and Kelly signing off. Healthcare IT Voices will return tomorrow. We’ll see you then.