EMR – Operational Excellence

Introduction:

The impact of both the 2009 ARRA-HITECH Act, HIPAA and the federal healthcare reform legislation is felt throughout the industry. Healthcare organizations are challenged by managing the cost providing quality care but recognize implementing EMR is a must have. Both are needed and implementation can be a drain on already stressed organizations. Which one is first for implementation? Patient information and care plans are tightly connected to the processes providing patient care, from patient admission through discharge. Implementing one before or after the other, can result in a system implemented into broken processes.  Systems of work within healthcare organizations are largely inefficient, wasteful and variable. EMR works best with processes that are consistent, stable and disciplined. Implementing EMR will be seen as a burden and ineffective. Healthcare staff and providers are experts at finding and using short-cuts and work-arounds, trying to “survive the day”.

Consider:

• 50+% of the waste in healthcare processes centers around identifying, aligning, coordinating and executing information inputs and outputs needed by the various sub value streams in a healthcare system.
• 50+% of the time spent by care providers is often spent hunting, chasing and fetching for information.
• This number gets even larger if you consider the types and frequency of resources that were not mobilized earlier … yet could have been mobilized earlier if the process had been designed to look for and initiate these tasks. Discharge as an example:
  • Med Rec not completed in time for discharge
  • Rides not communicated
  • Meds not launched until discharge order
  • Lab results
  • Communication to Assisted Living-Nursing Home
  • More…
• There is no effective process in the “Lean” toolkit that is designed to specifically focus on information flow.

Without a technique to assist EMR implementation teams to decipher what people want from what people need, there won’t be any significant impact to core operational performance metrics.

High Level Solution – EMR / OpEx Integration

Successfully implementing EMR with robust and effective work flow processes requires an understanding of what is needed to ‘flow’ information between, across and amongst departments. Once that is established, systems of work with EMR embedded are supported by documented standards that tightly connect process, patient and information in real time. So then, OpEx mobilization should link software provider’s objectives and internal IT team resources with Department/Care Provider needs.  Doing so, can increase the effectiveness and reduce the timeline to implement and launch EMR into a hospital system.

OpEx provides techniques such as Value Stream Mapping in order to define the specific pieces of information needed through the patient flow. At the same time processes that either provide or utilize that information are reengineered to ensure that patient information flows are connected with processes that are now effective and more efficient.

• Most important to the EMR installation team is that OpEx provides a fast and accurate portrayal of the real flow of information.  
• VSM and OpEx focuses on the inputs/outputs needed along the patient flow and aligning inputs with outputs through all operations.
  • Eliminating the need to hunt, chase, fetch.
  • Defining outputs
• Emergency phone calls, disruptions, guessing and interpretation.
• Minimizing IT/software changes modifications.
• Redesign the processes to provide the information needed, when its needed accurately and completely.
• Access to existing information from downstream personnel

Benefits

OpEx has been used in EMR (healthcare) and ERP (commercial industry) to coordinate, align and accelerate the effectiveness of major IT system solutions/implementations. OpEx brings the mobilization model to the EMR team. Together with the software provider, the internal IT team and the people who do the work can impact time, cost and stakeholder satisfaction at all levels. This technique fundamentally provides a process from which a team (software provider, internal IT team, departments, care providers) can design their process before they implement their process. 

This technique:

• Establishes a common understanding (common language) for the EMR team, RN’s, MD’s, staff, departments and shifts
• Provides a quick analysis of what is needed, what is NOT needed and the data source
• Provides a foundation and a direction for how the new system will flow key information (common understanding, cross functional buy in, common vision). The team can see, what, why and how…
• Accelerates EMR installations by 20-50%
• Establishes tight connections with the processes that will need and use the EMR information (through the patient flow)
• Improved effectiveness of EMR installations
• Creates common (favorable) bond early in the project process

Summary

Implementing process improvement in conjunction with an EMR solution is part of an integration of a larger overall business strategy for healthcare. Information completeness, accuracy, comprehensiveness and timeliness are imperatives. Integrating OpEx and EMR will take place at some time in every healthcare organization. Coordinating and synchronizing implementations of EMR with OpEx can reduce the cost of implementation, reduce total time for complete implementation, realize the increased performance and return on investment. To find out more about how Group50 can help your healthcare system significantly increase productivity and asset management, call us at (909) 949-9083, drop us a line at info@group50.com or request more information here.

About the Author:  Vincent Polito is Group50’s Healthcare Practice leader with over thirty years of experience as an executive and executive consultant in the design and delivery of Lean, Lean Transformation and Operational Excellence in the Healthcare, Medical Device, Industrial Manufacturing, Aerospace, Textile and Oil and Gas industries.  He has held senior management roles in operations, materials, quality, and business development.

Vinnie pioneered the application of Lean Tools and Techniques in Healthcare. At the forefront of Lean in Healthcare since 2003 he has provided guidance to over 100 hospitals, physician/specialty practices, insurance health plans and home health systems in North America. He has a grasp and appreciates of the mission and complexity of Healthcare. He translates Lean principles and techniques into effective delivery strategies and execution specifically meeting the critical needs and culture of Healthcare. Some his more notable Healthcare clients include, Thedacare, Denver Health, Beth Israel Deaconess, Barnes Jewish, New York Health and Hospitals, and Priority Health. His Lean support of Healthcare has included initiatives for non-clinical organizations including the Institute of Medicine (IOM), the Institute for Healthcare Improvement (IHI) and National Quality Forum (NQF).

Vinnie has led and executed Lean transformation in a diverse range of industries with a client list of Fortune 500 organizations including Boeing, Alcoa, Lockheed Martin, Rockwell-Collins, Duracell, Owens-Corning, Sandia Labs and Hanes Brands. #group50, #healthcare, #healthcareconsultant, healthcare consultant, healthcare consulting, healthcare consulting firm

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