One area we don't typically think of when we discuss health care IT is the emergency department (ED). That's because a fast-paced environment and the need for one-on-one care is not always conducive to technology solutions whose purpose is to automate aspects of care. Patients need help as quickly as possible, and that can minimize the opportunity to use technology to assess and manage ED activities.
But as sophisticated IT protocols become more commonplace within the health care sector, I believe areas like the ED, where IT development has been less integral, will begin to draw more deserved attention from executive leaders.
There's a right way and a wrong way to bring IT into the ED. As we move into the next phase of health reform and value-based reimbursement models, hospitals must avoid the most common implementation issues while embracing solutions that bring a substantial return on patient outcomes and cost reduction.
Here are some challenges I have seen health systems face when it comes to developing an IT solution in the ED, along with solutions to avoid those pitfalls.
Health Record Accessibility
In my experience, one of the biggest hurdles to IT implementation in the ED is making sure all parties have the necessary information to make an appropriate clinical decision. To accomplish this, you need to make sure that physicians, nursing staff and other specialists are able to access a patient’s protected health information (PHI) instantly and from anywhere.
Some health systems rely on legacy software that not everyone on the team can access. This means they're working with a blindfold. In most emergency situations, it's not possible to develop a complete picture of the individual's health history just by talking to them. The patient may be unconscious, unresponsive or otherwise unable to supply the requisite details that could guide the emergency care plan.
It's scenarios like these where the need for interoperable electronic health records (EHR) is most clear. Once you have a system in place, how you use it is critical. It's not enough to consult PHI after the initial treatment. Consider designating specific members of your team to comb through the patient's health record in order to identify key pieces of background information that will influence the treatment plan in the moment.
Overuse of ED Services
One of the biggest problems confronting hospitals is overuse of emergency services. A lot of people visit the ED when there's simply no need for emergency care, especially when it is their only source of health care. This leads to large bills for the patient and an overstretched hospital staff.
One option for providers is to use software to categorize patients based on their medical history and the amount of care they need. This can save time and money for hospitals and patients alike. Start by developing an extensive patient health history. With a full picture of the individual's background, your front-of-line care manager can deduce what might be happening and triage patients to the proper level of care, routing them to non-emergency departments better suited for their level of need. (This, of course, does not apply to trauma situations where patients must be treated right away.)
Managing an ED Without a Plan
You should be using your IT plan to manage repeatable and predictable tasks so that you can make the most of your limited resources. I see too many hospitals allow operations to continue as they always have based on what's worked in the past. That leaves money on the table.
I suggest starting to log and categorize every patient's visit. That way, every staff member's time on the clock is mapped and every item in inventory is carefully tracked. This allows you to begin to pick up on things you might have missed. For example, careful examination of visits can determine times you might need higher staffing levels according to patient volume. These insights might confirm what you suspect (i.e., that visits to the ED increase when urgent care centers close for the day), or they might provide you with information you hadn't anticipated (i.e., that volume actually peaks on Sundays because that's when your city's NFL team plays and people behave, shall we say, poorly).
Tracking your daily and seasonal trends can help you staff your ED accordingly. You can also track your patients' common conditions, which informs the types of medication and devices you need to keep stocked. And of course, you can track outcomes across team members or identify frequent fliers who tap into emergency services at every opportunity. With this much at stake, I expect to see hospitals take a much closer look at how they're currently using IT and what they can do to create savings while improving the well-being of their patients.
Originally posted on Forbes Technology Council (view original).