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Smart Devices in Health Care

CarePlus™ Mobile Connect improves your workflow efficiency and call bell response time, significantly improving patient satisfaction via CarePlus™ smartphone integration enabling the right caregiver to receive the right message, enabling alarm free quiet areas and improving satisfaction.

Caregivers are given options of how to respond to a call – accept, reject, auto escalate, or call back – this allows for a quicker response to be made to patient calls. The call back feature of the application also increases the communication between patients and caregivers, clinicians are able to communicate directly with patients via their bedside telephone. This feature increases patient satisfaction, as patient’s calls are acknowledged immediately. This feature also allows caregivers to better prioritise their tasks and manage their workflow.

CarePlus™ smartphone integration also allows for a quieter hospital environment, because the right message is sent to the right person there is no need for messages or alarms to be broadcast. CarePlus™ also allows for the alarm volume to be changed from the nurse station, allowing messages to be at a lower volume at night on the hospital ward. This helps to improve patient satisfaction by creating a more peaceful environment, conductive for healing and recovery.[1]

Introducing CarePlus™ Mobile Connect

NiQ Health is pleased to announce that their CarePlus™ nurse call system can now be integrated to smartphones through Mobile Connect, Powered by Amcom™. This smartphone integration allows clinicians to be alerted to patient calls, alarms and messages.

The application allows clinicians to accept, reject, message back, or auto-escalate alarms. A call back feature is also available that allows clinicians to respond to alarms by calling a patient’s room. This connects to the patient’s bedside phone; the clinician can then speak to the patient and understand their request. This communication helps nursing staff to better prioritise their workflow, assisting them in managing their response to various patient calls.

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The CarePlus™ architecture is perfectly positioned for a BYOD architecture. The CarePlus™ app contains no patient information. Bring Your Own Device (BYOD) is the policy of permitting employees to bring personally owned mobile to their workplace, and to use those devices to access privileged company information and applications. BYOD is making significant inroads in the business world, with about 44% of employees bringing their devices to work. In most cases, businesses simply can’t block the trend.

The four options available to clinicians when responding to patient calls are;

  1. Accept when the clinician wishes to acknowledge and accept a patient call.
  2. Reject if the caregiver is unable to respond they may reject the alarm. This rejection then auto escalates the call to another caregiver or group of caregivers. These escalation groups are predetermined by the Nurse Manager. The call will repeat circular amongst all caregivers and groups until accepted.
  3. Message back this feature allows text, photo and video messages to be exchanged. Useful when clinicians are providing each other information.
  4. Call back allowing clinicians to call back the patient’s bedside phone so that they may communicate with the patient and understand their request.

Mobile Connect features also include;
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  • Full traceability and record of all messages, message statuses can be checked via the smart device. Messages statuses can also be tracked online to determine whether the message is queued, en route, delivered, or acknowledged.
  • Separates personal messages from work related ones with a separate and secure inbox within the application.
  • All messages sent via the application are fully secure and encrypted, with HIPAA and HITECH approved messaging. There is also the option to perform a remote device wipe and an automated message removal.
  • The Mobile Connect application works on Apple®, Android®, Blackberry®, and Cisco® smart devices, including tablets. These messages can be sent via a cellular or Wi-Fi network, with push notifications alerting clinicians to these critical messages.

 

How CarePlus™ Mobile Connect improves patient satisfaction

HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) the first national, standardised, publicly reported, survey of patient’s perspectives of hospital care. This US based survey, in conjunction with Obama Care, allows valid comparisons to be made across hospitals locally, regionally and nationally regarding a patient’s hospital experience.

The three goals that have shaped HCAHPS include;

  1. To produce data about patient’s perceptions of care that allow for objective and meaningful comparisons of hospitals on topics important to consumers.
  2. Public reporting of the survey results, creating new incentives for hospitals to improve quality of care.
  3. Public reporting increases accountability, by providing transparency of the quality of hospital care provided in return for public investment.

HCAHPS is a 27-question survey sent to recently discharged patients; 18 of these questions relate to critical aspects of a patient’s hospital experience, 2 of these questions specifically relate to nurse call systems (question 4 and question 9). These questions directly relate to call bell response time, satisfaction of the response, and the night time noise level within the hospital.

CarePlus™ Alarm Management

The ECRI Institute, a non-profit organisation dedicated to researching and improving patient care within healthcare facilities, found the top healthcare hazard for 2014, 2013, and 2012 to be alarm fatigue.

Excessive alarms within healthcare environments lead to alarm fatigue for clinicians and may potentially result in patient harm. There are significant issues and potential problems with excessive alarms including:

• Caregivers may become overwhelmed by the alarms and be unable to distinguish between significant and insignificant alarms
• Alarms may distract nursing staff from important patient care activities
• Excessive alarms may also cause caregivers to become desensitised to alarms
• Alarms may not be communicated properly or in a timely manner to caregivers

In June 2013, the Joint Commission announced that alarm management would be a National Patient Safety Goal with provisions in place to improve alarm management in 2014.

CarePlus™ improves alarm management procedures by ensuring that the correct/assigned caregiver is notified of alarms, ensuring that alarms do not need to be broadcast and automatically escalates the alarm if not responded to within a variable thresholds depending upon patient acuity.. CarePlus™ decreases alarm broadcasting, reducing the likelihood of alarm fatigue for clinicians and caregivers.

CarePlus™ Benefits

tablet1The CarePlus™ Care Management Information System™ is available on a range of tablets. Enabling staff to address issues such as; staff patient ratios, bed management, compliance, QA, reporting, and workflow productivity – all while staff are mobile. The caregiver may be at the patient bedside, in a care area, or even off the ward. The CarePlus™ implementation enables mobile care management.

CarePlus™ has a web-enabled interface delivering the integration of medical monitoring device alarms, patient initiated alarms and staff initiated alarms. These alarms are sent, received, acknowledged, and/or escalated from mobile computing devices. Thus taking advantage of the latest technologies in mobile computing without chaining hospital infrastructure to proprietary devices and fixed consoles, and stymieing workflow productivity. Systems which have proprietary consoles and tie staff to the nurses’ station (thereby taking staff away from the patient’s bedside) will shortly be legacy to a modern health care facility. Health care providers wanting to utilize technology advances to improve patient safety, QA, workflow and productivity are demanding a mobile device.

Benefits for organizations implementing mobile computing and mobile telephony are significantly amplified. This is particularly true in the areas of Business Process Improvement (BPI), and dashboard reporting of Key Performance Indicators (KPI’s). Chief Nursing Information Officers and analytics staff have the tools to gather real time; patient, device, system and staff initiated data affecting key areas of a care areas performance, patient safety, staff safety, QA, and Reporting.

Why do healthcare clinicians need a smart mobile device?

The topic of smart devices in health care has received an enormous amount of attention since the introduction of smart phones and tablets, including Apple® and Android®’s smart phones and tablets. Demand for mobile devices in the health care market is growing and the hype is building. These innovations are important, as health care organizations work towards improving patient safety and workflow productivity. Smart devices are designed to facilitate mobility, providing a solution to the outmoded work practices around having fixed workstations (up to 8% of a clinician’s time per day is wasted commuting to and from their workstation). These devices allow clinicians to continue caring for patients, rather than spending time on find, fetch, retrieve. Thus the drive for efficiency will accelerate the adoption of smart devices within health care organizations.

Why use smart devices in health care?

Health care managers and clinicians face major coordination challenges on increasingly more acute care wards. The coordination of pathology, registrars, visiting specialists, Registered Nurses’ (RN’s), Personal Care Aides (PCA’s) and patient’s relatives are an increasingly significant task. These issues are further exacerbated by evolving medical technologies, competing fiscal demands, and a shortage of skilled nursing staff. To address these issues, managers and clinicians need organizational tools to manage the growing complexity of coordination and management. The smart mobile devices will give overworked managers and clinicians the ability to view these tools whilst mobile around the care units at work with the patients and their colleagues.

There are smart devices that meet the many different price points of the healthcare market. All major manufactures are providing mobile computing devices for consumers and commercial users. There are many healthcare facilities globally who are ahead of this trend, facilities like Cedars Sinai Hospital California have been testing the possibilities for efficiency and business process improvement from mobile computing. Smart devices are more accessible and useful than ever before, the potential benefits for all types of healthcare facilities with this technology are endless.

What does the healthcare industry want from smart devices?

Health care workers want to use tablets for a wide variety of tasks, including tasks such as;

• Lab orders and results
• Prescription drug reference
• Notes and memos
• Clinical decision support
• Medical imaging
• Communications
• Nurse call and alarm management
• Emergency call response
• Access to medical/healthcare resources – no more paper, books or pocket guides
• Improvements to workflow and efficiency

With results like these, why wouldn’t the healthcare industry use smartphone devices? With improvements to workflow, productivity and efficiency, the ROI into smart devices within healthcare is huge.

There are over 20,000 medical related applications available in the Apple® App Store. The market revenue for these apps is expected to reach $400 million by 2015. There is a great opportunity for the healthcare industry to embrace smart devices and make use of these apps.

Imagine the Possibilities…

In teaching hospitals, there is rarely more than one workstation at use during rounds because there is a sense of distance that takes place when shifting over to a workstation or wheeling along a computer-on-wheels. Now envision this process with handheld tablets! A doctor can actively engage the patient while writing or typing on a tablet, no different than they would with a notepad or chart in front of them. A team rounding at a university could have multiple tablets at work: the intern presenting off their device while the attending and resident verify labs and imaging reports on their own, all while staying in the circular huddle. Imagine the workflow productivity for nursing staff with the ability to interact with a range of medical applications and nurse call assignments – real time.

Imagine having a care unit within a hospital with no audible alarms, where every patient, device, system and staff initiated call was sent to the right responsible caregiver’s mobile device automatically. These life safety alarms and messages could be escalated and/or amplified through that same mobile device that staffs use for electronic medical records, clinical references and lab orders and results. Where messages can be sent and recorded to specialists like pathology and pharmacy – in real time.

Accepting responsibility for patient and medical device initiated calls all in front of the patient rather than back and forward to the nurse’s station. Immediate real time contact with pathology, and lab results sent real time to the allocated nurse no matter what shift or shift change is occurring. This all helps to solve the Dance of the Call Bells as described by Dr Lyn Deitrect et al.

CarePlus™ Mobile Connect is currently addressing these possibilities. Future apps and cross integration will revolutionise Nurse Patient information and workflow.

Mobile devices and efficiency improvements

A study using wireless communication integrated into the hospital’s nurse call system found that nurse’s response time to patient calls or requests improved by 51% when using a wireless mobile communication device [2].

Implementation of mobile tablets goes some way to address the “efficiency benefit” missed out on by the health care industry over the last 15 years. Mobile computing and the implementation of tablets will provide a similar efficiency to health care work practices over the next few years.

Smart devices with real time mobile nurse station capability goes some way to improving the Joint Commission on Accreditation of Health Care Organization’s identification that, the root cause of a majority of sentinel (adverse) events is communication.

Hospitals run on information; patient records, journals, text books, reference books etc., which are all currently being transferred to web based interfaces for easy lookup. Most of this information is still paper based, physicians move around with half-creased stacks of paper in their white coats. Paper is convenient because it is quick to access and it’s easy to write on. However, it’s not easily duplicable or shared, and en masse can become surprisingly heavy. Saving paper and “going green” is actually one of the reasons Stanford School of Medicine gave all their incoming medical students the iPad.

A single device can contain the records of multiple patients and the equivalent of thousands of charts, textbooks, Web References and Journals. Medicine has a very appropriate association with knowledge and education. Whether it’s UpToDate.com, Pocket Medicine, or the New England Journal of Medicine, doctors are constantly utilizing reference tools. In terms of medical software selection, there are many applications available with a vast majority running on Apple® and Android® devices.

[1] Deitrick, Bokovoy, Stern, Panik, ‘Dance of the Call Bells: Using Ethnography to Evaluate Patient Satisfaction with Quality of Care’, Journal of Nursing Care Quality, 21: 4, 2006, 16-324.
[2] Kuruzovich, Angst, Faraj, Agarwal, ‘Wireless Communication Role in Patient Response Time’, CIN: Computers, Informatics, Nursing, 26: 3, 2008, 159-166.