Intuitive Information Technology


  Enhancing Clinician Efficiency
             M. Procuniar
            November 2008
“There are two ways of being creative.
  One can sing and dance. Or one can
  create an environment in which
  singers and...
Objectives
• Define Intuitive Technology


• Identify 3 ways patient safety is impacted by
  technology
• Identify 3 ways ...
Intuitive Technology

• Intuitive: known automatically; known directly
  and instinctively, without being discovered or
  ...
“An intuitive technology works smoothly
   with the subtle twists of reality rather
  than trying (and failing) to overcom...
Identify ways patient safety is impacted by
                 technology
                                                  ...
Identify ways Clinician Efficiency is impacted
by technology
Comparative states of Clinician Efficiency before &
after introduction of New Technology
Disparate HIS Systems
EHR Adoption – Physician’s Perspective

• EHR failure rate is estimated at 50-80%
   – 20-30% fail within 1yr

• <8% of ph...
EHR Adoption – Nursing’s Perspective

• Survey of 263 Nursing respondents
   – 39% biggest barrier is fit into workflow
  ...
Effective Adoption
+
Intuitiveness
-




                -   Usefulness   +
Values of Various Technologies
                   Pen & Paper      Bedside /      Tablet PC        Digital Pen      Voice ...
Tablets – An extension of the EHR

• Stand-alone Use Cases:
  – Great for Ambulatory Care
  – Great for Practitioners
  – ...
Comparative states of Clinician Efficiency
Digital Pens

•Suburban Hospital ED
•Country Villa Health System
•Cherokee Indian Hospital Authority
•Thomas Jefferson Hos...
Comparative states of Clinician Efficiency
Voice Recognition

• Heritage Ministries Management
• Advanced Healthcare
Comparative states of Clinician Efficiency
Surface Technology

•InterKnowlogy – InterMountain Health, Scripps
Research Institute
•Teliris – Virtual FlipChart, TouchW...
Current states of Clinician Efficiency & related future states
of migration toward Intuitive Technology
Combining Technology

• Use technology where & how it makes sense
   – Tablets vs. Digital Pens
   – Tablets & Digital Pen...
Explain how these technologies can co-exist in today’s
hybrid electronic environment
Combining Technology, Part II
• Pairing Surface Technology with Voice Recognition
  – “VOX” in patient rooms would allow:
...
Explain how these technologies can co-exist in today’s
hybrid electronic environment
“We shall not cease from exploration
 And the end of all our exploring
 Will be to arrive where we started
 And know the p...
Upcoming SlideShare
Loading in …5
×

Intuitive Technology

489 views

Published on

Presentation given at AMIA Annual Symposium in Washington DC November 2008

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
489
On SlideShare
0
From Embeds
0
Number of Embeds
6
Actions
Shares
0
Downloads
1
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Intuitive Technology

  1. 1. Intuitive Information Technology Enhancing Clinician Efficiency M. Procuniar November 2008
  2. 2. “There are two ways of being creative. One can sing and dance. Or one can create an environment in which singers and dancers can flourish.” -Warren Bennis
  3. 3. Objectives • Define Intuitive Technology • Identify 3 ways patient safety is impacted by technology • Identify 3 ways clinician efficiency is impacted by technology • Explain the value tablet PCs, digital pens, and surface technology can bring to caregivers in a healthcare setting • List 3 current states of clinician efficiency and describe the related future state after application of intuitive technology • Explain how these technologies can co-exist in today’s hybrid electronic environment
  4. 4. Intuitive Technology • Intuitive: known automatically; known directly and instinctively, without being discovered or consciously perceived • Technology: Application of tools and methods; the study, development, and application of devices, machines, and techniques for manufacturing and productive processes • Natural, organic, second nature, requires little or no training • Gets users involved in the process
  5. 5. “An intuitive technology works smoothly with the subtle twists of reality rather than trying (and failing) to overcome them by brute force.” -Tom Graves
  6. 6. Identify ways patient safety is impacted by technology Clinician Perspective Patient Perspective Mild Impact - Moderate Impact - Severe Impact Trust Issues Participation in shared governance and Positive patient outcomes in post surgical measures vs. standardized practices vs. high % risk adjusted mortality lack of ownership and lack of rates standardization in practices Patient to Fear or reality that improved efficiency of tasks will lead to Right care at right time for non-critically ill patients vs. staff ratios increased patient to staff decreased patient ratios satisfaction scores and research documenting increased likelihood of failure to rescue within 30 days of post-op Perceived Technology extends the reach of the clinician and Right care at the right time vs. decrease in staff response value supports decision making vs. when called per HCAHPS lacks value and introduces survey (interpersonal redundancy promoting relationships) workarounds producing a threat to patient safety
  7. 7. Identify ways Clinician Efficiency is impacted by technology
  8. 8. Comparative states of Clinician Efficiency before & after introduction of New Technology
  9. 9. Disparate HIS Systems
  10. 10. EHR Adoption – Physician’s Perspective • EHR failure rate is estimated at 50-80% – 20-30% fail within 1yr • <8% of physicians enter orders via CPOE • Survey of 400 physicians – Retire in their 50’s vs. adopt EHRs – 81% do not use EHRs • Survey of 2800 physicians – Only 4% have a fully functional EHR – 13% have a “basic” EHR
  11. 11. EHR Adoption – Nursing’s Perspective • Survey of 263 Nursing respondents – 39% biggest barrier is fit into workflow – 35% familiarity with technology is a problem • Survey of Nurse Executives (KLAS) – Need quick response times for high volume of users – Unreliable devices  mistrust in the system – Missing functionality  quality gaps  workarounds – Learning curve is too high – Focus is on physician-based solutions
  12. 12. Effective Adoption + Intuitiveness - - Usefulness +
  13. 13. Values of Various Technologies Pen & Paper Bedside / Tablet PC Digital Pen Voice Surface Desktop PC Recognition Interface Manual Keyboard, Stylus, Digital pen on Voice to Touch or inscription of Mouse, onscreen special recorder; gesture, marks on Biometric keyboard, paper, dock, software Multi-user paper or other touch screen, Bluetooth decodes interface, permanent camera, bar interface speech to transfers raw surface code scanner text, records content into as print or digital media electronic record Device locations Anywhere Anchored to Can be Pocket sized Voice to $15000 per bedside carried or microphone, unit, unlikely docked; telephone, or to have weighs 2-3 lbs headset multiple units at this point on tech curve Scalability Easy –cheap, Moderately Moderately Moderately Easy –cheap, Difficult, not available easy –cheap, easy –cheap, easy –– available well (able to available, available, cheap, developed implement for take up room adoption available; for HC; lots of the masses) to retrofit issues adopters are WOW but older reluctant to intersection hospitals adopt; “step of efficiency backwards” & safety improvement not clear
  14. 14. Tablets – An extension of the EHR • Stand-alone Use Cases: – Great for Ambulatory Care – Great for Practitioners – Is it great for Hospital-based Clinicians? • Considerations: – Facility must have 100% Wireless coverage – Infection Control Risk
  15. 15. Comparative states of Clinician Efficiency
  16. 16. Digital Pens •Suburban Hospital ED •Country Villa Health System •Cherokee Indian Hospital Authority •Thomas Jefferson Hospital
  17. 17. Comparative states of Clinician Efficiency
  18. 18. Voice Recognition • Heritage Ministries Management • Advanced Healthcare
  19. 19. Comparative states of Clinician Efficiency
  20. 20. Surface Technology •InterKnowlogy – InterMountain Health, Scripps Research Institute •Teliris – Virtual FlipChart, TouchWall, TouchTable •Harrah’s Rio All-Suite – Personalized guest experience, information locator, interactive menu •AT&T – Device comparison, device advertising
  21. 21. Current states of Clinician Efficiency & related future states of migration toward Intuitive Technology
  22. 22. Combining Technology • Use technology where & how it makes sense – Tablets vs. Digital Pens – Tablets & Digital Pens • Paramedics in Ireland use digital pens in rural areas
  23. 23. Explain how these technologies can co-exist in today’s hybrid electronic environment
  24. 24. Combining Technology, Part II • Pairing Surface Technology with Voice Recognition – “VOX” in patient rooms would allow: • Instantaneous input/recall of any information needed • Reduction of latent charting • Elimination of designated “charters” during codes – Surface technology in patient rooms would allow: • Display of near real-time results from medical devices • Raw content instantly turned into digital format • Collaborative interaction with the patient’s chart
  25. 25. Explain how these technologies can co-exist in today’s hybrid electronic environment
  26. 26. “We shall not cease from exploration And the end of all our exploring Will be to arrive where we started And know the place for the first time.” -TS Elliot

×