The deployment of Virtual Desktop Infrastructures (VDI) within hospitals, clinics and supporting services has resulted in several improvements and efficiencies directly impacting clinical workflows and patient care. But when defining the value, there is often a gap between how IT, operations, and providers communicate and weigh the impact and outcomes.
From an IT and operations perspective, Cost Benefit and Cost Avoidance are the two primary factors we usually hear discussed. Cost benefit being focused on evaluating the monetary value, and cost avoidance in evaluating impacts of avoiding potential future cost and/or impacts. As with most IT initiatives, the dialogue is often narrowed in on the “techy talk” and the value is lost when the conversation needs to broaden outside of the IT vortex and marketed to the key clinical stakeholders and end-users, aka “the front lines.” Where IT falls short, is in analyzing, aligning and translating the impact VDI has on Clinical Efficiencies. To truly evaluate and understand VDI’s value, impacts and opportunities in a healthcare setting, the discussion needs to broaden Beyond the Technology and encompass how VDI directly impacts the delivery of healthcare, enables clinical standard work initiatives, and aligns with strategic goals.
Providers and clinical leaders want to know how the technology is going to impact their ability to safely, efficiently, and effectively deliver patient care. How will the technology ease their ability to take care of patients and effectively impact workflows? Why should they take the time to adopt and optimize the technology? What is in it for them? From an operational perspective, you could also apply a lean lens on removing waste, adding value, and improving the patient experience.
To answer those questions, and truly assess VDI’s value, the conversation needs to broaden beyond the cost avoidance and benefit factors, and start to weigh the value of the technologies effectiveness in directly transforming clinical workflows, and thus, indirectly impacting patient care.
DEFINING THE VALUE
Clinical Efficiencies and Cost Effectiveness:
A thorough healthcare technology assessment encompasses
Regardless of how awesome the technology is, if providers perceive the technology as getting in the way of their ability to deliver patient care, they will work around it. Those detours are costly and render the perception that the technology is broken and ineffective, regardless of the cost. If IT deploys VDI in a technology silo, it can easily become the monument that is perceived as breaking workflows. But when deployed in partnership with key clinical and operation stakeholders, VDI can truly transform clinical care.
Arguably, one of the biggest indirect clinical efficiencies we hear from providers about their use of a Virtualized Desktop, but the hardest to measure, is the impact to task and memory recall after an interruption. While there is solid evidence from psychology about the disruptive effects of interruption on human cognition,1 2 few studies have quantified the effects on clinical tasks. Studies have shown that
interruptions and distractions have been reported as a factor contributing up to 11% of medication- dispensing errors. 3 On hospital wards, interruption to nurses administering medications was associated with a 12% increase in procedural failure and a 13% increase in clinical error.4 Interruptions also have a time cost. In one study, clinical staff in an emergency department (ED) spent 24% of their time dealing with interruptions5 and it was found that ED doctors failed to return to 19% of interrupted tasks.6
A virtual desktop allows a clinician to quickly return to their desktop and work in progress as they move from task to task and location to location, minimizing the time taken to re-orient and restart the primary task after interruption; referred to as the resumption lag.7 Whereas with a traditional PC, clinicians would have to focus memory recall on what it was they were doing/thinking/analyzing prior to the interruption, relaunch applications, and re-navigate to where they left off. The exact impacts to cost, productivity and safety associated with a shortened resumption lag can be difficult to quantify, but we have heard from our clinical partners over and over that the adoption of VDI within their workflows is much more resilient to interruption effects over a traditional pc.
From a cost effectiveness perspective, VDI implementations have resulted in big wins in time savings and productivity. Slowness and time wasted launching applications on traditional desktops is one of the top complaints voiced by providers and care givers. VDI allows for a speedy reconnection to desktops as users move from desktop to desktop, eliminates the need to relaunch applications, and minimizes clicks to re-navigate back to where users last left off. Observations and time studies from deployments of VDI in various healthcare settings have repeatedly shown time savings and measurable wins in productivity. During the deployment VDI within one care center of a large healthcare system, time studies of launch times were conducted pre- and post-deployment. The studies confirmed that launching of desktops at the start of the day took an average of 15 minutes, and launching of the EHR as clinicians moved from workstation to workstation was taking an average of 45 seconds. With VDI, initial launch times took on average 1.25 minutes and relaunches an average of 8 seconds. Through a simple formula calculating the number of patient encounters per week, per provider, it was determined that care teams from the 9 specialty services at the care center were spending 280 minutes (4 hrs. 40 min) per week waiting for the EHR to launch. Post VDI deployment, the same calculations showed partners spending 49 min 57 secs launching the EHR per week (table 1). A savings of 3 hours and 50 minutes that can be reallocated to patient care. By clinic, partners saw an average of an 83% improvement in launching of the EHR, and by user, a 92% improvement in the initial launch of desktops at the start of the day.