Posts Tagged ‘scheduling’

Screenshot: Scheduling problem

July 22, 2010

**UPDATE  06/05/2012** Contains old/nonexistent screenshots!


I just posted about the scheduling problem and promised a mock-up screenshot. Here it is:

Diagram showing sliders and charts

The sliders on the left will affect the population histograms on the right.

Obviously numbers are off and scale is inaccurate… for now.

Solving the scheduling problem

July 22, 2010

One of the things I want Ankhos to accomplish is to simplify appointment scheduling. I’ve got some free time during a down-period of our launch so I’m writing this blog post as a brainstorm session for myself.

There are currently four fundamental goals that we are any scheduling system is trying to solve:

1. Be able to tell the patient when to arrive

2. Be able to spread patient load throughout or across workdays

3. Be able to show employees where time-critical workflow elements (busy times) are in their day to help department administrators plan their workday. For example, It would be nice for the chemo nurses to know what drugs they need for the day and how much.

4. Keep patient waiting time to a minimum.

These are probably no-brainers, but stating them explicitly helps the thought process.  In my math and computer science training, we studied complex algorithms and thought of ways to make them either faster, cheaper or less complex (Hint: You can only pick two). I want to try this approach to scheduling, also…


Down to the wire

July 8, 2010

Shuttle launch

It’s been really busy lately (thus, the lack of posts), but we’re finally starting 1.0 on Monday!  We’re going to be going side-by-side with the paper charts until we determine that all the bolts are screwed in tightly.

I’ve been working very closely with the staff at Carolina Oncology Specialists.  I’ve spent weeks, nay,  months watching, listening, asking questions.  And it has paid off. Ankhos is almost unrecognizable (even the name) from what we started with nearly 10 months ago. This is a good thing. I owe much to the staff who have helped with this effort, especially Dr. Orlowski and  lead R.N.  Joy Hester. Their enthusiasm and willingness to take my after-dinner calls has been indespensible to the progress of Ankhos.

The staff is armed with their cache of iPads and we’re ready to rock.  This  weekend will certainly be a busy one. There are many usability findings that need fixing in these next few days. They are little things like ‘this button should be bigger’, or ‘This link should be on this page’, but hopefully these are the types of bolts that need tightening.

Here’s looking forward to 1.1 and the innovative solutions we have for patient scheduling!

Querying the future

March 30, 2010

One of the coolest and most impressive aspects of keeping electronic records is the ability to compile massive amounts of information very quickly. But, many offices still use paper and pencil to plan their patient scheduling and pharmacy ordering.

“How much Flouroracil will we need tomorrow?”

“Do we have enough time/space to fit another patient in at 3:00?”

“Do the amounts of controlled substances in our pharmacy match up with the amount prescribed last week? Do we have enough for the upcoming week?”

“How many nurses will we need on Friday? Can Jane take the day off?”

These questions would take hours to answer if compiled by hand, but with an electronic record/scheduling system, they could be answered in seconds…. IF they are implemented correctly.

The flagship feature in Ankhos is the ability to schedule an arbitrary number of chemo cycles months in advance, letting nurses, administrators and pharmacists know exactly what treatments are coming up in the future. If we have answers to the questions above in elecrtonic format, we can make you and the staff of your oncology office much happier, safer and more prepared.

Regimen creation success

February 23, 2010

Today was the first day in three of on-site user tests for Ankhos. I sat with Joy, the lead nurse at COS and went through the creation of a few oncology regimens. Granted, the previous experiences she has had with regimen entry in other EMR products has been a nightmare but, in her words, Ankhos is “Awesome!”

Oncology regimens can be as simple as prescribing one dose of one drug on one day. They can also morph into tentacled behemoths capable of devouring days of productivity and chomping away at the morale of those charged with their creation. Today we concluded that the simple interface Ankhos uses is able to tame these horriffic beasts and make their creation… dare I say… fun.

To make regimen entry simple, we tried to break it down into fundamentals. We took a step back and noticed a few fundamental principles

1. Regimens are cyclical — There should be some notion of periodicity built in to how we specify them.

2. Regimens are cohesive — They are not simply a collection of drugs, but are notions of intent for how to treat a patient.

3. Regimens are subject to real life events — They have to be flexible enough to accommodate a patient missing a treatment, or not having a ride home, or having bad reactions during treatment.

4. Regimens are temporally dependent — Modification of an ordered regimen must be allowed to ‘cascade’ to future doses and schedules.

5. Regimens can be hierarchical — Some are derived from others, and if we can design our interface around that, we can make modification and addition of regimens easier.

By taking these principles into account, we were able to design an interface that is both easy to use and powerful enough to express the most complex regimens.  More testing tomorrow…

If there is enough interest, I would be willing to create a video demonstration of our regimen creation process.

Design Decision: Exams, CBCs, Labs are part of a regimen

January 8, 2010

The data structures we are using allow for easy addition and scheduling of exams, labs and CBCs (and anything else we want) on a recurring basis. In the say way you specify the days on which a drug is delivered for a regimen, you would be able to specify the days on which a patient returns for an exam.

So, if you are particularly nervous about a new regimen, you can schedule labs or exams more often so that they are always a part of that regimen.

With the visits ‘baked in’ to the regimens, we eliminate even more clicks for both the MDs and schedulers. If the dates of the exam are already specified, all that is left is to set a time. And we have a solution to make that easier, as well.

Screenshot: Regimen creator

January 7, 2010

The promised screenshot:

For those who don’t know, a regimen is the bread and butter of Oncology prescriptions. These are published combinations of drugs, specified over certain periods of time, delivered by certain vectors, potentially recurring at differing intervals.  These monstrosities are part of the reason electronic oncology scheduling is so different from, say a general practicioner’s scheduling. There are many more ‘layers’ of prescription scheduling needed, in addition to simple appointment scheduling. The screenshot of our regimen creator is below.