Web-based tool speeds up and simplifies physician scheduling


Scheduling medical practitioners’ work shifts at multiple clinics can often be an administrative headache – not to mention the inordinate amount of valuable time expended on the task.

Montreal-based Chyma Systems Inc. offers a Web-based software tool as the antidote to this staff scheduling nightmare.

Also called Chyma, the tool is designed to automate and centralize the scheduling process, and in so doing, to eliminate outmoded systems and paper processes.

According to the company, Chyma helps physicians and healthcare administrators virtually manage work schedules from a secure, centralized location.

In December, the company announced it was fine-tuning the tool’s calendaring capability with the addition of Chyma Rules that use ‘intelligent rules’ to automate the creation of fair and conflict-free schedules.

The rules are based on department, facility and individual instructions and users’ time-off requests. For instance, instructions can be based on a maximum number of work hours per week. Or, another rule may instruct the system to disallow a practitioner to be scheduled in two locations simultaneously.

The new feature is largely influenced by the SARS (Severe Acute Respiratory Syndrome) pandemic that occurred several years ago, says Dennis Reich, a Sudbury-based doctor and founder of Chyma Systems Inc.

He said the tool’s complex algorithms do the work, and then administrative staff can double check it. This produces a high degree of accuracy. “Many human errors that occurred during SARS will melt away,” Reich says.

The rules feature will be available by March of this year. Until then, Chyma users will continue utilizing existing capabilities – manual and template methods – that use a conflict checker to ensure (for instance) that one staff member isn’t scheduled in two locations.

But besides calendaring, the tool’s functionality includes messaging, knowledge, contacts, and discussion centres. Currently, around 13,000 Canadian physicians use the collaboration tool.

Creating a comprehensive tool that would address the scheduling needs of medical staff was a necessity, says Reich, given his own experience with mussed up shifts and poor information flow in the field.

Paper-based schedules would often lead staff to miss their shifts or even turn up at the wrong one. The answer, he says, was an online application that would provide up-to-date information across medical and non-medical institutions. That’s when he created Chyma.

With Chyma, a user can create a schedule, share it, and have physicians and other medical staff swap shifts online in real time. The online component aims to eliminate the paper process, and back-and-forth phone calls and e-mails requesting shift changes.

It also ensures that once shifts are swapped, physicians won’t forget to actually turn up for work – because the scheduling change will be instantaneous, explains Reich.

But to the need to prepare for pandemics — such as the SARS crisis -played a significant role in the creation of Chyma, he says.

“As soon as two of your health providers fall ill, you must quickly and dynamically adjust your human resources across multiple institutions.”

Or he cited the opposite – but equally important – scenario, in which hospitals may need to quickly quarantine their staff in specific locations.

“We needed a capability to talk to one another and tools that help on a local level.”

The tool isn’t solely designed for communication between medical facilities, says Reich. It can also be used by non-medical organizations.

For instance, Sault Ste. Marie-based Algoma Steel Inc. would often need to know when ophthalmologists were on-call in the event of eye injuries. Algoma Steel would call the hospital requesting a schedule, and receive a faxed document in return.

That communication is now based in Chyma. “The tool has little portlets or windows available to Algoma Steel so they can see only the ophthalmologist schedules,” he says.

This variable access capability addresses privacy concerns that users may have, says Reich.

For instance, a user can create different contact cards containing varying personal information – home phone number, pager number, home address – and designate who will have access to each variation.

Limited access is especially important as information on Chyma may be shared across a variety of external medical communities where health practitioners are stationed, such as hospitals, clinics, offices, jails and nursing homes, he says.

Chyma employs 128-bit SSL encryption technology and a username and password system, adds Reich. In addition, the tool tracks ‘audit trails’ to ensure transparency in user activity.

A Canadian network of clinics that employs 60 doctors implemented Chyma in 2005 to effectively deal with complex physician scheduling.

That network – the Family Focus Medical Clinic, a group of four walk-in clinics, in Halifax, Nova Scotia – has seen a decrease in the number of times a physician doesn’t show up for work.

“Ensuring a doctor is onsite at each clinic has been a huge benefit for us. When there’s no one to see patients, you’re still paying your overhead,” says Dr. Mark Fletcher, owner, operator and medical director at Family Focus.

Besides sharply reducing the instances of ‘no-shows’, Fletcher says he no longer scrambles to find a replacement physician when another has cancelled or wants to swap shifts.

Before Chyma, the scheduling process was very dependent on phone calls and e-mails, he says.

However, he admits that while the virtual calendaring tool has been a blessing, it isn’t without limitations. “I still find it easier to draft schedules on paper given our four locations and 60 doctors. Drafting electronically was awkward.”

He says “a couple of clicks” are required to switch from one schedule to another, when he’d prefer to get there faster with, perhaps, one click.

Reich says that while this new version may not address that issue, it won’t be difficult to rectify.

“It sounds like a solution might be to have a screen where all location schedules are shown in miniature in the corner of the screen. It wouldn’t be difficult to code.”

He adds, though, that often it’s easier for people to work and process tasks cognitively – as opposed to onscreen. “There will always be a place for some cognitive work to be done on paper.”

Collaboration tools such as Chyma have often been the domain of the corporate world where enterprise applications are a necessary means to consolidating data and business process.

However, there is a growing awareness and interest in these communication tools among industries, such as healthcare, says George Goodall, senior research analyst with London-based Info-Tech Research Group Inc.

He says in past medical emergencies such as the SARS outbreak, 9/11 and hurricane Katrina, rescue teams have experienced a breakdown in communication – and real-time communication tools help manage this.

However, according to Goodall, continued and effective communication flow can’t exist in a vacuum. Collaboration applications must work in tandem with established workflow processes and policies that may outline how this information is utilized.

“These tools can be great for marshalling and aligning resources, but that resource has to merge into the work process of professionals.”

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