The Future of EHR Documentation

A roundtable discussion with Enovate and “Healthcare IT Today”

Healthcare IT Today seeks out first-hand experiences to create actionable insights for its readers. Recently, John Lynn, the Founder and Chief Editor of the publication, sat down with Enovate’s Kevin Bridges, VP of Marketing and Business Development, and Marc LaFleur, VP of New Customer Development, to discuss the evolution of EHR documentation, mobile carts, and what the future holds.

The conversation covered advances in mobility, ergonomics, power capabilities, fleet management, and more. The core of the discussion recognized the critical role that today’s mobile EHR documentation workstations play and the importance of flexible mobile power, particularly in the time of COVID and the demands it puts on clinical workflows.

Mobile EHR workstations rise to meet the challenge of COVID

A mobile ‘Workstation on Wheels’ or WoW, may not appear to be the most sophisticated piece of technology in the hospital. Yet, it captures a constant stream of patient data in real-time at the bedside – data that runs both the clinical and business sides. In 2020, COVID placed new demands on workstation functionality and availability.

Remote visibility for EHR workstations

“Today, we apply analytics to healthcare in so many different ways, and now we can apply analytics to every single piece of technology,” John Lynn said. “This is an enormous challenge that many healthcare organizations face – just managing what has been implemented.”

“The pandemic highlighted the importance of having a mobile EHR solution coupled with the visibility to know what is available across the enterprise,” Bridges explained. “We saw a lack of remote visibility. When we talked to hospitals, they often didn’t know how many mobile EHR workstations were in their fleet.”

“This is an expensive capital asset,” Bridges added. “We developed Rhythm, our asset management platform, to deliver remote visibility. We can tell administrators how many units they have, where they are, and where they should be when abandoned. We can also report whether they need repairs or not.”

The push toward managed services with workstations

“The other question many CEOs are asking is whether they should be in the desktop business at all? They already outsourced their data center business to the cloud, and now Enovate is offering something similar – a full-service and a managed option. Are healthcare organizations moving towards the managed service option? Or, are they still wanting to buy?” asked John Lynn.

“If you look at a hospital, almost everything is on the network – even the beds, believe it or not,” Kevin Bridges said. “So, somebody has to maintain it. As hospitals gain efficiency with outsourcing IT, they are now moving toward outsourcing the management and maintenance of workstations on wheels with a subscription model. In this model – what we call clinical workstations as a service (CWaaS) – we can provide the equipment, the embedded technology to monitor the asset, and the technicians to maintain the equipment. We bundle all three aspects into a vendor-managed service plan.”

Enovate’s Uptime Service takes this managed service model to the next level.

“Our Uptime program reframes the discussion on how to own and manage mobile workstations,” Marc added. “IT departments are stretched thin with 30, 40, 50 projects that have to be allocated within a department that’s not growing and with a budget that’s not expanding.”

“Workstations on wheels have evolved with more durable designs and power options for greater mobility. The goal is to ensure clinical availability,” Kevin explained. “To this end, we provide Ready Replacements. By having on-site loaner workstations available, you can keep your clinical staff focused on their patients and reduce the service burden on your IT staff.”

“Tell me how your Rhythm management system interfaces with these shared services,” Lynn asked. “Does Rhythm see all these moving parts?”

“Absolutely,” LaFleur explained. “We contact the hospital saying, ‘Hey, we noticed one of our Ready Replacements was wheeled up to the fifth floor two hours ago. Do we need to schedule a technician?’ When we place these loaner workstations at the hospital, a nurse can have a replacement in her hands in minutes rather than hours. While she is busy using the loaner, we will dispatch one of our factory-trained technicians to make the repairs. So often, broken carts are abandoned in hallways and random closets, but we can see the need for a repair in real-time.”

How workstations support clinical efficiency

“Clinical efficiency and clinician burnout are hot topics right now,” John Lynn underscored. “Hassling with workstations only adds to the burden. What else are you doing to deal with efficiency and burnout for nurses?”

“We are developing workstations on wheels that utilize smart technologies that reduce the physical and mental fatigue that is common with conventional workstations,” Bridges said.

“Reducing fatigue is more than lightening the load of the battery and power system,” LaFleur said. “Placing medication bins on the workstation reduces footsteps to the medication storage room. We use Single Sign-On to eliminate the sharing of PINs and to track access to the medication bins. The nurse doesn’t have to worry that the meds will go missing from the workstation on her watch. Kevin and I are always looking for ways to reduce nursing anxiety because there’s so much fatigue in nursing.”

Will EHR documentation workstations be a thing of the past

“What can we predict about the future of the workstation?” John Lynn asked. “Are we looking at handheld devices with voice recognition to enter EHR documentation? Or will workstations continue to play the dominant role?”

“Kevin and I have been around a long time,” Marc said. “So, even though we have seen and heard it all, we know that change is inevitable.”

“Yes, but unless you build the hospital of the future from the ground up, you can’t get rid of the mobile workstation,” Marc continued. “We’ve talked to CIOs who proclaimed, ‘This is our last purchase of WOWs – the future is tablet-based.’ I agree that nanotechnology allows you to put vast computing power into the palm of your hand, but the input technology requires fingers. EHR documentation involves lots of fields and forms. The nurse will find it more efficient to navigate the complicated layout on her screen with a mouse and enter data with a full-sized keyboard. So, you have that challenge.

“What’s more, today, our mobile EHR carts are powering multiple, necessary devices – barcode scanner, specimen collection label printer, document scanners for ER registration, etc. You can’t hang all that hardware on your belt. For this reason alone, I see WOWs in our future.”

“Thank you both for enlightening our readers,” John Lynn concluded. “It’s exciting time to see how far EHR technology has evolved in the hospital setting.”