SHIFT YOUR TIME: From Workstation Downtime to 100 Percent Uptime
Last year, Banner Health Systems experienced sustained EHR downtime from a network problem. For a full day, staff lacked access to patient health records, and clinicians without EHR had to take patient notes manually. Several other hospitals in 2018 also lost EHR access, but from ransomware attacks.
Hospitals with mission-critical information systems take pains to prepare for the possibility of downtime. Redundant systems, off-site data storage, disaster recovery plans, and 99.9% service level agreements add to a degree of confidence. Despite this high level of prudence, the most likely EHR downtime is much more basic: Hardware gets broken.
When nurses wheel EHR workstations from room to room, bangs and bumps are unavoidable. When a unit goes down, it can take days before the unit is repaired and returned to the floor. The critical challenge is that the cost of such downtime keeps going up.
EHR systems were originally used by nurses and informatics staff and not by doctors. According to a study by the AC Group, with hospitals requiring their salaried doctors to use EHR workstations, the cost of physician downtime has gone from $488 per hour in 2011 to $634 in 2018. The 2011 study only looked at software downtime. Had they accounted for hardware and battery downtime, plus the related systems (radiology, laboratory, surveillance, clinical decision support) that interface with the EHR, the true cost would have been much higher.
While the problem is simple, the fix is more challenging. Most hospital IT departments operate at their maximum capacity, so assigning technicians to diagnose and fix broken workstations diverts resources from other critical IT initiatives.Mobile medical workstations have evolved dramatically over the last decade, and maintenance approaches have evolved as well. For the longest time, IT departments repaired the workstations themselves. In-house repairs presented two challenges: First, IT personnel are not trained to handle mechanical repair; their expertise is software and systems. The second major challenge is the downtime.
“Lengthy downtimes for workstation repairs have long been accepted as a fact of life,” explained Kevin Bridges, Enovate’s Vice President of Marketing and Business Development. “Opening a work order, diagnosing the problem, ordering parts, repairing, testing, and returning the cart to the floor can take days or even weeks.”
Over the years, each new approach to workstation maintenance also introduced unacceptable downtime. Outsourced service, maintaining a parts inventory, and even onsite technicians take time.
“With EHR’s critical role as the life pulse of the hospital, a closet full of dead workstations waiting for parts isn’t acceptable – so we decided to do something about it,” Kevin Bridges explained. “We developed the Enovate Uptime Program to deliver 100% fleet availability. The program is designed to keep workstations up and running without burdening the IT staff who would otherwise have to order parts and make repairs. Most importantly, the clinical staff can keep working without having to improvise EHR workarounds.”
Uptime is powered by Rhythm– With Uptime, a single click from the nurse initiates a service request for repair. This request is transmitted through Rhythm, Enovate’s cloud-based management system which continuously monitors the entire workstation fleet. Rhythm instantly identifies a Ready Replacement from the backup fleet allowing the nurse to continue her rounds with virtually no downtime. Meanwhile, Rhythm dispatches a factory-trained technician to make the repair.
Backup workstations without the cost– Few hospitals want to invest in an expensive fleet of back-up workstations, and when they do, the extra units typically end up in general circulation. With Uptime, the hospital only pays a monthly subscription fee. Enovate provisions a guaranteed number of Ready Replacements based on the size of the fleet.
“For IT departments, mechanical repairs are outside of their core competency – plus workstation maintenance distracts them from other critical IT projects,” Kevin Bridges said. “Enovate’s Uptime program frees them from the maintenance burden, avoids capital investment in extra units, and keeps the IT team focused on its mission.”