But take a look anyway, if you have an interest in process improvement in hospitals. This is a collection of my best posts on this topic.

Sunday, June 1, 2008

We want to listen. Are we good at it?

Although we are always listed among the "most wired" hospitals in America, with lots of clinical applications for both providers and patients, we still depend on people both inside and outside of the hospital to tell us how our information systems can be improved -- from the user's point of view.

I have mentioned how useful our PatientSite program is for patients, allowing them access to medical records, appointments, prescriptions, and the like. This is a very good system, but one of our patients sent in the following suggestion:

For the wish list: This might be a substantial change but I ask that you put it into the hopper for a someday rethink. I ask that you (BIDMC) begin to define an appointment from the patient's point of view, or at least offer us a view that serves us. For me, the "appointment" object is a trip to the hospital that may have a one-to-many relationship with several sub-objects that are of interest only to the hospital, for whom each person is a schedulable resource. Right now, I have one trip to BIDMC scheduled for Monday 6/9. To me that's one appointment, one trip, and patients would be better served if we had visibility into more appointments. To you it's appointments (resource bookings) for three separate objects (people). Bottom line, I'm appealing to the hospital to consider presenting things appropriately to the POV of the individual stakeholder. You might say that it does me very little good to offer me visibility into YOUR view of the resources, when that isn't the information that *I* need.

The reply from the tech support person:

Our programmer has checked the code again. You are correct, as just 5 appointments can be displayed on the Home page at one time. There is a finite number of appointments that will display. If you have a long list of appointments, the (later) appointment with Dr. X will display after some of the others have passed.

After this reply, the patient bumped it up to me:

This is way below your radar but I want you too to be aware of this as a thought. Here's something I just submitted to the PatientSite support team, to put onto the wish list.

And from me to the relevant Vice President, who wrote to the relevant IS folks:

Can we have patient site display more than 6 appointments at a time; i.e., longer out in the timeline? Please me know.

The reply:

I'm not sure what would be involved in changing this, but we will follow up with the team and get back to you.

A few days later, the follow-up:

I reviewed with the team, and it would be possible for us to increase the number of appointments and other events that display in MyEvents in PatientSite. I have attached a screenshot for your reference.
There are three options:
1. Raise the limit of future appointments from 5 to some higher value.
2. Show all appointments that fall within a specified date range, e.g., the next six months.
3. Show all future appointments regardless of date.
All three options are technically feasible. Approaches 2 and 3 would seem to better address the patient's request that we adopt a patient's point of view in the display.
Let me know if you would prefer one of these options over the others, and we can proceed from there.

VP replies:

I think we should do option 2 or 3. Either let patient give the time frame they want to see or all appointments. I will leave that to you , but it needs to be option 2 or 3.

IS replies:

Patients can now view all future appointments on their PatientSite Home page. If the list is longer than 6 appointments, a scroll bar will appear so they can scroll down. I have emailed the patient who originally made the enhancement request.


The good news is that we listened to this excellent idea from a patient and implemented it without a lot of fuss. The not-so-good news is that the patient felt he had to send me a note on this issue to get it done. Now, it might have made it on its own through the system, or it might not have. So, the next step for me is to find out from the VP involved how patient suggestions that are made to tech support get reported and prioritized by the IS team. In other words, this now becomes a BIDMC SPIRIT call-out from the CEO's office....

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