As a hospital specializing in cancer care, MD Anderson found that out-of the box electronic medical records systems with predefined requirements did not meet its needs, because those packages are designed for acute care centers, says Sherry Preston, business analyst manager of MD Anderson's electronic medical record development and support team. The hospital spent about eight years trying to get three different EMR tools customized, but none worked. "The bugaboo is the workflow," she notes.
So hospital management decided to develop its own unique system and train clinicians like herself -- who understood the nuances of nursing, pharmacy, labs, X-ray and medical records -- to become business analysts and to work with end users on getting input on the different modules that they wanted to interact with Clinic Station. "It was important because we had to be able to document and elicit requirements and understand the workflow of each corner of the hospital," explains Preston, who as a nurse worked in the clinics at MD Anderson for 26 years.
As part of that broader EMR work, in late spring of this year Preston began working with Scheetz's department to understand its workflow processes and to learn exactly how the group prioritizes and handles physical therapy orders after the orders come in from physicians. Scheetz says that one of the challenges they face is that they often have to validate that there is an actual signed physician order, and that can be a "manual and laborious process." A new physician order system is being developed to automate that process, and visualizations in iRise indicate that it will successfully ensure that there is a signed order.
Officials are currently waiting for the physician order system to be integrated into Clinic Station, and Scheetz says that should happen sometime during the summer. About 15,000 employees have access to Clinic Station. Preston's team will next use iRise to add a medication order-entry system into Clinic Station.
Preston estimates the hospital spent less than $300,000 to purchase iRise. She says there is very little about the tool that users don't like, other than the fact that learning how it works takes a significant amount of time and "if you don't use it you will lose it," since the tool requires several steps. The hospital has about 17 business analysts who use iRise on a regular basis.
There are some other things to keep in mind if you're planning to use software visualization tools. Preston says using the iRise software required MD Andersen to buy extra memory for business analysts' laptops. And it was important to deploy iRise on laptops, because analysts generally use the iRise software in meetings with users. The need for more memory "caught us by surprise because we didn't plan for it in advance," Preston explains.
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