Enterprisewide scheduler speeds response time
One of the key goals St. Vincent Hospitals and Health Services in Indianapolis set in implementing an enterprisewide scheduling system was including an infrastructure that would allow adequate response time to remote locations at a reasonable cost, says Kathleen Wilkey, project manager of information systems (IS).
To do that, St. Vincent used Citrix Winframe technology, implemented through HBOC, the vendor for its Pathways Healthcare Scheduling system, Wilkey says. "That technology also gives us the ability not to run any software on the workstation but rather on the Winframe server. That cuts down support costs."
It also eliminates the problem of having to send someone 70 miles to repair a broken PC at a remote outpatient facility, she points out. The bad news is that there's only one copy of the software. "If it's broken on one workstation, it's broken on all the workstations."
St. Vincent decided the potential benefits outweighed the inconvenience in that scenario, primarily because of the strong support provided the health system by Daughters of Charity Information Services in Evansville, IN. "It's less work for our IS staff," Wilkey adds. "We're able to let [the regional center] handle the support for us."
The health system began implementing enterprisewide scheduling for outpatients in November 1997 at one of its smaller hospitals in Carmel, IN. The project began with 11 departments, including nuclear medicine, ultrasound, and MRI. Although scheduling already was centralized, it was still being done manually and so had to be automated before the transition to enterprise scheduling could be made.
The next step was adding 12 departments at the system's largest hospital, in Indianapolis, and it recently brought on five departments at a third facility, a remote outpatient center, she adds. By late March, the system was scheduled to go live at two other outpatient facilities.
"What we're finding is that scheduling can be very complicated and very facility-specific," Wilkey says. "We have written all the rules into the system, with hints and comments, but [the challenge can be] that a remote facility might not want another facility or the scheduling department to overbook them."
The person in that department might know, for example, that a certain technician always works in extra patients or that another prefers a more structured arrangement. "It's really the identification of all those [idiosyncrasies] that's the hard part."
Another dilemma is whether the schedulers should be centralized physically, or whether they could be connected just as effectively through automated call distribution, Wilkey says. One issue is that schedulers at a remote outpatient facility do more than just schedule, so if they're moved to a central location, it might mean more FTEs have to be added, she points out.
And while the health system's vision is for one-stop, or one-call, shopping, it may not make sense to centralize the scheduling of diabetic education classes, for instance. "It might be that we have one phone number, but the caller hears, `If you're signing up for a diabetic class, press one; if you're scheduling an appointment, press two.'"
The questions regarding enterprisewide scheduling, she says, are these: What kind of infrastructure do I need? How am I going to support it? Will we have to make adjustments or modifications as we go along?
Wilkey has a counterpart who is handling the process piece of the implementation - what new processes are needed and how to train staff, for example - as Wilkey focuses on the IS piece. That leads to her final word of advice for those embarking on enterprise scheduling: "If you just automatically try to take stand-alone hospital processes and assume they will work at the enterprise level, we don't believe you'll succeed."
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