A recent article in Medical Economics, “The Promise of Next Generation EHRs” was an interesting read. It got me thinking, and there were a few parts of the article that left me uneasy, given the challenges in healthcare today.
First, the article cited reports that point to software as the primary administrative burden to physicians’ productivity. The article notes that inefficiencies in software lead to click fatigue and multitasking, which ultimately lead to mistakes.
Indeed, mistakes are very serious problems in healthcare. However, it’s not only physicians who suffer from inadequate software - nurses, clinicians and a host of administrative staff are spending most of their day using various software systems and applications.
Second, and perhaps more importantly, while stressing the need for flexibility and usability in information technology for healthcare orgs, the author specifically advocates that the best software is “designed by clinicians”. Ironically, this “designed by clinicians” paradigm is a major contributor to the dissatisfaction many users have with healthcare software products – including EHRs.
Of course, healthcare application vendors would be silly not to include significant input from current and former clinicians. Clinicians’ hands-on experience is invaluable to clinical in the form of environmental background, workflows, user scenarios, use cases, specific requirements and other types of content.
The much greater concern over healthcare institutions jumping onto the “designed by clinicians” bandwagon is that it quickly leads to the idea that software must be designed, not by just any clinicians, but by their own in-house team of clinicians.
Thus, when considering new software products, healthcare leaders are quick to ask the vendor, “Can we customize it?” (meaning a unique instance of a product, custom-developed for an organization) before they have seen much of the existing product. That question is where the real trouble begins. It is far from the end of the story, however.
Improving software in healthcare is a noble - and very necessary – goal. But when the rubber meets the road, software designed exclusively by clinicians leads to three major pain points that are already widespread in healthcare organizations.
The best software vendors use highly trained with a wide breadth of expertise in fields like information engineering, perceptive science, psychology, user interface (UI) and user experience (UX), for starters.
It takes all these skills and more to shape an optimal UX for a software product. Unfortunately, not every software developer is also gifted with design skills. Similarly, clinicians are untrained in the various disciplines of UX employed by a design expert during the product development process. As end-users, clinicians are often better at describing the problem rather then envisioning “clean slate” solutions that could drive the desired results.
In other words, both sides may be operating outside their area of expertise. Thus, having clinicians tell programmers what they want can lead to problems such as:
To avoid this scenario, I feel that the best outcomes result from software designed not by, but with clinicians at multiple points during the design, development and maintenance phases of the software lifecycle.
In recent years, custom development of healthcare management platforms has become ever more common. Vendors are eager to offer customization because they can charge more for the end product, while simply passing on the additional development costs directly to the customer. For some, in fact, it’s become a major part of their business model.
The more vendors provide custom development, the more customers ask for it, and so begins a vicious cycle. But the ugly truth is, while custom development or “customization” of healthcare IT products is lucrative for the manufacturer, it doesn’t necessarily benefit the customer. Much of customization work amounts to simple personal preferences which have no effect on patient care outcomes. Custom-developed products
One of the most important skills professional software designers have is the applied fundamental of design thinking. Design thinking uses a set of defined principles and constructs, combined with a very intentional process, to realize a desirable end product. Design thinking helps product designers fight the (very human) urge to “go with what you know”.
Most of us, when asked how a new system or product should look or work, will describe something very much like what we have used in the past – regardless of how well that product met our needs. People tend to lean on familiarity (often without even realizing it) which results in a “that’s the way we’ve always done it” attitude. It is this attitude that holds back much-needed progress in hospitals, clinics, and other healthcare organizations.
The unintended consequences of this perpetual cycle are:
After a few years and many thousands of dollars, too many healthcare organizations find themselves still encountering the same problems.
So what should healthcare organizations do? It will require a major attitude shift to get out of the rut that’s been dug over decades of stagnation and frustration at ineffective systems. Meaningful change requires buy-in, starting with management on down through all levels of the organization.
Here are some starting principles for effective change:
The takeaway here is that optimal product design “takes a village” – a multi-disciplinary team that includes, but is not controlled by, end users (clinicians, physicians, administrative staff).
ActionCue CI is built upon this principle. Our innovative solution was developed in partnership with clinicians, as well as highly trained UX/UI product designers, to address known problems in ways that go beyond what myopic visions of what so-called ”new” solutions can lead to. The dashboard is configurable to meet the unique needs of risk managers, clinicians, and healthcare executives while avoiding the pitfalls of full customization, resulting in a more cost-effective and intuitive product that end users love. By providing configurability without customization, ActionCue CI delivers an affordable solution that still meets specific users’ needs.
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It’s the beginning of a new year, and in 2018 the healthcare industry would greatly benefit from better utilization of resources. U.S. health care spending grew 4.3 percent in 2016, reaching $3.3 trillion, while an estimated $1 trillion is wasted each year on inefficiencies, redundancies and abuse. With an aging population, and chronic illnesses and obesity on the rise, emergency department staff will continue to be flooded with patients, while hospitals work to comply with new CMS mandates and rulings, and improve quality of patient care.
Hospitals are constantly working to increase productivity and reduce expenditures, while statistics continue to remind us that time is money. In 2017, EY conducted an advisory study of the healthcare industry, and after analyzing the data, suggested a holistic approach to reducing inefficiencies and improving quality of care. Of the five points presented, we’ll focus on the three areas where our ActionCue CI platform can make a significant impact for healthcare organizations in 2018: transforming the culture, advancing with analytic insights, and increasing productivity
Transforming the Culture
In 2017, we presented a four-part series on innovation and the role of leadership in creating action that improves patient safety and quality. A recurring theme in the series, and a concept we work to continuously promote, is creating a “culture of quality.” Improving culture is the first step towards improving patient safety and reducing inefficiency, and it must begin at the top. Organizational leadership must be deeply involved and aware of the challenges clinical staff face daily. Executive engagement is crucial to improving overall culture, but it’s no secret that executives face substantial time constraints. According to Becker’s Hospital Review, the average CEO spends about 2.5 hours per day in meetings, and 21.2% of a CEO’s solitary workday is devoted to reading and analyzing reports.
ActionCue CI allows staff to create comprehensive, easy-to-read reports in minutes, not days, providing real-time access to insights and performance measures while reducing time spent in meetings or analyzing confusing data sets. This creates more time for leadership to engage with clinical staff and take a more involved approach to culture. Because 51% of EY respondents believe employee satisfaction in healthcare drives patient satisfaction, not only will this boost morale, it will positively impact patient care.
Advancing with Analytic Insights
Access to reliable, accurate and insightful data is imperative as hospitals work to improve performance and quality. There’s more focus on patient outcomes than ever before, and as CMS continues to impose regulations and mandates, the spotlight is on hospitals to perform or risk losing funding. Executives need immediate access to meaningful metrics on safety events, corrective actions, performance indicators, quality management, risk management and more.
With event reporting, quality management and performance improvement tracking in one easy-to-use online platform, ActionCue CI is your Fast Path to Insight™. Its robust, real-time reporting features give executives the data they need to be proactive, rather than reactive, and drive better clinical outcomes.
Organizations’ leaders have historically accepted that quality and safety efforts require a large amount of time and effort, and lengthy processes. However, we believe applications should focus on collaboration and workflows that not only match the natural tasks and processes of users, but also shape the users’ behavior by encouraging methodologies that produce targeted results, and increase efficiency and accountability.
ActionCue’s design goes beyond ease-of-use to advance the way in which healthcare organizations engage with information in an application. The platform proves to be an enjoyable working team member, increasing productivity and facilitating education and improvement towards goals. Executives hoping to cut costs in 2018 should place significant focus on improving productivity and efficiency. With low operation costs, no hardware or installation requirements, and month-to-month subscriptions, the impact of ActionCue CI on cost reductions is two-fold.
As the healthcare industry continues to place more emphasis on quality and performance improvement, and improved clinical outcomes, 2018 promises to be a year during which increased efficiency and better utilization of resources is a major focus, and rightly so. If you’d like to learn more about how ActionCue CI can help you reach your quality and performance improvement goals more efficiently, contact us today and start 2018 off on the right foot.
By Keith Thurgood, PhD – Prista Board of Directors
We live in a VUCA world. Developed as an operational construct by the United States Army in the late 1990s, VUCA describes the world in four adjectives: volatile, uncertain, complex, ambiguous.
Since the Affordable Care Act (ACA) was signed into law in 2010, VUCA, as it relates to healthcare, has taken on new meaning with deeply imbedded dilemmas. Moreover these dilemmas are magnified by the fact that while doctors have been well-trained trained to practice the art and science of medicine, they have had little preparation for managing and leading change.
Healthcare enterprises are increasingly focused on transforming all aspects of care delivery, including cost structure, clinical quality, data transparency, patient experience and the overall efficiency and effectiveness of care delivered. There is no argument that these need to be addressed, but there is a question about who will lead these efforts. The answer has to be physician leaders.
Medicine has traditionally been organized as a craft-based industry where individual physicians, organized around their practice specialization, create a customized plan for each patient. What it’s being transformed into is a team-based practice, organized around patient or disease state, where groups of peers, treating similar patients in a shared setting, execute coordinated care delivery processes using agreed upon clinical guidelines and protocols. To drive and sustain this change, we need physician leaders who understand how to lead change and create alignment, and who don’t confuse being a leader with simply being given a leadership title. We need engaged, adaptive and collaborative leaders at every level of the organization. In short, we need to turn doctors into leaders.
To accomplish this, we need a radically new approach to leadership development. For guidance, we can look to one of the world’s premiere leadership development organizations, the U.S. military. No other institution devotes more time, energy and money to developing the character and competence of its future leaders. The military focuses on character and competence because how leaders get results matters.
The Army conveys this developmental message with the phrase, “Be, Know, Do.”
This framework encourages developing leaders by leveraging a variety of educational experiences, planning, and staff and positional roles, that challenge one’s character and competencies. The Army’s development of a seasoned combat leader is a 15-year journey supported by a progressive set of experiences that stretch the thinking, innovation and application of key ideas and concepts. The most effective leaders are developed over a long period of time.
Where do we start in healthcare? Rather than reading the latest book or signing up for another class or workshop, aspiring physician leaders should start their leadership development journey at the beginning: by first looking at one’s self. It’s difficult to do because it requires looking in the mirror, not out the window. Start by clearly identifying the type of future leader you want to be, and then develop a plan to bring that to life.