Friday, September 25, 2015

Six Questions

Published in VC's Notes on September 25, 2015

Six Questions

Thank you for your response to my column last week on campus security.  The number of comments I received showed that this subject is weighing on many of your minds as well as mine. 

Today I will address some of your questions and comments submitted during the last few weeks.  As a reminder, I read all of your submissions and forward many of them to senior leaders for further review and action as appropriate.  I appreciate and value all the feedback I receive through VC Notes.  

Here we go. 

Q:  For months, we have continued to have issues with staff being able to clock in and out on their PCs in Kronos. This is especially true in our clinic operations. Supervisors and managers spend too much time having to clock staff in and out, add time, edit time, etc. This is a big time waster for the staff and creates a great deal of frustration on the part of the employees who get to work on time, leave on time, but are not able to document their time. I am sure there are many mistakes made when you have to do this manually. We need someone to take this problem on and get to the bottom of it because it continues to happen on a daily basis. Thank you.

A:  Our Information Systems staff, in concert with Human Resources, has been working on the problem you describe and has determined it's related to a piece of supplemental software called Java that supports various applications.  Our PCs have different versions of Java installed and there can be compatibility problems with the applications they support.  With Kronos, users can experience difficulty with the time stamp feature to clock in and out on a desktop.  We have been working with Kronos to develop a version of the time stamp that does not rely on Java.  That feature has been tested and I'm told it is being deployed during the next couple of weeks.  There are larger changes coming with Kronos that are the result of an optimization study completed during the summer, but this particular issue is on the way to being resolved.

Q:  We were devastated to see the huge oak tree removed near the Clinical Science Building. Please assure us that the other two trees will not come to the same end. We feel those gorgeous, many centuries-old trees must be protected and do not need to be sacrificed, no matter the reason.

A:  We don't have an abundance of trees on our urban campus and so we treasure the ones we have all the more.  Unfortunately, branches of the tree were interfering with the electrical connection to the Clinical Sciences Building and the Pavilion and presented a safety concern.  After years of trimming the tree to the point that it was becoming misshapen, there was no practical alternative but to remove it.  The other two trees are safe.  In fact, Physical Facilities has a plan to renovate and improve the courtyard behind the Pavilion soon and the remaining oak trees will be incorporated into the design. 

Q:  I see many patients during my work day (sometimes more than 100 patients/day). I do see advanced, yet preventable, diseases that are taking the lives of hundreds of Mississippians every day. Do you have a plan to improve the preventive medicine, health education and screening awareness of our population? We don't even have education screens or awareness TV monitors in our own patient and waiting rooms. If we really want A Healthier Mississippi, prevention and awareness are going to be a key step!

A:  Your last sentence could not be more important or more true.  As I've said before in VC Notes, we are gradually shifting our focus from health care to health.  The development of our Office of Population Health and the revitalization of our Department of Preventive Medicine are two signs of our commitment to this transformation.  In addition, literally hundreds of smaller initiatives are under way to improve health literacy, promote healthy behaviors and encourage screenings.  And later this year, we hope to announce a major new initiative that will greatly enhance our commitment to health and wellness.  Stay tuned.

Q:  With the increasing number of staff and the continuous campus expansion of our hospital, is a crosswalk construction from stadium parking to the main campus in the plans? St. Dominic's and Baptist both have one and it seems as though our need is greater now more than ever before.

A:  Through the years, we've had lots of questions about building a crosswalk - really a pedestrian bridge - over State Street. Apart from the cost, which would be substantial, the main obstacle is that we have no structure on the west side of State Street to connect to, unlike the other hospitals you mention.  Someday, when we have the opportunity to develop the stadium property, we will likely consider a parking garage across State Street, and then a pedestrian bridge would be more feasible.  That's still well into the indeterminate future.  In the meantime, we will move forward with a second protected street-level crosswalk closer to Garage B. 

Q:  Please get going on the carpool request. I asked last July and then again three months ago. This would help our environment and ease crowding in the parking lot. It is a HUGE problem with a sensible solution.

A:  As I promised in an earlier VC Notes, we have been investigating the possibility of creating a formal carpool system in response to requests from you and others.  What we have discovered so far is that to make the system work, we would need a large, close-in parking area that can be set aside as preferential parking for registered carpoolers.  With current parking at maximum capacity and large parts of the inner campus given over to construction activities, we don't have the flexibility to create preferred carpool parking at this time.  But we will continue to explore options for making carpooling a feasible option. 

Q:  In your September 11 VC Notes you commented regarding Epic: "We've come a long way, and nobody wants to go back."  Respectfully, I would go back in a heartbeat and I don't know many faculty members who were here pre-Epic that don't feel the same way. Our IT/EHR system is the #1 reason I have no interest in remaining here on faculty after training. I remember what it was like here in April of 2012 pre-Epic. Physicians could teach more, saw more patients, demonstrated physical exams, residents had more time to learn, chart notes weren't an inaccurate cut/paste joke. Patients had more face time with practitioners. Medical education and non-algorithmic clinical care has been devastated.

A:  I appreciate your comment and understand the frustration you and many of our clinical staff feel with our electronic health record (EHR) system.  Epic isn't perfect, nor is any system of its type.  But EHRs are the future, and you're likely to encounter them anywhere else you go, in this country at least.  They confer many benefits, including portability, instant anytime-anywhere accessibility, and searchability.  They offer the potential for deep insights into population health that we are just beginning to tap.  Although they can interfere with patient care and teaching if we let them, our challenge is to adapt our practice to ensure those crucial activities are preserved.  And frankly, we would be doing a disservice to our students in our role as educators if we did not provide exposure to this new world of clinical documentation.  Are EHRs a near constant source of irritation?  They can be.  But that's the nature of technological change.  Some of us remember when innovations like desktop computers and the World Wide Web were in their infancy.  Now all that capability fits in your hand and is as intuitive as combing your hair.  Efforts to optimize Epic are going on all around the clinical enterprise, and we continue to move up the learning curve as a community.  Indeed, we hope to soon be in the top 5 percent of organizations making effective use of their EHR systems.  It's an uphill journey, yes, but I believe one day we will look around and the view will be spectacular.

And I want to thank all of you again for reading VC Notes and sharing your questions and comments.  Every day is another step toward A Healthier Mississippi.



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