Curbside Consult with Dr. Jayne 1/29/18

We talk quite a bit in the health IT world about efficiency strategies such as muscle memory, use of order sets, care plans, and team protocols. Those strategies and solutions are mandatory if you’re going to try to get through a day filled with dozens of patient encounters while keeping your sanity and trying to finish your documentation before you go home.

In my office, the clinical team works in an open area in the center of the clinical suite. Patient rooms, procedure rooms, the laboratory, and radiology areas are wrapped around the outside. In many ways it’s good, because you can see what’s going on with patients – whether they’ve gone to x-ray yet, whether they’re back from the restroom, etc.

In some ways it’s a challenge because you’re always “on stage” when patients walk by on their way to an exam room or another destination. You have to manage your own positive or negative energy in that situation, and avoid scowling at the EHR or expressing your frustration when patients roll in the door 10 minutes before closing time with a chief complaint they’ve had for weeks.

Our practice is a high-touch, high-service environment where we work hard to make patients feel that we appreciate their business and are invested in their well-being. You get used to wishing patients a “feel better” or “thanks for coming in” as they walk by on their way out.

At times, the muscle memory becomes a bit reflexive, though. My staff had some laughs at my expense this weekend. I was heads-down documenting and a couple of patients had gone by with the usual comments – “Thanks for coming in, we’ll call in a few days to check on you” and “Let us know if you’re not getting better” and so on. Another figure headed my way and I was on autopilot as I thanked him for coming in and said that I hope he feels better. He looked at me a little quizzically but smiled. As he went around the corner, my staff erupted in laughter — he was the evening pickup driver from the reference lab and I completely missed his uniform and the fact that I had not seen him in the exam room.

It was a good lesson that sometimes our quest for efficiency can blind us to the details of our day and that we have to stay vigilant to make sure we’re doing the amount of listening, data gathering, and synthesis of information that we really should be doing. Being on auto-pilot is not necessarily a good thing. I’m sure it’s not the first time the lab rep has encountered someone who commented as I did, but it certainly made me think twice about being more attentive as people are walking by the clinical work area.

The weekend was super busy and confirmed that influenza is not yet on the wane. We’ve had to temporarily shut down our online check-in system because of the patient volumes we’re seeing. The automation was allowing large queues to build without the ability to intervene. When we have people arrive at the office instead, we can let them know what the wait time is at their location as well as where the next-closest location with a shorter wait time might be. I have four days to recover before my next clinical shift, and after tonight, I definitely need it.

I’m starting to do my HIMSS planning and happened across this graphic along with encouragement from HIMSS for people to join in order to save on registration. Even with the “member discount,” HIMSS is still an expensive proposition, with some of the more convenient hotels that are close to the convention center being some of the most expensive. I’ve stayed in enough budget hotels that are hike from the convention center to have earned a little splurge this year, which should be good for trying to rest and refresh between the conference and evening activities.

I tried to eyeball the session schedule, partly in response to some teasers in the HIMSS18 Preview edition of Healthcare IT News. Unfortunately, the one session I wanted to put on my calendar was advertised as being on “Wednesday, March 8” which unless I’m missing something, isn’t a date on this year’s calendar. I searched for the session on both Wednesday the 7th and Thursday the 8th and couldn’t find it on either, leading me to believe that perhaps it’s in another space/time dimension.

I’m also starting to put my evening plans together and there are openings in the social schedule. If you are interested in having Team HIStalk drop by your event, send along an invitation. We register anonymously so you won’t know exactly whether Dr. Jayne or anyone else will be in the house, but we’ll be sure to mention your event in our daily HIMSS recap. If your event is open to HIStalk readers, let us know and we’ll include it on HIStalk as we prepare for the big show. I love meeting new people at events and hearing their impression of HIMSS and the industry as a whole. Plus, I’ve got some new dancing shoes and am looking forward to being out on the town.

One of my medical school classmates reached out to me over the weekend knowing I’m in touch with the EHR industry. He’s trying to figure out how to attach his practice to the class action suit that was filed against Allscripts, alleging that the company “intentionally, willfully, recklessly, and/or negligently” failed to take precautions to prevent or minimize the recent SamSam ransomware attack. The filing is actually an interesting read and provides a primer on ransomware and previous similar attacks.

I explained to my colleague how a filing is laid out and that the responsible attorney is listed at the end. I’m not sure how serious he is about joining the Class or getting involved, but if he does and provides updates, I’ll certainly pass them along. Allscripts has tens of thousands of physicians using its platforms, but it’s unclear how many of them were on the impacted systems.

Are you ready for a ransomware attack? If not, why? Leave a comment or email me.

Email Dr. Jayne.