Software Siren Songs in Healthcare
Monongahela Valley Hospital Integrates Automatic Tracking in Emergency Department to Enhance Patient Experience; Busy ED Uses Wireless Technology to Reduce Average Patient Visit Length
Where there's a problem, there's always a software solution (and salesperson) waiting around the corner. The above story reminds me of the manufacturing world…. in factories, we're told if we want to reduce cycle time, to reduce WIP, to “get lean”, all we need is the latest software from Vendor X. That topic has been written about ad nauseum by many on this blog.
This mindset is also seen in the lean healthcare world, where I am now working. Got patient delays? You need software!
Tracking patients electronically is the same idea of having “inventory visibility” in a factory. Just knowing where your inventory is doesn't help reduce the need for it. The technology is there and it works, for what it does, but how much does visibility help?
In this press release, the hospital supposedly had a 16% reduction in patient waiting time. Who knows how much was spent on software.
I've seen many many cases where patient waiting times can be reduced 30-50% through the implementation of lean methods.
My challenge to hospital leadership (as well as factory leadership)…. don't rely only on software solutions to fix your problems. More than likely, the real enemy is broken processes. Lean implementations fix processes and (when done right) really inspire people to continuous improvement and improving the workplace.
Software implementations rarely deliver as much. Software often is viewed as a one time fix. Lean builds skills and methods for true continuous improvement.
How much does this description remind you of manufacturing software?
The software in conjunction with infrared/RFID-based locating hardware provides real-time, wireless tracking of the location of all patients and mobile medical equipment. Patients and staff wear wireless badges which send infrared signals to sensors located throughout the department, waiting room and support areas. The Amelior EDTracker software uses a rules-based intelligence engine to translate interactions between patients, staff and equipment into insights on the location and the care status of each patient.
Ah yes, “rules-based intelligence engines”. We already have that…. it's called employee's brains. You can make the most of your employees' brains using lean.
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While I agree with your point that operations should rely on lean processes instead of fancy software to fix problems, I think this is a good exception. (This wireless solution is similar to what Lehigh Valley Hospital did, except that Lehigh started using wireless to improve the cleaning (ie the turns) of empty floor rooms, not necessarily addressing the ED. This spread to the OR and PACU. I saw Lehigh’s presentation at the IIE conference a few weeks ago.)
Relying on the implementation of software, especially in this case where a wireless system was used, is a result of the hospital layout being a monument. The hospital is not going to get rebuilt, nor is it going to be remodelled to improve layout. The wireless/software system uses technology to replace visual cues that would be used in an operation with a physical lean layout.
Hopefully, the hospital is using the software to help see and fix the broken processes, which I suspect that they are.
Thanks for your comments, Matt. I’m not trying to say that technology is bad. I’m just trying to warn people of the “quick fix” mentality that sometimes takes root. Software CAN be helpful, particularly when done in the context of process re-design and improvement. But let’s say you put in RFID and patient tracking tools, but if you still have:
1) discouraged employees who are worn out from battling the same waste everyday
2) lack of standard work, meaning there aren’t clear pathways from technology to human response
then you might have a real mess on your hands.
When implementing a technology as described in the article, I’d strongly recommend a lean effort first.