Technology Evaluation Tools for a Complex Hospital Acquisition Process

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The last few blogs have focused on how collaboration can occur within a team and how different roles can be leveraged effectively.  How do we engage the expertise of different roles to evaluate various aspects of technologies that leverage the value of your EMR investment? How do we create collaboration among stake holders to enable the acquisition of tools that enable better patient care?

Sphere3® ’s recommendation for evaluating technology whether a device or system has followed this simple three-pronged method: Electronics Life, Technology Life and Workflow Ability. However, the importance of data in the adoption and adaptation of these tools has created the need to evaluate its availability and accessibility. We call this Data Accessibility & usability.

Electronics Life is a function of how long the manufactured device or component would live in the hospital environment. As electronics age their components deteriorate which can cause the technology to glitch.  This evaluation point has quickly started to lessen in the minds of hospitals as electronics have neared commodity standard. While it is still important to understand the life span and serviceability of a component their durability has started to level set in the marketplace.   Think of the smart phone, the expectations we have for lifespan and long term use rates will vary based on whether it’s a purpose built device or a non-commercial device. We vary our evaluation standards of lifespan or even fix-ability based on our ability to negotiate outsourced management of the device.

Questions to Ask:

  1. Is the device or component something we plan to manage internally or is the external management more cost effective and less risk to the hospital?
  2. What are the available manufacture provided warranties?
  3. What is the lifespan of the existing hardware and what is the manufactures commitment to future transition plans?

Technology Life is how you evaluate the commonly referred to “features and benefits” of a product surrounding the core functionality or nature of the product. Or, as I used to say “whiz-bang” items that make life easier. These items are generally enabled by the software platform associated with the hardware or components.  Whereas a “common” function is made easier through a more advanced technology ability. A good example is a crank window verses an automatic window in a car – the window will still raise and lower but the users experience is significantly different. Technology life is always limited by the electronics components – this is where you begin to define the value of the system vs it’s software.

Questions to Ask:

  1. What is the core functionality this system, component or device is serving? What problem are we trying to solve?
  2. What is required to deliver on that core or base functionality?

Workflow Ability is how the technology and electronics can transcend the core functionality of the platform. For example, the nurse call system was developed to enable communication between patient and care team or critical needs between care team and care team (code blue). Modern nurse call platforms have workflow enablement functionality for multi-faceted caregiver to caregiver communication.  The challenge is, in most cases, is the nurse call is tethered to the wall and requires integration with other technologies to mobilize its power. Integration requires cooperation, humbleness, and partnership not only between technology providers to allow hospitals to meet their best of breed strategy. The main advantage to utilizing a tool such as nurse call for transcendent workflow is that it is a regulated and required system so the hospital “has” to have one. What technologies do you “have to have” based on regulation that can be leveraged beyond their core functionality? The base cost should be level set in evaluation, and the workflow ability cost should be evaluated.

Questions to ask:

  1. What workflows overlap between technologies, and where do you see the most value gained?
  2. What current integrations are available and does that align with our best of breed strategy?
  3. Is the Vendor willing to collaborate ad build interfaces as needed to meet your desired strategy?
  4. Does your vendor limit your strategy by being unable (or unwilling) to cooperate?

Data accessibility & usability must not be overlooked in the process. Sphere3 has evaluated platforms and discussed functionalities with hospitals, we have found common items skipped in the evaluation process—analytics or data capability. Often evaluation of the data stops at a simple question “What reports can be produced” or “What historical records must be kept? (All transactions should be kept…)  Some technology providers have stepped into the idea that there may be value to their data and do not allow hospitals to “own” their data. They have essentially hamstringed the hospitals ability to analyze. Their overreaching and onerous contracts slow the hospitals ability to understand how technology enabled care is or is not affecting change. Clinical Informatics must have the ability to create from data and without full access it crushes creativity and creation which hinders care for patients. Technology providers should be open and available to partner with Clinical Informatics create improvement strategies to improve patient care.   Common data, records of transactions and interactions should be free and accessible for the hospital. Processing tools, visualization and real algorithms should be the technology providers core competency and value proposition.

Questions to Ask:

  1. Is your data accessible by the hospital team? Do I have to purchase a software license to enable it?
  2. Does the hospital own the data once I have access to it?
  3. Does the vendor provide us with a data schema and glossary to build our own reports from? (Review this to make sure you can build the reports you wish to see)
  4. Is your historical database free from constraint in the contract?
  5. Is their adhoc tool “good enough” to meet basic expectations, and EASY enough for your managers and directors to use? (How many clicks does it take to build a report?)
  6. Is it real time available?

As your hospital evaluates technologies that leverage or enhance your EMR it is essential to recognize that each of these areas functionally align with a department or role in your hospital.  The evaluation process will require multiple stakeholders to evaluate the electronics, workflow, technology, and data. When you start your evaluation process, identify who will own each area and provide unique insights into each?

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