HIMSS14: Focus on the destination, not the tools

ORLANDO--The decision to embark on an innovation program should stem from a vision, not from the desire to use a particular tool or technology, said speakers at the Healthcare Information and Management Systems Society annual conference.

“It’s easy to get caught up in the technology, but you need to have a vision,” said Sarah Korf Dill, client service partner, Slalom Consulting. “You don’t go into it with the tools in mind.”

With help from Slalom Consulting, Ill.-based Advocate Health Care set out to achieve a number of ROI goals, including better internal communication, improved collaboration and productivity, increased patient, physician and employee satisfaction, improved patient safety and achievement of cost savings or cost avoidance.

To that end, Advocate pursued a holistic change management approach, which entailed a multipronged strategy that focused on measurement and sustainability, training, stakeholder identification and analysis, training, sponsorship and governance, communication, change readiness and impact.

“Communication tools needed work. It wasn’t what we were going to do, but how we were going to do it,” said Rance Clouser, Advocate's vice president of field services.

Advocate focused on the destination by establishing goals, objectives and vision, identifying the problems that need solving, determining critical milestones, pinpointing desired impacts and ROI and clarifying benefits for all stakeholders, said Clouser.

The health system focused on sustainability by instilling long-term organizational commitment from executives, and by establishing sponsors and a steering committee. “Engaging people who are the influencers and strong communicators helped get the message out,” said Dill.

In an incremental fashion, Advocate implemented a number of communication technologies and enhancements to their older system. These included a TelePresence network, digital signage, a significant email upgrade, instant messaging, web conferencing, a unified associate directory and collaboration sites.

“We didn’t bring all technologies on at once. We found that associates easily become overwhelmed, so we had to make sure we timed it well and provided collateral for it,” Clouser said.

Advocate also moved its system hosting to the cloud, saving about $1 million per year, he said.

The new technologies significantly impacted workflow and even employee job descriptions. Pushback was inevitable. “We had a lot of conversations that were not pleasant,” he said, but buy-in followed as the roles assumed a higher value.

With mobile devices, Advocate set up a hotline to handle any technical problems clinicians faced on the job. Clouser said they planned for gaps, and clearly communicated with employees expectations to help ease implementation.

Clouser cited some benefits with wound victims, who had their information shared with collaborating physicians in a seamless, integrated fashion. “It was a huge win for us.”

Advocate also launched a transitional call center, where nurses—working from home—contacted patients needing follow-up care. They utilized the lean methodology and followed best practices, he said.

Other technologies adopted included a Patient Experience System, a custom application that allowed Advocate to gather patient feedback and deliver it to the right people and departments. It enabled associates to place follow-up calls to discharged patients, and included standard and department-specific call scripts, he said.  

The speakers cited one case study showing one of the many of the hidden ROIs of a more connected and integrated system. When a nurse investigated a medical record of a patient coming in with a nosebleed, she noticed that the patient was on two blood thinners and immediately contacted the physician to get the prescriptions changed.

In the end, adoption is essential to ROI, said Dill. “If you don’t have people using it, clinical improvements will not be possible.”