SMALL GAP, BIG VALUE

A new workflow that is doubling the time physicians can spend with their patients,
and dramatically reducing time at workstations.



THE PROBLEM

With Gov’ment regulations, and all the legal “cover your ass” processes, a physician spends more time on a screen, than interacting with patients.

Electronic Health Records (EHR’s) are meant to enable physicians to track, document, and manage orders for patients under their care. However, the reality is that they are pulling attention away from patients.

THE OBSERVATIONS

Observations — Physicians will generally round on their patients in one of two ways.

The “All in one”

Time spent with patient is inherently shorter as the physician is trying to retain the info for up to 20 patients in one facility. Physician prefer this approach, though conclude it is less effective.

  • Time with each patient ~ 7 min
  • Time at workstation after rounds > 4 hrs
  • Total Rounding Time > 9 hr 30 min

Benefits

  • Faster rounding time
  • Patient feel more “attended”
  • Continuous task flow

Obstacles

  • Less time per patient
  • Heavy cognitive load
  • Delayed documentation
  • Fragmented notes
  • Large opportunity to loose place in process
  • Delayed order management
  • Notes are taken on post-its or on the back of the chart

The “Stop and go”

This type of flow is more fragmented for the physician, the use of an EHR is a large cognitive task change. Physician often comment this approach takes much longer to complete.

  • Time with each patient ~ 10 min.
  • Total time at workstation > 3 hrs
  • Total Rounding Time > 9 hrs

Benefits

  • Information is not lost
  • Increased documentation accuracy
  • Lower cognitive load

Obstacles

  • Longer rounding time
  • Each patient has a higher wait time
  • Loss of order in patient list

THE TENENTS

1. Decrease time spent at workstations.

2. Increase time with patient(s).

3. Allow physician to naturally interact with the patient.

THE PROCESS

Key Observation — Every physician, with out fail, carries a smart phone.
Can we split documentation into the quick notes physicians take in the patient room?



Reduce, Reuse, Recycle — Use the same note templates, and only surface the quick structured sections. This will allow the physician to focus on the patient while creating the note draft. After leaving the patient, the physician will have made significant progress toward a complete note.

THE OUTCOME

Key Observation — Every physician, with out fail, carries a smart phone.
Can we split documentation into the quick notes physicians take in the patient room?

Time with Patient
⬆︎ 55%

Time at workstation
⬇︎ 240%

Rounding Time
⬇︎ 60%


By combining the bedside notes with a fast, less intrusive, phone solution, physicians can spend more focused time with patients as they are also cutting time from workstation documentation.

Using a phone to draft a note reduces workstation time to simple review and sign interactions.

User observations have shown that patients feel a better connection with physicians as a result of better care. These reactions are attributed to the lower cognitive load per patient required for physicians, and the ability to save time by reducing duplicated efforts.

Tyrale Bloomfield

@tyrale

615.336.2600

hello@tyrale.com