EPtalk by Dr. Jayne 2/17/22

I enjoyed this short piece on “Overrated tech: 5 tools execs think hospitals should skip.” Suggestions given by health system executives include proprietary technology, augmented / virtual reality, applications written for on-premises use, and niche technology. Rounding out the list was the undead of business equipment: the fax machine. I’m always amazed when hospital or medical licensing forms want a fax number. No matter how hard we work to get away from them, the little machines soldier on.

If I had to add a couple of overrated technologies to the list, I’d suggest the following: freestanding patient portals that don’t integrate with the EHR, home monitoring devices that don’t have a neat and tidy way of sending data to the responsible physician, and emergency department wait-time displays on billboards and websites. If you have time to compare wait times, then it’s less likely that the emergency department is the right location for your care.

The new calendar year has set my continuing medical education counter back to zero, so I’ve been keeping an eye out for good online presentations that also deliver CME hours. Despite the fact many of us have been working virtually for years now, I still see quite a bit of bad behavior on webinars. You would think that with all our collective experience, people would have gotten better at being professional when on large group webinars. I’ve seen enough annoying habits that I could write a “tips and tricks” document. The highlight reel:

• If you are a host or presenter and know you’re not going to allow verbal audience participation, please set up the webinar so that the audience is in listen-only mode. If you forget to do this, hopefully you know how to mute everyone. There will always be some person driving, making lunch, or taking their phone and the webinar to the restroom.
• For audience members, pay attention to what the presenters say about fielding questions. If they ask you to put your questions in the Q&A area as opposed to in the chat, please do so. As someone who runs a lot of webinars, it’s hard to manage multiple streams, so usually we pick one way to handle things. Our organization’s policies might keep us from locking down the other functionality or hiding it from you, but you’ll get a better response if you do as the presenter asks.
• Also for hosts, the whole idea of “we’re going to start about five minutes late to allow people time to join” is extremely disrespectful to those who were prepared and on time. Although you might think you’re doing us a favor and telling us that so we can multi-task for a few minutes, the reality is that a good chunk of your audience is aggravated by it, while another chunk will delve into email or texting and you won’t get them fully back when it’s actually time. If everyone started on time, maybe latecomers would learn a lesson.

Speaking of pushing deadlines, HIMSS has extended the registration discount for HIMSS22 through February 22, citing organizational budget and travel permission issues. I know a number of organizations that are still under no-travel restrictions. Although COVID cases are easing, hospital staffing is still a struggle. Teams are exhausted and there’s often no hope for replenishing the bench. I think leaders are increasingly aware of the optics of jetting off to Orlando while their teams are still underwater.

HIMSS also notes they are adding programming and speakers, including sessions on aging and loneliness, policy updates, and international perspectives. I’m not sure that the addition of those topics would make me want to go if I hadn’t already booked, so it also feels like a “registrations are low, let’s see how many other people we can drag through the door” type maneuver.

HIMSS also continues to send emails trying to get attendees to sign up for events that require additional fees, such as the Women in Health IT Networking Reception. It costs $55 for a 90-minute event, which despite the advertising, doesn’t seem like enough time to “share stories, recognize and celebrate your peers, and form valuable connections that will last a lifetime.” Maybe I’ll engineer my schedule to eyeball the event during peak entry and exit times, though – I’m sure there will be some outstanding shoes to be seen.

Thinking about these events makes me wish Mr. H would reconsider the idea of throwing an HIStalk kegger in some parking lot. There’s an undeveloped lot across the street from my hotel that would be perfect. That would be a real way to make memories that would last a lifetime, I’m sure.

A lot of my work as a CMIO revolves around using EHRs and related technologies, such as clinical decision support, to reduce variability in patient care. A recent piece looked at how physicians within a single health system often make different treatment choices for identical patient scenarios. Certain physicians were much more likely to use recommended standards of care than their peers, which can be concerning if not following the standards leads to variability that worsens outcomes.

The authors looked at 14 “straightforward” clinical scenarios (as opposed to complex cases) to score physician performance. Some of the scenarios looked at surgical procedures, where the top surgeons opted for non-surgical interventions at greater rates than their low-performing peers. This supports the idea that wasteful spending is often tied to inappropriate care. It will be interesting to see how hospitals respond to this since they make a good amount of money from the questionable surgical procedures compared to the non-surgical interventions.

An intrepid reader sent me this picture from a healthcare facility that should remain nameless. It looks like they’re having an issue with their emergency call system, so they hit the Home Depot and stocked up on stick-on doorbells. The handwritten label is a nice touch. I’m not sure what The Joint Commission or any other accrediting body would think of the solution, but it does have a certain resourcefulness to it.

What kind of entertaining solutions have you seen when your organization just needs to make do? Leave a comment or email me.

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