mHealth, system infrastructure changes drive improvements
BOSTON—Integration into an EMR and system infrastructure changes can drive major improvements in the quality and efficiency of care, according to speakers at the mHealth +Telehealth World Congress 2013.
James Albert, former vice president and chief information officer, Jordan Hospital in Plymouth, Mass. said an inpatient mHealth pilot involving smartphone applications improved the level and quality of care in the inpatient setting.
A team developed apps which allowed for integrated voice and data communications plus system/information access on and off the hospital campus. The apps incorporate instant alarming and critical data delivery and acknowledgement, he said. The secure and quiet texting and paging aimed to replace noisy end-of-life pagers and silver phones.
Albert said the technology offers the following key features:
- Single sign-on link with active directory and EMR
- Ability to launch EMR within mobile device app suite for orders, rounding and documentation
- Ability to synchronize pooled devices with time and attendance system, scheduling, EMR, phone and alarms
- Real-time care team and patient communications
- Nurse call, telemetry, critical labs, other alarms, with audit logs and escalation rules
Results of the pilot found wide employee and patient satisfaction, as well as a quieter hospital environment and higher staff productivity. “The nurse walked one less mile per shift,” he said, adding that the nurses used secure texting, as opposed to voice communication, 93 percent of the time.
He also said it raised the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores from the mid-70s to the mid-90s in two weeks. “We saw an immediate improvement.”
Eric Brown, president and chief executive officer, California Telehealth Network (CTN), also shared efforts to leverage technology to improve quality and efficiency of care—but in his case he worked primarily with providers in rural or underserved areas. Brown noted that 5.3 million people live in rural California where most physicians have not adopted an EHR.
“It’s a unique telehealth opportunity,” he said.
Brown said CTN worked with rural and community clinics to implement Eceptionist, a web-based patient referral and appointment scheduling platform, to replace the traditional technology used to refer patients to hospitals: faxes and mail. The system is interoperable with multiple EHR platforms and medical hardware platforms.
The introduction was successful, he said, especially because it can function even when a clinic has not adopted an EHR. At the same time, in the long run, “these initiatives encourage EHR adoption,” Brown said.
Success also was found with web-based videoconfercing technology, Brown said. Through its platform, CTNconnect, he said remote clinics can videoconference with their preferred physicians.
With physicians often only able to reach remote clinics once or twice per week, it has enabled more consistent communication on patients and patient care, he said.