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Consolidating on a Single Device
By Jeff Goldman
The Hospice of the Comforter, founded in 1990, has served more than 27,000 patients throughout three counties in central Florida over the past 20 years. "We have a little over 530 employees, and at the current time we have about 750 patients on our service on any given day," says Doug Stone, the hospice's vice president of finance.

The vast majority of the hospice's services, Stone says, are provided in the clients' homes. "They're scattered about the three county area, which really means that we have a highly mobile workforce going out to service those clients," he says.

In 2008, Stone says, the hospice began looking for a solution to simplify its mobile voice and data access. "The service before was very fractured," he says. "We had employees who had some Nextel push-to-talk phones, we had a lot of our nurses who had AirCards, and we had a great number of pagers... Literally, there were nurses with a company phone, a personal phone, an AirCard, and a pager."

One key requirement was that the solution had to support laptop connectivity. "The nurses carry a laptop computer, and the laptop contains our electronic medical record," Stone says. "After seeing each patient, the nurses synchronize their laptop with the master database here at our office building -- and so, to get rid of the AirCards, which we wanted to do, we needed to have a device that could be used as a tethered modem."

The hospice also needed a highly secure solution. "We had significant concerns about HIPAA and patient privacy, so we ended up with the BlackBerrys in large part because of the extreme degree of control we can exercise over the device," he says.

The BlackBerry deployment

In October of 2008, the hospice launched a deployment of 250 BlackBerry devices (Curves and Tours). "We have them in the hands of our physicians, our nurses, our marketing people, our admissions personnel, our pastors, our psychosocial counselors or social workers, and then all of their supervisors," Stone says. "The idea was that the entire team would be in touch and integrated through that one communication device."

Stone says the hospice isn't likely to replace or upgrade the devices until Sprint rolls out its 4G service, at which point they'll be first in line to switch to 4G BlackBerrys. "That'll be a huge benefit, because our nurses spend 15 to 20 minutes a day synchronizing the device," he says. "If the [speed] is as advertised, it should give us 15 minutes of extra labor for each nurse each day."

In addition to using the BlackBerry smartphones for voice, email and text messaging, the hospice uses TeleNav Track to monitor the location of its nine medical equipment trucks. "The trucks all use TeleNav -- the drivers jump in the cab, turn it on to begin their day, and it broadcasts their position back our dispatch center," Stone says.

That location awareness, Stone says, helps the dispatch center in two key ways. "If someone needs a piece of equipment, we can always find a truck that's nearest to that patient and dispatch it to the patient," he says. "If we get a new patient admission, we can do the same thing -- we can find the closest truck -- and those trucks always carry three or four complete setups of inventory for a newly admitted patient."

While the TeleNav Track solution is currently limited to the hospice's equipment trucks, Stone says they're looking at the possibility of providing it to physicians as well. "We'll have a patient scheduler make the appointments with all the patients and families the day before, so when the physician turns on the device, they have an optimized route already set up for the next day," Stone says.

Cost savings and efficiency

The BlackBerry deployment, Stone says, immediately resulted in significant cost savings. "We were spending over $150 per nurse when that nurse had three devices, and I think our cost per device now is in the $80 range per month," he says. "So we've had at least a 40 percent savings, if not more."

The new solution has also improved the responsiveness of key personnel. "We've found that our marketing and admissions people are generally responding faster than the competition to referrals and calls that we've had," Stone says.
 
It's worth noting, Stone says, that this deployment was actually the second time the hospice had attempted to switch to BlackBerry devices. "They tried this a couple of years ago... they gave 25 BlackBerrys to our employees, and the employees turned them back in," he says. "The problem was, our typical employee is not a new graduate from nursing school -- they're generally older, and they're late adopters of technology."

Learning from that experience, Stone says they did this rollout very slowly, with a focused training effort, and made it clear that it wasn't optional. "Perhaps it was just timing -- they're ubiquitous now, and people see them more often... but it went from being something they were scared of two years ago to something that... is very much a status symbol and something that the employees are proud of," he says.

Stone says there's one key thing the hospice did that was particularly helpful in encouraging acceptance of the new solution. "As a benefit to the employee, we let them use that phone for their own personal use," he says. "That guaranteed that the employees would actually carry that phone with them at all times and use it interactively every day."

And the resulting improvements for the hospice, Stone says, have been notable. "The efficiency gained has been remarkable, and the ability to enhance our teamwork has been remarkable," he says. "We are heavily dependent on these devices now... and I don't think anybody here could imagine going back to where we were."
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