Jai Valluri is a Senior Manager in the Customer Business Transformation (CBT) team that is part of Cisco’s Voice Technology Group. Jai leads CBT’s consulting practice in the Healthcare vertical. The CBT team comprises a group of experienced business consultants who work with many of the world's leading companies on strategies to leverage Unified Communications and drive business value through cost savings, increased revenue, improved employee productivity and more effective business processes.
Jai has 11+ years of experience and has held a variety of roles in business, engineering and consulting across multiple industry verticals including high-tech, telecommunications, healthcare and industrial goods. Prior to joining Cisco, he was a Business Development Manager at EMC responsible for Strategy & Business Development. Prior to EMC, Jai has a background in Management Consulting from Bain & Company, where he worked with senior management of clients in a variety of industries and advised them on strategic and operational issues facing their businesses.
Jai holds an MBA from The Wharton School, University of Pennsylvania and a Bachelors and Masters in Electrical Engineering from the Indian Institute of Technology and University of Maryland respectively.
Jai Valluri is a Senior Manager in the Customer Business Transformation (CBT) team that is part of Cisco’s Voice Technology Group. Jai leads CBT’s consulting practice in the Healthcare vertical. The CBT team comprises a group of experienced business consultants who work with many of the world's leading companies on strategies to leverage Unified Communications an
In a previous post I shared some highlights from different studies that showed the impact of communication inefficiencies in Healthcare. Today I wanted to share a specific use case that shows how Healthcare Providers can leverage Unified Communications in the Emergency Department (ED) to streamline access to on-call specialists. A few months ago I had to visit the Emergency Room at my local hospital to get treatment for some very severe pain. An Emergency Room visit is rarely an enjoyable experience but what made this visit more unpleasant was the length of time I spent waiting. I waited for nearly 3½ hours before I was assigned a bed. There was a long wait between the time I was seen by the nurse and the ED physician. It took an even longer time for the ED physician to find the on-call specialist and come back to tell me that the on-call specialist had confirmed his suspicions. There was no emergency so I could be discharged but there was another 20 minute wait before the nurse could actually discharge me. While I waited I wondered what the key reasons were for the delays and what my experience would have been like if the nurses and physicians had better communications capabilities. Let’s look at one of the areas of delay – finding the on-call specialist. This process can be quite tedious and slow in many hospitals. On-call schedules are often not available online and a nurse or an ED Tech might have to refer to a paper schedule to determine who the on-call specialist is for different specialties and their associated contact numbers. Having found the number from the paper schedule the ED Tech or nurse calls the number manually. If the doctor doesn’t answer he or she has to look for other contact numbers and calls them. This ties up the nurses and keeps them away from providing care to patients. Fortunately hospitals can significantly streamline this process and reduce time to connect to an on-call specialist by as much as 50%, by leveraging a Cisco Unified Communications solution that is integrated with a partner’s (Magpie Healthcare) On-call application. A nurse or an ED Tech can just use their wireless phone and select one of the specialties for which they need an on-call specialist and hang up, which frees them up to be with their patients. The system looks up the specialist who is on-call, calls the different numbers and connects the call back to the requesting person once the specialist answers. The system also automatically looks for a backup if the specialist doesn’t answer. At a hospital with less than 100 beds this solution drove an annual productivity benefit of over $350,000. Beyond this example there are other use cases in the ED where integrating collaboration capabilities with applications to streamline workflows can help improve the experience for patients. I will periodically share other examples that I am seeing and the benefits that they are driving. What examples have you seen in the ED where enhancing collaboration is improving the experience for patients?
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In this series I want to share my perspectives on how healthcare organizations can and are leveraging collaboration technologies to drive transformation. However, before discussing specific examples of transformation I wanted to review the impact of inefficient communications & collaboration in the current environment. Healthcare delivery inherently involves a significant amount of communication and interaction among clinicians as well as between clinicians and patients. It should come as no surprise that in a typical hospital environment there are several inefficiencies in these communications, resulting in a broad reaching impact, which goes well beyond lowering staff productivity and reducing operational efficiencies. More importantly they result in patient safety and quality of care being compromised, patient experience being less than satisfactory and staff that is less satisfied with their work life. A recent joint study by the Center for Health Information & Decision Systems (CHIDS) at the University of Maryland and the Cisco Internet Business Solutions Group (IBSG) estimated that the annual “cost” to US hospitals due to poor communications is in excess of $25 billion. Patient safety issues were highlighted in a 2006 Joint Commission study that analyzed more than 4000 patient sentinel events (unexpected occurrence involving death or serious physical or psychological injury) over a 10 year period and found that communication lapses was the single biggest root cause and the key factor for two-thirds of the events. Also, in a recent nursing survey conducted by Zogby International and commissioned by Cisco, 77% of those surveyed said that communication lapses have a high-impact on patient safety. My experience in working with different healthcare organizations is that, difficulties in locating and collaborating with other clinicians and staff members is one of the key challenges that most organizations face. Clinicians waste precious time each day trying to track down other available clinicians, calling multiple numbers and trying different channels of communication, waiting for people to respond to a page etc. In the nursing survey mentioned above 86% of the respondents said that “time spent chasing other people to get answers” could be as much as two hours per shift. The wasted time reduces the time that clinicians can spend on direct patient care. A 36-hospital nursing time and motion study published in 2008 found that nurses on average only spend 31% of their time on patient care in the room while almost 40% of their time is spent at the nurses’ station. Patient care is also indirectly impacted because of higher stress levels in staff that might have to work overtime. These issues only exacerbate the staffing shortage challenges that many hospitals face by reducing their ability to retain and attract the best talent. But it doesn’t end there, communication challenges can often have a cascading effect on patient flow that affect multiple areas within a hospital and ultimately lead to higher costs, lost revenue and reduced patient satisfaction. I worked with one hospital where inefficient collaboration resulted in patients waiting 45 min each time they needed to be transported between the ED (Emergency Department) and radiology. While there were long lines of patients that were waiting to be transported, other patients were waiting to be admitted to the ED. Often, because all beds were full the ED went into divert protocol, which meant the hospital was diverting all new patients to neighboring hospitals resulting in lost revenue. Ineffective communication also resulted in delayed patient discharge and delays in getting the rooms ready for the next patient. Even after the beds were cleaned and available, patients were often waiting in the ED to be transferred to an inpatient bed because of ineffective coordination between the ED and the floors. In other areas such as surgery, I have seen examples where a significant percentage of surgeries are delayed because of delays in assembling one or more members of the surgery team. Leading organization are integrating collaboration capabilities into healthcare workflows to address these challenges. In the next set of posts I’ll discuss some of these examples and the associated business impact.
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One of the sources of inefficiency in the current healthcare system is ineffective communications among care providers. Studies estimate that US hospitals “waste” in excess of $25 billion annually due to inefficient communications but more importantly breakdown in communications are the biggest root cause of patient Sentinel Events, according to the Joint Commission. Several of these communication challenges can be addressed through technology solutions. While technology solutions alone can’t address the issues, technology as part of a holistic approach that addresses people and process issues such as end-user training, cultural changes, workflow integration etc. can help to transform healthcare. Unified Communications (UC), which integrates voice, video, data, mobility and presence capabilities, provides a technology platform to enhance collaboration and improve patient care while helping to reduce costs. The cost savings can help pay for the investment in UC and can also help to fund investments in advanced collaboration solutions. However, leading Healthcare organizations are looking beyond cost savings to even greater sources of business value that UC can drive and are integrating UC and collaboration capabilities into workflows to enhance staff productivity, improve patient safety, enhance quality of care and deliver better patient experiences. While there are a number of innovative examples of collaboration solutions that are driving value in Healthcare, organizations can start to realize quick wins through capabilities such as: Wireless IP phones for nurses to enhance mobility and productivity Nurse call integration with wireless phones to reduce response time to patient requests Asset and resource tracking from wireless and wired phones to reduce patient waiting time and enhance staff productivity On-demand video based language interpretation to reduce patient waiting time, enhance interpreter productivity and improve quality of care These are just a few examples of solutions that organizations are deploying. How are you addressing the communication challenges to enhance patient care? Are you able to provide your clinicians with the right patient information and access to the right people at the right time so that they can deliver the most appropriate care? How do clinical collaboration solutions fit in your overall strategy and roadmap? What solutions if any have you deployed and what business value have you realized?
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