Feature February 29, 2012 David Rossi

Advantages of the patient tracking board

A common problem for Urgent Care centers is keeping track of the status of each patient; who is where, what stage in the process they are at, and what is stopping them from moving forward to the diagnosis and discharge steps.

In the absence of a good technology-based solution to this issue, medical offices have sometimes adopted strange ways of keeping track of patient progress. A good example of this is how in-house labs are ordered and tracked. An approach I have seen in more than one facility is for a clipboard to be placed horizontally in a certain slot when a test is ordered and rotated to vertical by the lab technician when the lab is completed. Hopefully the lab tech and physician observe these changes as they happen to be passing wherever the clipboard is placed. Obviously such strategies are far from ideal, relying on as this one does, on people noticing changes at random intervals. When processing patients efficiently is a key ingredient of your offering (you’re an Urgent Care touting fast patient turn-around, for example) a better solution is sorely needed.

Tracking Boards of various kinds, originally of the whiteboard-and-marker kind and latterly electronic, have become more and more common in the ED environment. The advantage is that they provide the care team with an instant “snap shot” of where patients and medical personnel are both physically and in the treatment process. But Tracking Boards (of both kinds) can present a number of issues, notably access and confidentiality and interactivity.

Access
Who gets to update the tracking board? Is there an official “keeper”, or can whoever happens to be passing update it? Is that person “tied” to the board and therefore limited in whatever other activities he or she can perform.

Confidentiality
As regards confidentiality, patients do not want to see the details of their condition displayed for other patients and their families to see. The use of cryptic abbreviations is used to circumvent some of these issues, “ETOH” being a common example of what we might call “medical euphemisms.” For physicians who might only occasionally work in a particular environment, however, such strategies might provide a barrier to understanding and thus efficiency.

Interactivity
Another issue, especially in the case of electronic tracking boards of the “now serving customer 57” variety is their lack of interactivity. It’s essentially a one-way form of communication, whereby the medical personnel can’t interact with the tracking board to tell the system that things have changed.

The strength of the tracking board, that it does provide a quick overview of what’s going on at the facility, is also a weakness. As physicians and others periodically pass the tracking board they will see a series of snapshots. It will be up to them, however, to try to observe what changes have occurred and to infer why such changes have taken place. This is mentally demanding and a distracting from medical personnel’s primary responsibilities.

The ideal patient tracking board would have the following features:

Configurability
The tracking board should be configurable to show the right data to the right people. There is not one single consumer for the tracking board’s data but rather many different constituencies. The tracking board should be able to take many forms to feed subtly different versions of the same information to different people. Lab techs, for example, are focused on what tests and they need to run and when, so the physical location of the patient is not of great importance to them. A physician ready to examine his or her next patient certainly is, on the other hand, interested in the patient’s location. If the tracking board is open to public view, additionally, it should be possible to limit the data visible to preserve patient confidentiality.

Interactivity
A tracking board needs to interact with the EMR of which it is a part. When displayed on a touchscreen, for example, clicking on a particular area of the board should take the user into the appropriate area of the EMR. If the tracking board displays the fact that the EKG previously ordered for a particular patient is complete, a single click of the tracking board should take the user to the part of the EMR where the results can be viewed.

Portability
A tracking board should be able to serve as the general status board described previously, the whiteboard replacement. It should, however, be more than that. Users equipped with tablet computers or smart phones might want access to a custom tracking board view geared to their device and medical responsibilities, freeing them from the chore of constantly checking the tracking board in one central location.

Proactivity
Finally, rather than being static and passive, the tracking board should have the ability to reach out to key users and proactively tell them when statuses that affect their workflow change. For example, when a lab test result has been recorded in the EMR, that change should be highlighted to whoever has registered an interest in it via cosmetic changes in the tracking board, such as color changes, but also text messages, emails, pages and other forms of communication. In this way, medical professionals can be kept up to date.

Patient tracking boards are an important and useful tool for running a busy medical office. As Urgent Care Centers see more and more patients and strive to achieve greater and greater efficiency, the kind of configurable patient tracking board integrated into ScriptRx’s EMR is a great way to keep all members of the medical care team on the same page.

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