Baton Rouge makes me think of crawfish, the Bayou and Zydeco greats Clifton Chernier and Queen Ida.
Long ago, the Queen and her Bon Temps Band cut a wide swath up the East Coast and landed at a basement dive in Chapel Hill, not far from where I lived at the time. Ida and her boys burst forth with an indescribably happy rhythm played with Coke bottles, washboards, accordions and fiddles. Barefoot and energized, the rest of us danced until we wore the paint right off of the concrete floors, all the while falling hopelessly … completely … head over heels in love with Zydeco.
My guess is that most of the clinicians and healthcare staff at Baton Rouge’s Franciscan Missionaries of Our Lady (FMOL) Hospital System are pretty fond of Zydeco, too. I’d wager that they love the gritty vocals, syncopated rhythms and steel guitar almost as much as they love mixing a mobile workstyle with the use of their own devices.
FMOL’s system-wide healthcare IT goal was to deploy mobile access to electronic medical records (EMRs), clinical tools and business applications, as well as to enable a bring-your-own-device (BYOD) strategy for healthcare workers. To say that they succeeded is, to be sure, an understatement.
Today, mobile clinicians and healthcare professionals provide seamless care to patients thanks to the FMOL IT team’s hard work. Approximately 5000 concurrent instances of XenDesktop and 3200 XenApp sessions are enabled!
We talked with Johnny Brister, IT Systems director, FMOL, about the journey. The lessons learned and anecdotes that he shared will bring insight to those just starting down this path. The wins will be music to the ears of those who have already traveled this road.
Lesson 1: Local color colors your deployment.
“I guess you’ve figured out that Louisiana hasn’t got anything that resembles a metropolis,” Johnny deadpanned. “From a technology standpoint, that makes things really interesting,” he continued, breaking into a wide grin.
Indeed, Louisiana Health Care Quality Forum statistics from Jamie Martin shed light on what he means by “interesting.” Sixty four percent of the population inhabits rural areas. 26% of residents operate at the lowest US literacy levels. Women are the primary healthcare decision makers. Mobile healthcare apps are extremely important for clinicians and patients because many must travel long distances to get treatment. What’s more, a 2015 US Census bureau survey estimates the population of the entire State at 4,670,724, slightly more than that of the City of Los Angeles, making Louisiana only the 25th most populous state.
Taking into account the challenge of a large, disparate, rural population, Johnny and his team designed a mobility strategy that could effectively accommodate a wide range of diverse users with varying degrees of technical acumen and infrastructure capabilities – from those with DSL or 56K modems on up. Not only are users located in the hospital environment in East Baton Rouge Parish, but also, many live or work in rural regions of Louisiana and beyond. Some of the healthcare system’s mobile users even live in other states.
The take-away: study the demographics of your user base and cater to them.
Lesson 2: ‘I’m game’ is not a game plan.
“We hit our stride in the bring-your-own-device (BYOD) arena about four years ago,” Johnny explained. “Citrix technology enabled us to do that.”
“Early in the process of developing the organization’s BYOD strategy, the team got a big kick out of having exposure to the wide range of new devices coming on the market,” he said. “We were game for anything then.” Devices continued to proliferate quickly, however, and the team realized that it couldn’t manage the influx of devices without setting guidelines for BYOD users.
Ultimately, they made a list of ground rules for requestors. Yes, any device could be supported; no, it wouldn’t automatically happen. In order to qualify for device support, users would need to present valid credentials in addition to having access to an Internet connection and support for Citrix Receiver. FMOL would ensure device security by using Citrix Receiver as the delivery mechanism through which applications and data are pushed out.
The take-away: to make BYOD work, you need to set and communicate clear standards. There must be a clear strategy.
Lesson 3: Users aren’t mind readers.
It isn’t enough to simply deploy a healthcare information technology (HIT) solution for a large population of users. As the team at FMOL found out, other actions are crucial to ensure a successful deployment.
First, users need to be made aware that the new technology infrastructure has been implemented.
Second, they need to know what that new solution means to them in their day-to-day business operations. Will they save time? Will they find the new infrastructure easier to navigate? Will there be fewer steps needed to get a particular task accomplished?
Third, communication to the masses is important. At FMOL, once mobile clinicians, healthcare professionals and business users became aware of the degree to which new technology could revolutionize their work lives (and give them more time to be at home or with family), they enthusiastically talked about their experiences with colleagues. Word-of-mouth coupled with communications from the IT group helped gain adoption.
The take-away: deployment is Step 1. Building awareness is Step 2. Adoption follows.
Lesson 4: Automation is your friend.
Everyone in a hospital setting has a specific, defined role. That role comes with certain technology requirements.
Johnny and the team found that designing preconfigured sets of applications that apply to various types of clinicians was a smart idea that could save time and increase user satisfaction during the onboarding process. Now, each physician enrolls his device. A prescribed group of applications then is pushed down from the Citrix infrastructure based on the specific role that the clinician plays. “By automating the onboarding process, we now save time and alleviate a lot of the pain that previously was inherent in giving a new physician access to all of the technology needed,” Johnny acknowledged.
The take-away: automating repetitive processes saves time and money and results in better service to users.
Lesson 5: Put security at the top of your list – it’s that important.
At FMOL, Citrix XenMobile technology enables geo-fencing. Thanks to one of two technologies – either a global positioning system (GPS) or radio frequency identification (RFID) — geographical boundaries can be defined for any device that is registered on the network. The geo-fence (virtual barrier) enables the associated IT team to locate the device if it is lost or stolen and wipe it clean of sensitive information.
“We also have the ability to ‘wrap’ an application and put in our own FMOL app store,” Brister explained. “We can preconfigure it, set boundaries on it, and manage what it can or cannot talk to.” With Citrix XenMobile, FMOL has the necessary protection in place to enable the IT department to monitor all devices on the network and to implement quick action in the event of a security breach.
Citrix Sharefile also plays a big role in securing sensitive patient information and data at FMOL. Clinicians can securely send anything from documents to large image files via Sharefile. This is particularly helpful given the large number of patients who travel large distances to see specialists.
“One patient had to bring records from one doctor’s office to another clinician who was working on her case,” Brister remembered. “She had driven an hour and a half to reach the first doctor’s office, and the second was located quite a distance away.” The issue of sharing a large image file arose. It was too large to copy onto a disk. After brainstorming, the team determined that the best course of action was to copy the file into Citrix Sharefile and transmit it electronically to the other healthcare provider.
Citrix Netscaler is another technology in use at FMOL. Netscaler helps the team provide a superior user experience by optimizing, securing and controlling the delivery of enterprise and cloud services.
Your takeaway: technology that helps you ensure regulatory compliance and the security of sensitive information is not a “nice-to-have.” It is a must-have.
Lesson 6: Champions help you win.
“Clinicians at FMOL now are accustomed to using Citrix technology. We have a large number of adopters,” Johnny explained. “The single most important thing that got FMOL to the point of having high adoption was the fact that we designated a champion in each facility.”
Each location within the healthcare system had a different work culture. Different cultures matter. Each facility provides a variety of different services. This impacted the technology needed and the deployment. The FMOL IT team partnered with champions in various locations to build a solution that met the range of user needs.
In essence, users helped design the system. As the new solution initially rolled out, thirty physicians participated in a pilot across all facilities.
“By time it got to last hospital, 350 people were involved in the pilot,” Brister recalled. “Physicians were asking us for technology. Of course, they needed training, but they were fully onboard with the concept of change.”
Your takeaway: champions work for you. They are unbiased third parties who evangelize to the masses.
Lesson 7: Caution! Perception is reality to some users.
Johnny and the IT team discovered a lot about human nature in the course of implementing their mobility infrastructure. “People develop a perception after repeating a task a number of times,” he offered. “This was true of one task that previously required multiple steps. The whole operation took an elapsed time of roughly 30 seconds.”
The IT team was able to simplify the task to just one step. They shaved 18 seconds off of the time required to complete the task.
“Amazingly, we found that constantly clicking or doing something feels faster to users,” Johnny commented. “Ultimately the team actually had to prove that the required time was shorter before some users would believe it!”
The takeaway: arm users with facts. Answer their questions and address their concerns, and provide training.
Lesson 8: If something works well, consider extending its reach.
As part of the overall technology deployment, Franciscan Health and Wellness Services developed a wellness and care management program founded on evidence-based medicine. Healthy Lives™ is a comprehensive health and wellness program for employees of FMOL that espouses holistic care. The idea was to make the workforce healthier and, at the same time, reduce the cost of the healthcare system’s health insurance plan costs.
The program is comprised of four components, some of which are technology-based:
- Creation and analysis of a comprehensive workplace profile
- Biometric screenings and health risk assessments of employees
- Customized Wellness services including incentives, education, and clinical expertise
- Health coaching by local, registered nurses and dieticians
Participation in the 2011 benefit year was 80% among FMOL team members and dependents. The program improved the quality of care and significantly bent the cost curve of the hospital’s health plan expenses.
Its success ultimately drove more innovation. FMOL decided to share the program with businesses in the communities the hospital system serves. This technology now provides value to the community and creates a revenue stream for the hospital.
The takeaway: with a little creativity, technology deployments can serve multiple purposes.
What is the bottom line in all of this? The sweet sound of victory comes from creativity, perseverance and innovation. Keep the goal in mind, capitalize on the momentum, and above all, dance!
*If you are in the healthcare industry, we invite you to begin a dialogue with us. You can share your thoughts on the topics in this blog or any other healthcare IT issue with a Citrix researcher by clicking here.