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Hurley Medical Center - Guru Wizards for Invision Entry for Performance-Centered Design Competition 2000 |
Developed by: Duane Degler, for IPGems This presentation is best viewed on an 800x600 display resolution.
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 Prior State The Invision mainframe system was in use for about 18 months prior to the development of the Guru interventions. Estimates by performers and managers varied considerably in terms of expectations of the performer’s time-to-competence, but it was considered to be at least 6 months. Training was done by senior registration management in short one-on-one sessions, then the trainee registrar spent the first 3-6 months working on advance registration of hospital inpatients – so a significant period of time would go by before they were directly in contact with patients to process a registration. Being "directly in contact with patients" means having an ill, injured, drunk or infirm person sitting immediately across from the registrar, answering complex questions about insurance, next of kin, diagnoses and treatment circumstances. It also means during busy times having long lines of people waiting to be registered, increasing the stress and pressure on the registrar. While Guru Wizards could not directly ease the pressures of that environment, they were targeted at increasing the confidence of the registrar and the time-to-competence required by the hospital. The Invision system has been significantly customized by Hurley to better match their specific registration business process. However, this process is not necessarily immediately apparent to registrars, as they appear to concentrate on the data requirements of each screen rather than thinking about the sequence of screens as building toward a complete registration. Experienced users are extremely fast when using the system, because the mainframe allows "type-ahead" – an experienced registrar working on routine patient registration can often be typing two screens ahead of what is being displayed on screen. While this created concerns that mis-typing breaks the flow and possibly introduces errors that are less recoverable, in practice this rarely happens, and the productivity and registrar motivation (toward being "perfectionists" and being in control of the technology, rather than vice versa) was high. The problems arise mainly in the information needs of departments that receive information from the system at a later time. Billing processes insurance claims and patient billing based on information in the system – if that information is incomplete or inaccurate, it can be months before the error is identified. Because of the complexity of insurance regulation, the initial intervention could only attack the most immediate problem: registrar understanding and clearly focusing the registrar on important information (through the use of dialog boxes to focus attention and direct system input).
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© Duane Degler 2000
