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Advancing)Technology:))Point)of)care)documenta7on)op7ons.
David Tapia, MBA, FACHE
Presentation Objectives
• The&learner&will&be&able&to&iden6fy&at&least&two&benefits&and&two&barriers&to&point&of&care&documenta6on&in&their&prac6ce.
• The&learner&will&be&able&iden6fy&at&least&two&different&point&of&care&devices&that&may&be&appropriate&in&their&prac6ce.&&
• The&learner&will&be&able&to&demonstrate&how&to&u6lize&a&decision&making&path&focused&on&key&considera6ons&for&choosing&a&point&of&care&device&for&their&prac6ce.
POC Documentation Benefits of Using Technology in the Home
" Real-time information " Documentation " Interdisciplinary communication " Coordination of care " Efficiency " Reduce mileage " Employee satisfaction
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POC Documentation Barriers of Using Technology in the Home
" Patient interaction " Clinician resistance " Cost/affordability " Learning curve/training/support " Loss/damage " Extra piece of equipment to carry " Incorrect notion that it hinders productivity
Optimal Decision Making Path
Step 1: Analyze Your Current Situation
" What types of devices are you using for POC documentation?
" What type of system (MR/EMR) are you currently using for documentation? Are you still on paper?
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Step 2: Identify the Opportunity or Problem
Step 3: Establish Your Goals
Example: To select a device that will help you to remove these barriers and experience the benefits of improved POC documentation.
Step 4: Research / Identify Your Options
" Internet research " Web demonstrations " Networking " Employee feedback " Test devices " Get references – site visit
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POC Devices Optional Financing Models
" Employer sponsored " Employee owned " Hybrid " Mobile Device Management model
" Option to Lease tablets vs buy
" Remote lock & wipe tablets in case lost or stolen
" Control data usage per user to avoid expensive overages
" Use geo-fencing and GPS for security measures
What’s Out There?
Step 5: Evaluate Your Options
" Notebook/Laptop " Netbook " Tablet PC " New tablets " Other (e.g., handheld/smartphones)
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What to Look for in a POC Device POC Software Compatibility
Client-server Solution:
" Notebook/Laptop " Tablet PC
Web-based Solution:
" Notebook/Laptop " Tablet PC " Netbook " New tablets
What to Look for in a POC Device Prioritize this List
" Compatibility (Software & Flash)
" Affordability " Portability " Ease & speed of
use " Display (size) " Multi-functionality
" Connectivity** " Battery life " Camera " Performance " Storage " Apps/other software " Accessories**
Comparing POC Devices Best in Each Class
Laptop Netbook Tablet PC Tablets Initial Investment X Monthly Access X Portability X Web-based EMR X X Web-based & Client-Server X X Flash Compatibility X X X X Intuitive (Less Training Req.) X Speed of Use X Ease of Documentation X X X Reduced patient barrier X X Battery Life X Camera X Storage X X Maintenance X
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POC Devices New Tablets
" Apple iPad 4 " Asus Vivo Tab " Dell XPS " Microsoft Surface " Other Tablets:
• Sony Xperia Tab Z • Google Nexus 7 • Samsung Note 8
New Tablets Key Benefits
" Easy to carry " Easy to use " Cost effective " More efficient " Reduces common barrier " Useful applications " Other usage opportunities
Tablets Key Differences
" Screen size (7-10 in) " 3G/4G connectivity " Wireless carriers " Compatibility (EMR
& Flash) " Operating systems
" Storage options " Cameras " Apps/other software " Accessories
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iPad 4 & iPad mini
Advantages)• Both&are&lightweight&and&portable&• Powerful&processors&• Great&reputa6on&and&brand&recogni6on&• Intui6ve&Opera6ng&System&• Op6on&between&7.8”&or&9.5”&screen&
Disadvantages)• No&external&storage&or&
memory&expansion&• Opera6ng&system&is&very&
restricted&• No&Flash&compa6bility&&
Pricing)• iPad&mini’s&start&at&$329&• iPad&4&starts&at&$499&
Asus Vivo Tab
Advantages)• Large&screen&12”&with&docking&keyboard&• Powered&by&new&Windows&8&OS&• Digital&stylus&easily&integrates&wri6ng&func6on&• External&expansion&and&media&slots&
Disadvantages)• New&Windows&8&OS&–&some&learning&
curve&• Might&be&too&large&for&some&
clinicians&• Price&
Pricing)• Star6ng&at&$799&
Dell XPS New class of devices called “Convertibles”
Advantages)• Large&screen&12.5”&&• Powered&by&new&Windows&8&OS&• Serves&as&both&a&tablet&and&laptop&• External&expansion&and&media&slots&
Disadvantages)• New&Windows&8&OS&–&some&learning&
curve&• Isn’t&this&just&a&big&superfast&laptop?&• High&price&
Pricing)• Star6ng&at&$1199&
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Microsoft Surface RT & Pro
Advantages)• Both&are&lightweight&and&portable&• Large&10”&screen&• Created&specifically&to&compete&with&iPads&• Docking&Keyboard&op6ons&• External&slots&for&media&&&storage&expansion&
Disadvantages)• New&Windows&8&OS&–&some&learning&curve&• Keyboard&on&Surface&RT&feels&cheaply&made&• Surface&Pro&is&more&clunky&and&larger&• High&price&for&the&Pro&
Microsod&Surface&RT&
Microsod&Surface&Pro&
Pricing)• Surface&RT&starts&at&$499&• Surface&Pro&starts&at&$999&
Google Nexus 7
Advantages)• Latest&version&of&Android&4.1&JellyBean&• Great&bafery&life,&fast&processor&• Above&average&screen&resolu6on&• External&slots&for&media&&&storage&expansion&• Rated&the&“Best&$200&Tablet&you&can&buy”&–&by&
Engadget&
Disadvantages)• Screen&size&7”&might&be&too&small&for&POC&• Only&has&a&front&camera&• Few&expansion&slots&• No&3G/4G&op6ons&
Pricing)• Starts&at&$199&
Samsung Galaxy Note 8
Advantages)• Latest&version&of&Android&4.1&JellyBean&• Powerful&processor&• New&Stylus&features&electromagne6c&proper6es&• External&slots&for&media&&&storage&expansion&• “Watch&On”&feature&serves&as&a&universal&
remote&and&media&hub&
Disadvantages)• OS&loaded&with&features&might¬&be&easy&to&
navigate&for&a&new&user&• Price&
Pricing)• Starts&at&$399&
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Sony Xperia Tab Z
Advantages)• Latest&version&of&Android&4.1&JellyBean&• Large&10”&screen&near&Re6na&display&• External&slots&for&media&&&storage&expansion&• Water&resistant&and&dustiproof!&
Disadvantages)• Sony&is&s6ll&new&to&the&tablet&market&• Brand&new&models&typically&need&at&least&
one&genera6on&to&work&out&kinks&• Price&
Pricing)• Will&be&released&in&Q2&2013&• Overseas&pricing&around&
$899&
Optimal Care Tips
" Flexibility is key " Remain open to
better opportunities " Utilize the benefits of
technology advancement
" Tech excellence contributes to clinical excellence!
" Have a backup plan " Anticipate anxiety " Mutually set a realistic
learning curve " Invest in device
accessories " Try new ways of using
your device
Thank You For Attending. We have devices available for demonstration
Questions? Ask now or contact us via email.
Dave&Tapia,&MBA,&FACHE&Managing&Partner&Exegete&Healthcare&Interna6onal,&LLC&[email protected]&&
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Addendum Case Study Optimal Care’s Mission
To provide the highest quality care with compassion and respect for each person
through personal, clinical and technological excellence.
Optimal Care Case Study&Timeline
Census started at 20 patients and grew rapidly to a census of 200 in first year
" 2006: Paper documentation – standard-based forms
" 2008: Transitioned to client-server system using Tablet PCs
" 2010: Transitioned to Web-based system using iPads and multiple devices
Optimal Care in 2008 Client-server Software + Tablet PCs
Initial Investment $300,000 Monthly Costs $5,000
License Fees User $3,500/User Host $4,000/Host HHA $3,000/HHA License
Laptops/Tablet PCs $2,000/Each
PDAs – HHA Documentation $50/Mo Activation
Security Software Licenses $120/Tracking
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Client Server Software Solution Weaknesses
Administrative: " Cost for growth " Device " License " Dependence on IT " Training – 40+
Hours " Theft – HIPAA
concerns
Clinical: " Device limitations " Delayed
documentation " Lengthy sign-on time
• Tablet PC • Software program
" Employee dissatisfaction
Tablet PC Weaknesses
" Larger, more difficult to carry " Battery life " Internet access " Updates " Requirements
Web-based Software Solution Opportunities
Administrative: " No upfront costs or
for growth " Billing/financial
integration " Real-time QA " Reporting capability " Replace IT " No HIPAA concerns
Clinical: " More oversight " Coordination of Care " Improved
communication " Survey-ready " Improved
documentation " Process improvement
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Optimal Care in 2010 Goals for New Software + Devices
" To find a mission-driven solution for both administrative and clinical care needs
" Employee satisfaction " Administrative oversight " Real-time documentation
Optimal Care Case Study Web-based Software + iPads
Initial Investment $35,000 Monthly Costs
$5,500 (Maintenance + Web) License Fees $0 Tablets $600/Each Web Connection Fees $15-25/Month
Apple iPad Opportunities
Administrative: " Affordable pricing &
plans " Dependable " Less training
needed " Works with EMR
Clinical: " Easy to use & carry " GPS " Performance " Patient education
tool " Compatible
keyboard cases
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Optimal Care Results
" iPads provided to all clinicians " True Point of Care " >90% of actual POC documentation " Improves work/life balance
“The iPad is Wonderful! I no longer go home and spend the evening with a laptop on my lap. My work is already done.”
Optimal Care Results
" Quality assurance oversight " Survey/record audit-ready " Real-time interdisciplinary communication " Using the latest technology to deliver the
highest quality care
“With the iPad, I can now play my patient her favorite music as part of her dementia care!”
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