My wife and I have been watching the CBS reality show, Big Brother, since season one back in 2000. For good or bad, our kids are hooked on it too… The show spans the length of a summer, more than 100 days straight. It kicks off with a large group of “Houseguests” that compete in various challenges along the way, with a built-in milestone each of the “house” voting out one of their own. The last one standing win a half million dollars at the end of the season. Not bad huh?
Well, yeah, if you’re an exhibitionist… Every move and every sound you make is recorded, all day and every night. All the annoying things that are said and all of the goofy habits people have are exposed, for basically, the entire world to see and cast judgment on. There aren’t a lot of “bathroom” scenes, but yes. CBS knows what the Houseguests are doing at all times, including when they go to the bathroom… For that reason, yours truly would never sign up for this show – although I’ve wanted to SOOO BADLY! (By the way, we’re rooting for Paul to win #BB18 in the finale on Wednesday night!)
So when we introduce the idea of technology capable of “patient tracking” in our clinics, with the obvious requirement of tracking “staff” too, we’re met with an immediate responsive opinion that Big Brother is now infiltrating our hospital! And the first question that is always asked is, “Are you going to track me in the bathroom?”
Uh… No. No matter how interesting you may think the knowledge of your bathroom habits are to the organization, we really don’t want to know when you go to the bathroom or for how long… Eew.
I think what folks are really asking though, is a fair question. “How much anonymity am I going to lose here?”
To answer this question, we really need to ask ourselves, “how much anonymity and privacy we even have these days in healthcare as it is?” With Sarbanes Oxley and all that HIPAA entails these days, I’d say not much at all when you think about it. Whether we know it or not, nearly everything we access in today’s medical record is being tracked and logged. And its not just the monitoring of the patient data we access. The date and time of day is collected as well. All of this information is fed into an algorithm that flags whether ‘Toby should have accessed this patient information at this time on this day.” If there is an anomaly (something out of the ordinary), then that “transaction” is “flagged” and Toby should expect a visit from the Compliance office very soon.
So, really we should be used to some sense of Big Brother as it is. Having said that, RTLS in Healthcare is NOT primarily about staff and their productivity or non-productivity. It is about tracking the patient experience in order to make their stay with us as pleasant and as efficient as it can be. After all, who wants to be sick and visit a hospital that makes them wait 2 times longer than the most popular lines at Disney World just to see a doctor that will only spend a short time with them anyway? Answer: nobody. Everyone wants the VIP, red carpet experience – yet few actually receive it on a regular basis.
Who wants to be sick and visit a hospital that makes them wait 2 times longer than the most popular lines at Disney World?
Now all clinicians have the absolute BEST intentions to get patients in and out as fast as they can. But different circumstances and factors keep that from happening sometimes. Sometimes the patient is too late arriving in the clinic, which backs everyone else up. Sometimes the physician is bogged down with administrative work they must complete before they even get to the clinic, causing them to be late resulting in delays afterward. Sometimes the clinics are short-staffed with a full patient load causing kind of a “controlled chaos.” They try to manage the extra workload, but its hard.
Sometimes there is IT outages that cause brief delays causing time and coordination problems to occur. Every day, there are nuances and unique problems to address with different patients that cause clinicians to constantly think on their feet and have to manage a ton of variables in their heads with little help from the EMR…
Knowing where patients are; how long they’ve been waiting; whom they are with currently (staff); and what staff members are available to help, are basic questions that RTLS in healthcare can answer unequivocally with a great deal of accuracy and little to no effort on nurses or physicians. The data is on a wall, on a mobile tablet, on a phone, or on the PC desktop in front of them.
For hospitals like Dana Farber Cancer Institute in Boston, and Florida Hospital – Celebration Health in Orlando, the apprehension was brief. At first, some staff was marginally against the idea of “being tracked.” But after several weeks of using the system and seeing the benefits of it in action, they really can’t live without it. One staff member told my CIO, Chris Belmont and me, on a site visit to Dana Farber last year, “when the RTLS system goes down, people around here lose their minds until its back online!” They’re dependent on the system and find a lot of value in it every day, making them more efficient by just knowing the current status of everyone, both patients and staff.
“When the RTLS system goes down, people around here lose their minds until its back online!”
Wake Forest Baptist Medical Center in North Carolina, have upgraded their system to be Tier 1 which, in and outage, it basically means, “no one goes home until the system is back up.” There is built in redundancy and disaster recovery plans in place to make that process easier, with Tier 1 status. Additional investment is also put into Tier 1 systems to make the system as available as possible. No one would put that kind of money into a system that was not useful or beneficial to patient care and the organization as a whole.
So at the end of the day, clinicians are probably not thrilled to wear “track-able” badges, but they believe in the usefulness of the system and the efficiencies it affords making the patient experience more pleasant and, in some cases, more seamless. Before they know it, the system that they avoided at first, they soon will be unable to live without. This happens time after time.
Would love to hear your comments of acceptance or otherwise from your experiences…?