Inside New York-Presbyterian Hospital's Major Mobile Upgrade - InformationWeek
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Healthcare // Mobile & Wireless
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7/30/2015
10:06 AM
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Inside New York-Presbyterian Hospital's Major Mobile Upgrade

Executives from New York-Presbyterian Hospital describe how they brought directories and communications into the 21st Century in this InformationWeek Elite 100 profile.

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InformationWeek is spotlighting the companies whose innovative solutions to technology and business challenges earned them a place on our 2015 Elite 100. For more on the program, and to see profiles of the Top 10 Elite 100 finalists, click here.

When a person becomes a patient in a hospital, a team forms around them. Keeping that team informed and connected to other specialists, caregivers, and teams is a constant challenge -- especially when the healthcare organization encompasses six hospitals and more than 26,000 employees. That challenge was taken up by New York-Presbyterian Hospital in the project that earned it a spot in the InformationWeek Elite 100.

Aurelia Boyer, senior vice president and CIO, and Dr. Peter Fleischut, associate chief innovation officer at New York-Presbyterian Hospital, discussed the nature of the challenge and how they found a solution, in a telephone interview with InformationWeek.

"One of the things we've been trying to improve around the hospital is the ability of people to collaborate around patient care," said Boyer. " A hospital is about collaboration and teamwork. It's been an asynchronous communication, where we rely on beepers and call lists where a person might not be available, and it's been rather inefficient."

Aurelia Boyer, Senior VP and CIO
(Image: New York-Presbyterian Hospital)

Aurelia Boyer, Senior VP and CIO
(Image: New York-Presbyterian Hospital)

The particular problems faced by a hospital make off-the-shelf products a difficult fit. "It goes back to the whole notion of who's on the care team for any given patient on any given day. In fact, it changes every shift," Boyer said. "The nurses come in and out, depending on their schedule. The residents rotate from day-to-day and team-to-team. There are attending physicians, physical therapists, [etc.], and so we've always struggled with identifying the right people and choosing the tools that would let them communicate in the most efficient way."

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Such communication is the key to the solution developed by New York-Presbyterian, called NYP Connect. "One of the things that started before NYP Connect was work around the care team," said Boyer. "We were able to identify, on an ongoing basis, who's assigned to the patient today. It's helped them communicate with one another, helped them communicate with the patient, and helped the patient understand who's taking care of them."

Database Complications

The complicated nature of the care teams was only a part of the challenge the development team faced in building an application to bring better communications to the hospitals. "The other problem is that we identify people in different ways," Boyer said. "The physicians are identified through a credentialing system, and that has a lot of information about how they're licensed and other things. Other employees are identified only through the IT department's Active Directory."

The initial solution was to build information about the care team into the patient's electronic health record (EHR). A great deal of the data about the makeup of the team was already stored there, and Fleischut's

Continued on next page

Curtis Franklin Jr. is Senior Editor at Dark Reading. In this role he focuses on product and technology coverage for the publication. In addition he works on audio and video programming for Dark Reading and contributes to activities at Interop ITX, Black Hat, INsecurity, and ... View Full Bio
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jastroff
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jastroff,
User Rank: Ninja
8/4/2015 | 6:56:48 PM
NYP Connect
@curtis -- great article about one of my favorite, local hospitals, thanks.

<< Beyond simply making users feel good about their phones and the ability to find people, NYP Connect represents a very real cost saving for New York-Presbyterian Hospital. "For every 500 users, we save about 100 hours every day," said Fleischut. "That was based really around two features: Sending out pages, and finding someone to call them over the telephone."

Cost and time saving = better communication and patient care. Such a big deal can come from these IT changes.
JulienOrmidal
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JulienOrmidal,
User Rank: Apprentice
8/3/2015 | 4:06:38 PM
Re: Useful innovation
Yeah thats true. thats a great story and its realy impressive but I do agree with you, its a really huge thing to build and it could be really complicated to deal with on the long run if not done well ..
tzubair
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tzubair,
User Rank: Ninja
7/31/2015 | 5:41:34 PM
Re: Reality Check
"For example, i know nurses who work with Palliative care and most of the notes that they take in regards to patients health is observation based, notes on changes in personality which often might not seem to be as important as physical information (medical statistics or other reports that deal with the physical status of the patient)"

@Gary: I don't think it's really the cost of the tablet that matters. It's the software and the overall architecture that supports the information flow right from the capture to the storage and to the transmission and analysis. That system itself will cost a lot and its not easy to implement even if the hardware is affordable.
tzubair
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tzubair,
User Rank: Ninja
7/31/2015 | 5:21:12 PM
Re: Useful innovation
"For example, i know nurses who work with Palliative care and most of the notes that they take in regards to patients health is observation based, notes on changes in personality which often might not seem to be as important as physical information (medical statistics or other reports that deal with the physical status of the patient)"

@stratustician: The common word for this kind of knowledge is tacit knowledge which is different from explicit knowledge and is often not captured or documented. You're right that it has a siginificant impact on patient care and the ability to take the right decisions. However, it only comes with experience.
Charlie Babcock
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Charlie Babcock,
User Rank: Author
7/30/2015 | 8:32:13 PM
Team-based patient information
A nice inside look at how CIO Boyer and Dr. Peter Fleischut, assoc. chief innovation officer provode better team-based patient information at New York-Presbyterian Hospital, 
progman2000
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progman2000,
User Rank: Ninja
7/30/2015 | 7:49:53 PM
Re: Useful innovation
I work with hospital IT and this is an impressive story - not a lot of hospitals would be able to pull this off. Still, I think it sounds like a HIPAA disaster waiting to happen and would scare the crap out of most CIO's.
Gary_EL
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Gary_EL,
User Rank: Ninja
7/30/2015 | 6:36:22 PM
Re: Reality Check
Compared to vast amount of money that must have been spent setting up this system, I don't think that the cost of buying a tablet for a poorly paid assistant lab tech will be too much of a roadblock. All of this makes you kind of wonder how a mammoth organization like NYP ever functioned without this type of institution-wide digital cement.
Stratustician
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Stratustician,
User Rank: Ninja
7/30/2015 | 3:33:43 PM
Re: Useful innovation
I agree, often the communication and documentation is lacking which inadvertently leads to lesser-quality care for patients.  For example, i know nurses who work with Palliative care and most of the notes that they take in regards to patients health is observation based, notes on changes in personality which often might not seem to be as important as physical information (medical statistics or other reports that deal with the physical status of the patient).  Hopefully we will see applications that allow for this type of data collection since especially with patients who have trouble communicating.
tzubair
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tzubair,
User Rank: Ninja
7/30/2015 | 2:46:40 PM
Useful innovation
Having lived with patients at the hospital quite a few times, I can say that information transfer and management is a big challenge. No matter how manny documentations you have against every patient, certain communication is never documented and passed verbally (or isn't passed at all). I wonder how much of this problem can this innovation change. On paper, it looks quite useful but whether it'll be as practical as it sounds, that remains a question.
tzubair
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50%
tzubair,
User Rank: Ninja
7/30/2015 | 2:40:58 PM
Re: Reality Check
"All too often the gee-whiz factor dazzles the decisionmakers who tend to earn six figures annually, and, meanwhile, the rank and file don't have the same level of disposable income to purchase the high tech toys the executive office believes it should have."

@asksqn: I think that problem will always be there. It's difficult to find decision makers who have been through the ground levels and are aware of all the problems. No matter how much their exposure has been, it's still no match for someone who has faced the harsh realities in an actual scenario.
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