1. David Boxberger dboxberger@peer-tech.com 503-297-0337 ext 111 Jon LeBre jlebre@peer-tech.com 503-297-0337 ext 118 OCHIN Learning Forum 2012 Device Placement to Improve Patient Care and Provider Happiness

2. Goal Share our experiences helping offices and hospitals pick and place computing equipment with the intent of improving patient care and keeping providers happy.

3. Technology should be… easily accessible appropriately located properly resourced appropriate for the provider/patients/office supportive of work flow dynamic (not static) There is no one right answer. Unfortunately, there are lots of not quite right answers. Global Concepts

4. Patient’s Home Access to chart and relevant health information Reception Patient kiosk Front desk Now – Electronic signature pad, Barcode printer, multipurpose scanner, camera Future - ??? (ask Paul Matthews ) Phone integration… Lots of peripherals = lots of USB ports Front desk is getting crowded! Exam room Placement is paramount Thin clients are OK Work with provider to fine tune placement by room Wall mount, cabinet, counter, or cart Charting station Workflow and office infrastructure dictate placement Single purpose system Provider’s Home Access to EHR and other office tools Ambulatory Office – Focus Areas

5. Budget This is not the low cost option Budget has been our biggest challenge Facility Space Infrastructure Provider preferences Providers directly exert influence Resources Technology Planning Training Ongoing evaluation Ambulatory Office - Challenges

6. Ambulatory Office- Approach 1.Walk through Follow patient’s path 2.Treat each exam room separately 3.Use a floor plan 4.Review placement prior to budgeting

7. Admissions Now -Scanning, barcode printing, electronic signatures, photos, printing, bracelet printing Future – Phone integration Patient rooms Wireless or web kiosk/tv in room Trend towards hiding hospital technology Thin client, barcode reader Workflow and built infrastructure determine placement (Charting is not popular in patient rooms) Charting station Thin client (location, location, location) ED Now - Order entry, scanning, barcode printing, electronic signature, payment, status board Fixed devices or carts Lots of access Critical Access Hospitals – Focus Areas

8. Facility Infrastructure Complexity Process and Delivery No Clear Vision/Many Clear Visions Difficult to get leadership to agree Complex patient demographic Not much time to experiment Nascent planning processes Critical Access- Challenges

9. Critical Access- Approach 1.Walk through Follow patient’s path 2.Each department is unique Solicit feedback from the staff working in each area 3.Find common denominators 4.Use a floor plan 5.Review placement prior to budgeting 6.Be open to change 7.The clinic will be totally different

10. Engage patients, staff, and providers Prepare for sticker shock Embrace novel solutions Don’t be afraid to change Closing Thoughts