Organization and efficiency has always been Associate Professor of Clinical Medicine at University of Pennsylvania Health System Dr. Subha Airan-Javia’s strong suit. So when she started her medical residency it was easy for her to spot where different system just weren’t working — or where bureaucracy was taking up too much time. These gaps were the impetus for her to innovate. 

“I started at Penn in 2004 and early on in my experience as a resident I realized there were a lot of inefficiencies,” she said. “Workflow and problem solving is something I’ve always been interested in, and ways to be more efficient — specifically, integrating technologies.”

At HIMSS19 Airan-Javia and her colleague Dr. Neha Patel, the associate chief medical informatics officer at the University of Pennsylvania Health System, will talk about how they implemented new technologies in healthcare systems in their presentation “To Buy or to Build: How to Get Your Project Off the Ground.” The speakers took different routes; Patel worked with a vender and Airan-Javia built the technology in house. 

For Airan-Javia the decision to build a technology in house came down to what was on the market at the time — or in her case, wasn’t. 

When she first started working in the system as an intern she remembered using word documents to mange the list of patients. The docs were also used for notes and patient handovers. 

That was when she decided to start working on a tool of her own that could meet the needs of clinicians. 

“We wanted to build a tool that was fully electronic, fully mobile and really enhanced our workflow. And I did an evaluation at the time to what was available, what functionalities [did] our vendors have and what vendors were we getting and none of them had this robust functionality,” Airan-Javia said. 

So she started a collaboration with the IT department and clinical information officers. She said they approached the development of the product through a user-centered and problem-based design. 

Once the first rendition of the tool was up and running, for the most part clinicians were able to onboard quite easily, she said. 

“About a year in I had 700 users and the vast majority said in three days were comfortable using it, and most people were within a day of using it,” Airan-Javia said. 

The tool has gone through three iterations and won multiple awards. The final version is called the Carelign. 

“We created a tool that really met the need of the clinician. Then they are kind of free from the burden what a lot of these other companies do — billing and coding and regulatory stuff,” she said. “I am a hospitalist and obviously I’ve been able to work with the other clinicians and look at what do we need from the design and the data and functionality aspect. ... Probably [in] any industry where you have highly stressed individuals, there were some people who adopted it immediately and said 'This is amazing and really changing my life.' And there were some people, a small minority, who were resistant, but then within a week were emailing and texting 'This has completely changed my life,' or 'I’ve gone paperless.’”

While the tool may have changed the workflow for doctors and practitioners at the University of Pennsylvania Medical, it is sometimes hard for professionals to know exactly where to turn for these tools. 

“People often compare health technology to the development of horse to cars,” she said. “Before cars, if you asked people what they wanted they would have said faster horses — because it is hard to know what is even possible if that isn’t your area.”

Airan-Javia and Patel will be presenting their experiences at HIMSS19 in a session called "To Buy or to Build: How to Get Your Project Off the Ground." It's scheduled for Thursday, February 14, from 8:30-9:30 a.m. in room W315A.