Here are 10 reasons ASCs must address their IT needs early in the development process.
1. DOH inspection. When the Department of Health sends inspectors to your ASC for its initial inspection, the inspectors will likely want to see everything needed for the ASC to be fully operational is in place, including your many IT components. If a critical IT component is missing or not fully installed, this could lead to delays in the ASC passing inspection and opening its doors for patients.
Every day after the planned go-live date that an ASC is not operational is a day where potential revenue is lost. Addressing your IT needs early will ensure it is not the cause of any delays. This is the most important reason to make sure you plan your IT as far in advance as possible.
2. Cabling. Your ASC will need significant cabling throughout the facility, so it is best to allocate ample time to plan for where it will need to go and then have time for the most efficient cabling infrastructure design and implementation. You will need to identify the locations where you’re going to need voice and data services; audio and video components; surveillance; access control; and more. It’s preferable to run cabling during construction than after, when walls and ceilings are in place.
If you don’t run all of the cabling before you complete construction, you will likely pay a premium to finish the cabling since the walls will be closed and the installation process will take longer. In addition, you could encounter scheduling issues as you may not be able to proceed with cases while cabling installation is occurring. If you decide to have installation take place in the evening so you can keep your case schedule intact, it’s worth noting that rates are typically much higher at night.
Finally, if there are any changes that need to be made to the placement of services requiring cabling, and thus rerouting of cabling, it’s much easier — and often more aesthetically pleasing (see #10) to make such changes during construction than after.
3. Budgeting. Not only does it take significant time to identify your ASC’s many IT needs and wants, it will take some time for your IT provider to determine estimated budget for all technology and its installation. These are costs that you will want to make sure your ASC’s ownership have ample time to review and discuss.
Once they learn the projected figures, they might debate whether they want to invest in some of their wants. It’s important to get the buy-in from the physicians early in the IT process and be very transparent about what their dollars are going toward. It is more difficult — and potentially more costly — to make changes to an approved plan and budget.
4. Workflow. When you engage your IT provider prior to breaking ground on a project, the provider will likely be in a position to take on a much more active role in developing the IT workflow around your clinical and business workflow plans and needs. A few examples:
● In your OR and procedure rooms, it is critical to identify and plan for the locations where team members and their equipment will go. You want to make sure when you look at the rooms’ floor plans that you know where patients will lay and, in relation to patients, where will equipment will be installed. For example, where is the anesthesiologist going to sit? Where is the anesthesia equipment going to go? What outlet/power access does he or she need for that equipment? How is the location of the anesthesiologist and the anesthesia equipment going to affect the physician and nursing staff performing the procedure? You will want ample time to plan your OR and procedure room layout, including taking into consideration all of your present and potentially future technical needs.
You don’t want to tell physicians they must change the way they prefer to perform procedures to accommodate poor IT planning. You need to be able to — to the best of your ability — plan your technical needs to their preferred workflow. That will make your physicians and OR staff more efficient, which will translate to improvement in physician satisfaction and overall ASC efficiency.
● If you’re planning to have your nursing team use wireless technology when taking the patient through the ASC, you must make sure you perform a “wireless survey” to identify where you will place wireless access points. These access points help ensure staff is taking a patient from pre-op to the OR, the signal strength of the wireless technology doesn’t drop and cause an interruption in clinical workflow.
● If your front desk staff need to get up from their computers and take 15 steps to scan a document or pick up a piece of paper from a printer, is that really efficient? Your IT provider can help identify those areas for better technology implementation that will permit these team members to save time, be more productive and get through their work faster.
5. Practice management and EMR system configuration. During the process of the selection of a practice management system and EMR system, if you go that route, the rule of thumb is it takes anywhere from 12-14 weeks from the day you agree to purchase the system to go live. The challenge a new ASC will face with this process is placing and configuring systems when the ASC is under construction and not ready for equipment deployment.
Even though you’re in the construction period, don’t wait for the facility to be ready for the technology to begin preparing it for your ASC’s use. You should be able to work with your IT provider to proceed with configuration and testing of your systems off-site during that time. When it comes times for you to install the equipment in the ASC, you should be as far along in the configuration process as possible so you have less work on the systems to complete upon their installation.
In addition, training your staff is critical, so ensure you allocate ample time for it.
6. Performing mock cases. By planning early, you not only have the opportunity to perform an in-depth IT analysis before the facility goes live, you can perform a number of mock cases to identify any IT glitches or final changes that you want made prior to patients coming in the door. In these mock cases, you can simulate the entire patient visit, beginning with checking in at the front desk, moving into pre-op, the OR or procedure room, post-op and discharge.
The mock cases should include simulating the use of your IT during the patient visit. This will allow you to identify any technical issues interrupting workflow that need to be fixed and opportunities for areas of improvement.
7. Enhanced features. So you know your new ASC will need computers, monitors, a practice management system, phone system, Internet access and many other basic IT components to run an efficient facility. But what about enhanced features? These may include a audio systems in the OR or procedure room for physician use during surgery; a television in the staff lounge; guest access to wireless service in the waiting room; and video conferencing ability in a conference room.
Another example: Many physicians expect to have cell phone service available throughout the ASC, including in the ORs and procedure rooms. You will want to have time to make sure you have cell service wherever physicians expect it. If you don’t, then you need to have time to come up with a plan and address such a lack of service. A solution may entail placing an antenna on the roof of the facility and installing a repeater appliance to bring cell phone service into the facility.
It is important to have time to sit down with the ASC ownership and identify their IT wants and needs, including enhanced features such as these listed, before construction is underway and completed.
8. Telecommunications services. Identifying a telecommunications provider needs to be completed very early in the ASC’s development process. Not only do you want time to identify your needs, research carriers and choose a vendor, installing phone lines and setting up Internet service may take a several months. If this process is not started early, it could delay opening the facility.
9. Placement of IT. Identifying the IT equipment you need is only part of the process. Where this equipment will live in your facility is perhaps just as important, and you will want plenty of time to make such decisions. Will computers sit on desks or be mounted on to walls? What machines will go on carts and where will they be plugged in when they’re in use (as noted earlier with anesthesia)? How far do team members need to walk to access the different pieces of technology they need to perform their job (as noted earlier with front desk staff)? If you perform pediatric procedures, can children in the ASC reach your computers and wreak havoc? Ultimately, one must ask: Do all of these decisions maximize the use of your space and help ensure the most efficient workflow possible?
10. Aesthetics. While it may seem like a secondary concern, the aesthetics related to your IT can have a long-lasting impact after your facility opens. If you plan properly, you can minimize the amount of cabling that’s visible since most of it will be within the walls of your ASC. But if you don’t, you may find that you have spent $5 million to build a state-of-the-art facility that now has visible wires running from one end of a room to another because you identified an IT need following completion of construction.
As another example, if you decide that a white waiting room is optimal for patient and visitor comfort, the appearance of black monitors used by your receptionists may stand out like a sore thumb. While these black monitors can be replaced by white versions, making this change will take time and waste money.
3 quick tips
Here are three other quick tips related to addressing IT needs during the development of a new ASC.
● Include IT in your project timeline. Developing a timeline for the project that includes IT-related milestones is very important to a successful development.
● Provide constant IT status updates to the stakeholders. A weekly meeting with the ASC’s project manager, general contractor, architect, IT account executive and other stakeholders that includes updates on IT-related activities will help keep everyone up to date on the progress of the project. You would be surprised how many things can fall through the cracks without consistent communication.
● Partner with the right IT provider. When looking for service providers, including IT, when developing an ASC, it’s very important that your partners understand the healthcare arena because it’s an industry different from all others. Your partners need to take into consideration security and compliance, including HIPAA. You will want an IT provider that doesn’t just deliver you servers and hardware, but an IT company that understands the impact IT can have on delivering the highest quality patient care.
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