Hospital Projects Implementation

No one prepares you for all the unexpected detours in a project scope. A project's health constantly needs to be monitored by the PM of the project and in that respect, hospitals that do not have a clear PM to manage all the stakeholders along with the frequent, indecisiveness by clinical managers are greatly at risk in making very expensive mistakes. Its a frequent scene to have many technology and medical equipment vendors who promise many a great thing while laughing on their way to the bank.

There is much stirring in the pot to reduce the cost of healthcare and/or the need to reduce doctor's pay. But, no one talks about how we can reduce cost of healthcare by building organizations that efficient and grow in the right way.

Here are several ways we can save money:

Truth be told, people do not review quotes. Vendors give clinical folks their business cards and there ends that. The physician/clinician who has 2 minutes worth of time and 1 minute of listening skill to make a multi-million dollar decision that require major MEP planning and technology infrastructure discussion. This is fatal.

Resource Planning. There is constant hiring but nobody is at their desk and every other person seems to be a contractor. If you want to grow: grow in the right way.

Planning and Tracking. Hospital projects need to be planned to the nitty gritty. There are surely countless instances how your facility would have saved money this way.

Information Exchange. Its my opinion that the management and leadership's style of running the organization affect its general health. Team work and the general idea to improve the health of each patient should be a core value within each employee. Each employee should have rights to make decisions that fit their scope of work and this should not be taken away.

The image exemplies this post. I am unable to provide the credit to the person who created this

image since it was from a series of forwarded emails.

Data-EMR

Capsule Technologies sells the product, Data Captor, that overcomes the problems of interoperability to help you store copious amounts of variables in your EMR. This piece of technology will now force us to look at the big picture to help us document what is truly important. Readings from your medical equipment such as ventilators, infusion pumps, physiological monitors can all be transferred over to your EPIC, ECLIPSYS, CERNER records without a hitch. Clinical folks, though, have to ascertain the balance of the necessary info needed for effective diagnosis and comprehensive info to study trends. How good is the QC of medical transcription that actually takes place? Does everybody review the notes received? How much of the patient's data should we store and be responsible for? Perhaps, that should be capitalized on? We'll store your comprehensive healthcare data for 3 yrs, 5 yrs, 7yrs, each at its own cost.

Given the no.of devices at the bedside, the no. of variables that are being measured for the time of your stay, how much of that do we really need to store? Are we really going to review your charts all that much? What should be next in line if it isnt already is a device that can chart trends? Perhaps, we can have Smart devices that can do personal modelling of a person's preferences, tolerances and reactions during a hospital stay. We'd have a preprogrammed idea of each particular patient type.

The stories of Non-profit

Non-profit industries have many low-performers interspersed with some high performers. Is this a result of the lack of competition ? The healthcare industry, in my opinion, should mostly be profit driven. Howelse are we going to drive top-notch care? It's a process-driven atmosphere filled with fear of rules and regulations. Not to forget, there is also much bureaucracy and a mindset that is almost military like. In the sense that the management style does little to empower its employees with the creative enthusiasm necessary to expedite solutions.

EMR Implementation

Electronic Medical Records (EMR) is not a new concept. It has been in the works for a while and you'd think that if needed, we could have completely converted over from paper-based records overnight. But only less than 16% of hospitals as of 2006 had implemented EMR. I am not sure of the current stats and if anyone could provide me that, I'd be ecstatic. Nevertheless, the number is probably still low. How else are we going to make fun of a doc's chicken scribble?

The advantages of having EMR vs paper are plenty. Here are a few:

1. Radiology Images are available almost immediately (unless of course, for some reason there is a computer glitch, i.e., "some one" missed a step in clicking save or the server is down).

2. Your cardiologist can access your files from his hotel room in Japan when he is on vacation. Well, you get the idea.

3. We just cut out the whole medical transcription route. No more expenses for dictation of Physician clinical notes. To all the folks who are in this career path, time for a switching onto an alternate route. HIPAA will be needing plenty of help.

4. We'll free up enormous amount of space. Maybe even add a few five-star hotel type, patient rooms.

In 2004, President Bush created the ONC office to establish a National Health Information Network (NHIN), the outcome of which I am not sure.

It would be ideal to create a centralized EMR system for the US, similar to what is being set up by the UK. It is an urgent need for conversion. It cannot possibly be economically efficient if we wait for the future. Cerner, Epic/Eclipsys and other companies should be forced to come to an agreement.

CE-IT merge

http://www.ceitcollaboration.org/
The launch of the new CE-IT website is a clear indication of the merging of minds. AAMI, HIMMS and ACCE have launched this new collaboration which may be a bane or a boon to all. Merged efforts are economically savvy but the new always forces the demise of the tried and true. Clinical engineers routinely end up as equipment planners, sales or as R&D specialists. BMETs are CE, without the presentation and business acumen. Some call them "glorified mechanics". I think neither. The plan is for hospitals to streamline efforts, save money and provide the ultimate customer service. The blending of the worlds may be the best thing that happened. Medical equipment planners will have to learn that its not just a physiological monitor that is being bought and what is inclusive and less talked about are the servers and networking and cabling. IT has to realize that its not all about security and its not just another display, it would have to be an FDA grade monitor. Patient centric vs. data centric.
Are we building the tower of babel?

Hero

The greatest passages of a person's life are when they are sick and suffering. It is when kindness and compassion is evoked from others. The low moment of one is the chance for another to step up to the plate to become the hero. This concept I had always had even before I had foolishy been beguiled into reading the book "Choke" by author Chuck Phalanuik. The publisher had brilliantly packaged cheap descriptions of sexual encounters with a cover that could have been pulled off a grey's anatomy book and a thrilling synopsis at the back that in no way indicated that we were to be thrown into a world where sex in the church is the norm. I have sworn never to read bestsellers.

Nevertheless, I can still take the little good from that book. I have a spark of hope that we can create a ripple effect and affect change for the whole world. It may be an unrealistic optimism or it could be that I am being delusional. Everybody can be somebody's hero. My quest is in healthcare. What's yours?

"Whatever gift each of you may have received, use it in service to one another, like good stewards dispensing the grace of God in its varied forms." (1 Peter 4:10)