In the new value-based environment, the patient experience is paramount. And supporting a positive provider experience is also a top priority for healthcare organizations.
Making the most of point-of-care technology to achieve these goals involves more than selecting hardware and software components to capture, access and manage health data. It requires implementing technology that supports care team workflow and enhances patient satisfaction and safety.
Ergonomic factors, functionality, ease of use and design of the physical environment must all be considered. In this PeerView, Baptist Health CIO/CMIO David Bensema, MD, FACP, MBA, shares the strategies and technologies his organization uses to elevate its levels of patient and provider satisfaction.
David collaborates with other C-suite leadership on developing enterprise-wide strategic IT initiatives for Baptist Health. The organization comprises eight hospitals and more than 250 care sites across Kentucky, including retail clinics, home health services, urgent care, imaging centers, ambulatory practices and fitness sites. He and his team are also responsible for information systems and technology implementations, and work closely with all clinical personnel.
CDW: What technologies are you introducing at Baptist Health to support a better patient experience?
DAVID: We just built a new seven-story care tower in Lexington that has provided an opportunity for us to beta test some new elements before we retrofit existing facilities. From a design standpoint, all the rooms in the new hospital are private rooms, which we think is a key to patient satisfaction. In terms of technologies, we are trialing white noise generators, and they have already improved the “quiet at night” numbers in our internal patient surveys. We have also trialed electronic white boards for patient rooms to address patient safety and peace of mind. Patients feel more secure when they can see who their nurse and hospitalist will be for the day, and we are working on adding images so they will have a picture as well as the name. The board also includes information such as fall risk and infection control notifications. This information is replicated on a smaller white board posted by the door outside the patient’s room so anyone coming in from transport, radiology or wherever will know what precautions are required. All the information is updated through a central station under a single person’s responsibility.
CDW: Based on the results you’ve observed so far, do you have plans to expand the use of the white board technology?
DAVID: We are definitely looking to expand it into other sites. The cost is very reasonable, and the benefit already appears to be well worth it in terms of HCAHPS scoring. It looks like it’s going to be one of those satisfiers for both patients and staff. We expect staff engagement scores to improve with this, too. It’s an example of technology use that actually drives humanistic benefits.
CDW: Are there other patient-focused technologies you’re considering in the near future?
DAVID: Definitely. As part of our transition to Epic, we are going to re-implement the patient kiosks we had previously. In the hospitals, patients will be able to use the kiosks to register, check the schedule and navigate the facility. We also plan to use them in clinics to shorten registration lines and empower patients to provide additional information regarding their visit. This helps them move quickly beyond the operational bureaucratic component, expediting access to the care they need.
We are also putting plans in place to roll out Epic’s MyChart Bedside into all of our 2,100 beds over the next 18 months to two years. Patients will be able to use it to view their health information, lab results and videos, and also message their care team using either the large screen in their room or an iPad.
CDW: We understand you’ve also had some initial success with implementing Epic Rover. Can you tell us more about the benefits?
DAVID: It’s been very exciting. Epic Rover is a mobile app that our phlebotomists have started using to access their draw lists, schedules and results, and do barcode scanning for patient and specimen identification. The day we went live, our phlebotomists charged out of the lab all excited because they were going to be able to see real-time updates to their lab list — and be able to barcode scan the patient’s wrist and know they were getting the right lab from the right patient and that they had the right vials full.
Their efficiency has increased and we’ve reduced redraws for the patient, which is important from a patient comfort perspective. And our clinicians like it because it allows them to have lab results in the morning when they start to round.
CDW: What impact will adding these new applications have on your technology infrastructure?
DAVID: We have just upgraded our Wi-Fi in every hospital, so now we have excellent penetration into the far reaches and darkest corners, eliminating the dead spaces. This is important for our applications but also for meeting patient and visitor expectations. Our patients are all looking to do more with their devices or ours, such as streaming Netflix, and no one likes a jumpy picture. We know that robust wireless is just part of providing support for our patients and their families. In many of our hospitals, several family members come with the patient, and they all come with smartphones and the expectation that they’re going to have wireless access. With our increased bandwidth, we can support that.
CDW: What steps have you taken to ensure technology integrates well with — and even improves — clinician workflow?
DAVID: We’ve created education modules to help point clinicians to things they can do to enhance their smart sets, and to order their routine labs more expeditiously with fewer clicks. Recognizing the importance of the “triangle of care” between the patient, caregiver and computer, we have gone into every single exam room across all our ambulatory practices — and we employ approximately 600 physicians and 450 advanced providers — to orient the computers as optimally as possible, whether that’s putting it on a wall-mount arm or having it on a desk. We avoid mobile carts and laptops, partially because of the need for a 24-inch monitor with Epic, but use thin clients to maximize space. Because we have a lot of shared rooms, we try to make the computer as flexible as possible. Clinicians can adjust the height, the keyboard tilt and the apps running in the background, for example. We try to be as accommodating as we can.
CDW: In what ways are clinicians involved in your process for evaluating and selecting technology?
DAVID: At our base level for Epic governance, we have three steering councils — physician, nursing/multidisciplinary and ancillary — that report to a clinical steering council. I sit on the council as an advisory resource only. So the physicians themselves are the ones who can request and approve technology exceptions and changes for other physicians, based on the business case. For example, our EDs use medical scribes. They requested and received a hardware exception so the scribes could use laptops for documentation in some of our older EDs where there’s simply not enough space to bring another large computer into the exam room.
CDW: What tips on best practices can you offer peers who seek to optimize the patient and provider experience?
DAVID: Put on your sneakers or your walking shoes and get out into the physical space with the users. Ask them questions about how they currently work and what would make it better. Then take their recommendations, create a mock-up and invite the clinicians to critique it. Listen and be flexible. Don’t get so stuck on the fact that a hole has been drilled in the wall here or a cable was pulled there that you can’t change, because change is inevitable. If you get this right, it’s even more fulfilling than getting the technical code right because you’re watching people smile as they use the technology.