LOS ANGELES – Residents and interns work long hours at UCLA Medical Center, but there’s no time to waste on their shifts.
And time is money, as the medical center tries to deal with regulations that limit the amount of hours that medical students can work each week. Every hour not covered by a resident or intern means teaching hospitals must pay another medical professional to handle it.
Watching residents spend one to two hours a day organizing patient information seemed to be a task ripe for automation, said Neil Martin, MD, chairman of neurosurgery at UCLA.
An application developed and marketed by Global Care Quest, an Aliso Viejo, Calif.-based company in which Martin now has a financial interest, serves that purpose.
Martin said savings in his department alone are about $350,000 annually, and use of the application quickly spread to other deparments as residents saw the potential for time savings and reductions in data compilation.
Before the rounding application, called ICIS, was developed, residents often came to the hospital as early as 4:30 a.m., logged into the facility’s clinical information systems and downloaded information on 30 to 50 patients, which they then organized into spreadsheets, databases or templated forms that they could use during medical rounds.
Martin asked residents about the information they most needed to do rounds, and they cited the basics – name, identification number, diagnosis on admission, room number and medical record number. As the application was developed, lab data and vital sign information were added.
ICIS is able to draw information from various clinical systems and has the ability to display it on a variety of form factors, ranging from laptops to personal digital assistants.
As residents rotated out of the neurosurgery department, they showed the application to other residents. Now, two years after the idea arose, some 1,400 residents have used the application, and 40 customized lists of information have been generated for various departments.
Recent federal regulations limit the hours that interns can work to 80 in a week, Martin said. Twenty residents in neurosurgery using the application and conservatively saving an hour per day would mean more than 7,000 saved hours per year. That time, if covered by a $50-per-hour nurse practitioner, would equal $350,000 in additional spending, he said.
“We’ve been able to provide more quality and more standardization,” Martin said. “Human transcription errors have largely been eliminated, and residents can make a complete decision based on a complete data set.”
“If using a new application takes any more time, even if it’s twice as good, it’s not going to fly,” he added. “The secret we found was that if you study what the existing work processes are and can make them easier and faster, then you have a winner.”