Mary Finlay is deputy CIO of Partners HealthCare System Inc., the Boston-based parent company for a group of hospitals that includes Massachusetts General Hospital and Brigham and Women's Hospital. There, technology is used as a way to improve patient safety and customer service. Finlay sees wireless technology as the next big trend in health care, with RFID and tablet PCs helping to ensure prescribed medicines reach the right patients in the right doses.
When you're considering IT projects, how do you justify the expense to the higher-ups?
Finlay: It's really all over the mark in terms of when we do a traditional ROI. We're doing a pilot with RFID. We are looking to use that for equipment tracking. One of the notorious problems in a hospital is that nurses hoard equipment because they want the equipment when they want it, where they want it. So then you can't find the equipment. So we think RFID has great promise for being able to track the wheelchairs, the IV poles, the kinds of things that nurses need. So we are piloting that right now at Brigham and Women's Hospital.
Can you tell me about the process, about who said 'AHA! RFID can solve this problem.'
Finlay: I think that particular project was a group within IS that started looking at RFID 18 months ago. They said, 'Where is the technology? What are some of the things we need to start to thinking about? How could it be applied to health care?' It's still considered an expensive technology so in that case it's 'Let's pilot it and get all these bumps out of the way.'
Do you have to get approval for projects or can you set the spending priorities within your department's budget?
Finlay: So typically it's a CIO within one of our hospitals taking the idea back to management and saying 'Boy, it looks like RFID is ready for a pilot. What about if we tried it here?' That gets the business engaged. And that frankly comes about because that CIO is part of the leadership team and they're going to the operational meetings every week and hearing things like ' We can't find equipment.' That's how that comes about.
How do you justify a project? Do you use ROI, or improving patient care, or something else?
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Finlay: Improving patient care is always top priority. I think different technologies lend itself to that. So, for instance, if we have a big implementation with wireless. So one of the applications we have is where we have nurses using tablet PCs at the bedside to record medication that they give to the patient. It improves the accuracy, there are a number of safety measures in there so it improves patient safety. It also improves the nurse's time and their workflow as well. Now in some cases like that where it's almost a no-brainer of why this makes sense, we don't necessarily do an exhaustive ROI because when you get into areas where you can demonstrate that it's going to improve patient care it's pretty much an easy sell.
What about HIPPA? Did that shake up the IT priorities?
Finlay: Really what HIPPA did was take two areas that we have been focused on for some time anyway, privacy and security, and raised the awareness of those issues among patients -- and inside our organization as well. So in many ways we saw it as a positive. And sometimes it's hard to say that about regulatory requirements. But it really allowed us to justify some of the work that we're already doing around privacy and security.
Is there a project coming up you're really excited about?
Finlay: We are still doing a lot with wireless and I think we're still at the beginning stages of what that will mean for us. We're piloting doing dermatology visits from the home. There's a shortage of dermatologists . Try to get in for an appointment -- it's very tough. So we're going to pilot with patients primarily around acne to be able to transmit pictures from a digital phone to their dermatologist and then have the consultation. We are doing that in conjunction with Blue Cross/Blue Shield. So I think what we're able to do in the home and thinking about nontraditional ways of delivering medicine is just an area that is going to continue to grow.
One of your wireless projects is a wireless nurse call system. So if someone is bedridden and wants water, instead of pressing a buzzer to signal a nurse to the central station, the nurses can get requests for water directly.
Finlay: This is our medication administration work. One of the major issues around health care is the number of medication errors that occur. You're given the wrong medication or given medication that interacts with another medication --or you're on he wrong medication for your weight. So we have devoted a lot of time to looking at how we can improve that process. This particular process is 'How we can make sure the right medication is being given to the right patient -- at the right dosage?' And we're having nurses use tablet PCs. They're using these to scan a barcode on the patient's wrist (on a bracelet) so they know they have the right patient, they scan the barcode on the medication label so they've got the right medication and they are entering onto the tablet what amount has been administered to the patient.
That sounds like a valuable project.
Finlay: You step back and say, 'Yeah, we're all affected by this. So how can you use technology?' Hypertension is a chronic condition that we see frequently. There is a high level of patients who, after they are prescribed medication, don't follow through and take their medication. So our telemedicine group is starting to look at whether there is a way that we can track the actual taking of the medication at home. Can we transmit information every time they open up the jar for their medication? You step back and say, 'Cool.'