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Medical clinic discovers joys of scheduling


When we consider innovation and technology in health care we typically think about new drugs and vaccines, advanced imaging, and electronic medical-record systems, all targeting better clinical care. The irony is that the places employing these advanced technologies have rudimentary paper-based systems running their administrative functions.

Imagine trying to schedule numerous physicians, multiple clinical facilities and other resources each week using a pen, a phone and a lot of determination. Add in numerous last-minute change requests and you start to understand the nightmare being replicated across many of Canada's best clinical settings.

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Consider the case of the Alberta Urology Institute in Edmonton, which specializes in the medical and surgical treatment of conditions such as prostate cancer. The institute has 13 urologists and a number of physicians training as residents in a rotation that perform surgeries and surgical assists. Each procedure must be scheduled and resources such as the operating room and associated equipment and personnel booked hundreds of times for each planning cycle.

In the past this process was accomplished through a labour-intensive, paper-based system with an administrative assistant manually working out the logistics for the schedule, which at best was workable but rarely optimal. The satisfaction of getting the work done was usually short-lived, as ad-hoc changes by physicians swapping shifts or last-minute modifications not reflected in the master schedule eventually occurred and undermined the integrity of any plan.


It seems obvious that this process could easily be semi-automated – numerous industries already address complex resource scheduling. But health care is the living embodiment of the saying that "the painfully obvious is painful long before it's obvious."

Even information about an appointment is considered part of a patient's medical record, and as such, it wraps the data in an aura of mystique and some very real legislation in the form of the Health Information Act that limits its use.

Through a fortuitous referral from its IT support vendor, F12 Networks, the Alberta Urology Institute was connected with Popcorn Technologies in Calgary. Popcorn specializes in managing enterprising processes and content using Microsoft's SharePoint environment.

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SharePoint allows for the rapid deployment of customized solutions by adding to pre-built components that eliminate the need for developers to write computer code. Popcorn was able to deploy a working solution for the urologists extremely quickly. It is often difficult for professionals to articulate what they want a certain technology to do, but it tends to be much easier for them to quickly identify what they don't like when presented with a solution.

By rapidly developing simple components, Popcorn was able to test options, solicit feedback, and produce a new prototype in a very agile and responsive manner.


The impact on clinical practice was immediate and far-reaching.

By providing a common format and tool, no one is left wondering who is scheduled, where and when. This has had unintended consequences for residents in training. The practice can now, on the fly, see which physician trainees are available for surgical assists and bring them into learning-opportunity procedures that, in the past, would have been missed.

Having a complete view of people and resources means the institute can efficiently allocate resources, then strategically level them to ensure everyone is busy without being overworked and that scarce operating room time is used effectively.

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This further facilitated collaboration and communications among colleagues, who are able to easily trade shifts, document why the trade was made and then instantly reconcile that with other physicians so a solution cascades through the practice. By pushing the scheduling functionality out to the physicians, they are able to reduce the administrative co-ordination required since shift changes and updates to the schedule are part of the same process.

This effectively places the data capture closer to the point of the decision, improving quality while still providing an administrative oversight so that nuances can be reconciled before changes are made to the schedule.

Another unintended benefit has been for the residency training program – this initiative has given these soon-to-be-specialists insight into the tools needed to effectively run a practice. It's an experience that is not available in medical school and it's often not available in other clinical settings still struggling with these issues.

While not the original intent of this initiative, the accuracy of the data and the ease relevant reporting can be generated has made for better office management while making clinical reporting for things such as call schedules to Alberta Health Services reasonably seamless. In the past the institute scrambled to assemble this data.

What began as a push from Popcorn for functionality is quickly becoming a pull from the Alberta Urology Institute to really leverage SharePoint technology in ways the vendor did not originally envision.

Popcorn essentially fell into the health-care space and continues to seek further opportunities in the field, which appears particularly ripe for similar disruptive innovations throughout the country.

Special to The Globe and Mail

Chad Saunders is an assistant professor in the Entrepreneurship & Innovation and Strategy Areas of the Haskayne School of Business at the University of Calgary.

This is the latest in a regular series of case studies by a rotating group of business professors from across the country. They appear every Friday on the Report on Small Business website.

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