THE PEDIATRIC OFFICE PROJECT

INTRODUCTION

Since January 9th, 2016, Miranda Sowers, Mary Beth Hill, and David Slifer have assisted with a
transition from an outdated paper medical record filing system to a fully digital system at E.M.R.
Service office. The project was completed on June 20th, 2017 to great success. Each team member
was given a specific task to help the project. Miranda Sowers has worked for E.M.R. Services the
longest and oversaw training the doctors, nurses, and front desk staff. Mary Beth Hill worked on
the acquisition and pricing for the Ipads 11 and 3 docking stations needed. She was also in charge
of the installation of the docking stations. David Slifer analyzed the savings from the transition
and the cost to dispose of the current paper records. The team, along with the staff of the pediatric
office, all helped with the data input from the paper records to the new digital system.

Our initial cost for the project was stated at $4,598.00. This included the 11 Ipads for $2,960.00,
$138.00 for the 3 mounts, and $1,500.00 for the disposal of the documents. We ended up needing
to upgrade the pediatric office’s WiFi to help support the new system. This cost an extra $150.00
for a new wireless router added to the initial cost. The previous 25 MBPS also needed to be
upgraded to 50 MBPS that added an additional $40.00 a month. Despite this slight increase in cost,
the monthly savings from the switch still reached an approximate $5,460.00.

We began our work on January 9th, 2016 and set an initial end date for May 26th, 2017. This date
had to be adjusted to fit in a slightly longer training schedule. A few employees took longer to
become fully acclimated to the system and required more training from Ms. Sowers. In turn we
were forced to push back our projected end date to June 26th, 2017 as the data input that required
the entirety of the staff. Despite the setback, we still managed to finish the project and have it
operational by June 20th, 2017. To ensure the success of the new system, we had the patients take
a survey after their visit had ended. We asked them to compare the old system to the new system
and whether they thought the new system was user friendly. A clear majority of the patients agreed
that the new system was a great improvement.

WORK COMPLETED

The project consisted of three main phases undertaken by each team member and the office.

 Compiling the budget and determining overall savings from the system switch. Done by
Ms. Hill and Mr. Slifer
o $2,960.00 for 11 Ipads
o $138.00 for 3 mounts
o $1,500.00 for 10 trash cans worth of paper records to shred
o An additional $150.00 for a wireless router was added 4 months later
o Initial savings of $5,500 per month. Changed to $5,460.00 with inclusion of 50
MBPS internet upgrade for $40.00 a month
 Training for the staff. Done by Ms. Sowers. Estimated timeline of 3.5 months. Pushed back
an additional month for a total of 4.5 months of training.
 Data input of old paper records and patient information. Done by team and office.
Estimated timeline of 2 months.

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Ms. Hill found the best prices for the Ipads at Wal-Mart for $269.00 per IPad. She also found the
mounts at Wal-Mart for $46.00 per mount. Mr. Slifer found the best and most cost-effective
shredding done by Stealth Shredding for $150.00 per trash can full of documents. He also ran cost
benefit analyses of the current paper filing systems vs the new digital systems. His initial estimate
was a larger upfront cost to implement the system, but after it was underway the savings would be
more beneficial on a month to month basis. The installation of the Ipads was undertaken within
the first 2 months of the projects implementation by Ms. Hill. On June 23rd, 2017, the new
upgraded internet and new router were installed. Stress tests were performed by Shentel to ensure
the success of the new system.

Training began immediately on January 9th, 2017 by Ms. Sowers. This included a comprehensive
overview of the new digital systems to each member of the staff. Ms. Sowers then took each group
aside, doctors, nurses, and front desk staff, to teach them the details of how they would each be
using the system. While the system was picked for its ease of use and small learning curve, there
were still a few who initially struggled with it. Ms. Sowers helped these people on an individual
basis to ensure they would be comfortable on a day to day basis. Training was completed on April
14th, 2017 with every employee feeling confident in their ability to operate the new system.

While Ms. Sowers was working with the groups of each employee type, Ms. Hill and Mr. Slifer
were working with the other groups to begin the data transfer from the paper records to the digital
system. The pediatric clinic had previously kept most their files on paper and stored in filing
cabinets. These included patient records, billing files, insurance information, and the certifications
of the various employees. Apart from the certifications, all the other files needed to be transferred
onto the new system. This allows any employee, anywhere in the office, to access all the files that
were previously more difficult to get to. Completion of the data input was on June 20th, 2017.

PROBLEMS ENCOUNTERED

We only ran into a few minor problems during our project. Most of them were minor and required
very little adjustment to our schedule and budget. The main issue we faced was the setback in
training a few individuals. There was always a possibility that some of the older members of the
staff would have a harder time adjusting to the new system. Ms. Sowers was able to work with
them in a one on one environment for a few extra sessions and helped clear up the issues within a
few weeks. As a result of the extra training, we had to readjust out timeline to make sure we could
get all the data uploaded to the new system. Though this did put our end date back almost a month,
we were still able to finish a full 6 days before our adjusted time. In our progress report we
mentioned the possibility of hiring new part-time staff to help make up for time. This was not
needed as the current staff and the E.M.R. team all stepped up to push through the data input.
Below is a graph detailing our timeline throughout the project.

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Fig. 1. Project timeline with Initial, Updated, and Final Timelines. Note: The final timeline includes the 2
months of surveying done to ensure the project was a success.

Another issue was the stress the new system was putting on the existing WiFi infrastructure.
Before, the pediatric center was using an outdated router with only 25 MBPS download speeds.
We found quite early that this was not going to be enough bandwidth to make sure our system ran
smoothly. After meeting with the pediatric centers staff, we decided an upgraded of both the router
and the bandwidth to 50 MBPS was the most cost effective solution. This had no effect on the time
it took to complete the project as it was installed 3 days after the data input was complete. It did
add onto the monthly costs by an additional $40.00. This is still well below the original cost of
$5,500.00 the pediatric office was paying before.

RESULTS

The Pediatric Office Project was largely a success in terms of budgeting and time management.
Even though we initially underestimated the time it would take to train, and therefore input the
data, we still managed to complete the project in a timely manner. The digital system we put in
place is very user friendly for both the staff and the patients. In the future, we will look to create
more realistic timelines for our projects and try to take into account the bandwidth needs of our
system.

We project that the pediatric office will continue to save money over time with our new system in
place. They no longer need to put money into paper, ink, printers, and printer maintenance. Instead,
the office can focus their resources on better medical equipment for their patients. Below we have
two graphs representing the costs breakdowns per month before and after the project was
completed.

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Fig. 2. A percentage breakdown of how much money was being used in different areas to provide upkeep
on the paper systems.

Fig. 3. A percentage breakdown of the amount of money saved from switching systems.

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At the completion of the project, starting June 21st, 2017, we asked patients to complete a survey
before they left their appointments. Below is a graph representing the data we compiled.

Fig. 4. Survey Results taken from June 23rd to August 20th, 2017.

The feedback shown has been very positive so far. We hope to continue this trend in all future
projects. This type of feedback is what empowers us to continue to help similar offices upgrade
their systems to help the patients or consumers enjoy their visit.

CONCLUSION

Despite a few setbacks in time and money, the project was an overwhelming success. All the staff
and patients seem to be enjoying the ease of the new system. The money that will be saved will do
nothing but help benefit both the staff and patients. Rather than having to wait for paper records
to be pulled and reviewed, the new digital system ensures that all the nurses and doctors have
everything they need at their fingertips. This has resulted in shorter wait times for patients. Money
is already being allocated by the pediatric office to upgrade some of their medical equipment to
further help the patients.

We at E.M.R Services are extremely proud of the work completed not only by Ms. Sowers, Ms.
Hill, and Mr. Slifer, but by the entire staff of the pediatric office. Every one pushed themselves to
help achieve this projects completion. We are thankful for the pediatric office’s and E.M.R.
Services support throughout its entirety.

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RECOMMENDATIONS

Going forward with the all digital system, we recommend that the pediatric office find an on-call
IT professional to be available to fix any issues that may arise. We have already provided them
with a list of possible candidates to fill this position and extended an open invitation to help them
with the vetting process. Regular maintenance and updates to the system will be required as well.
The training done by Ms. Sowers included how to complete this. Once again, we are available at
any point to help with this process.

We have identified a few individuals within the office to undertake training new employees as
well. Our recommendation is that these individuals be adequately compensated for the extra time
this would take out of their schedule, and that they continue to train themselves to ensure they are
up to date.

The pediatric office has other health care professionals that they deal with as well. Many of these
offices are possible candidates for a digital system overhaul and we hope that they will consider
us for the future.