Clinicians don't want this pilot to end

What made the initiative different is that it was grassroots driven
By Diana Manos
02:38 PM
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Patients at the Hospital of the University of Pennsylvania might wonder why their nurses are always on their smartphones – until they learn those nurses are actually sending secure messages to everyone on a patient’s care team.

It’s part of a highly successful pilot that began more than a year ago, and one that caregivers don’t ever want to see end.

“What made this pilot unique is that it was grassroots-driven,” said Neha Patel, MD, one of the pilot’s developers.

Patel, an assistant professor of medicine at HUP, partnered with the information systems department at Penn Medicine to develop an mHealth strategy that would not only improve communication among a patient’s care team, but also save clinicians time.

Patel and a colleague will discuss the pilot at the upcoming mHealth Summit in December at National Harbor, Md.

For the pilot, which began in May 2013, residents, faculty physicians, pharmacists, social workers and discharge planning nurses were provided with iPhones or iTouches in four of the hospital’s departments: three general units and one surgery outfit. They used a secured-messaging mobile application called Cureatr to communicate everything but emergency messages with a patient’s entire team. As shifts changed, the phone was passed on. Communication remained fairly seamless, Patel said.

Now, nearly a year and a half after the pilot started, staff at HUP refuses to let go of their phones or Cureatr. When staff rotates to units that don’t use the app, Patel explained, they complain that communication is “archaic.” 

It’s no wonder. A HUP time-motion study showed residents were spending about 20 percent of their day communicating with other healthcare providers, either face-to-face or on the phone.

Communication among healthcare providers typically takes up a substantial portion of a workday and suffers from a range of inefficiencies, including interruption-prone workflow; no prioritization of received messages and lack of closed-loop communication.

Solving that problem was somewhat difficult because team-based care necessitates sheer scale and complexity of communication, Patel said, and poor communication in hospitals can have substantial economic consequences.

HUP is working on a plan to make the “pilot” into something permanent and expand it to the entire hospital, according to Patel.

That’s good news for C. William Hanson, MD, chief medical information officer for not only HUP, but also its health system, Penn Medicine. Penn Medicine has an in-house team of app developers who recently created Connexus, an app that allows providers to pull up patient data on their smartphones.

Hanson said he likes the app because “it has unshackled clinicians from the desktop and provides real-time, on-the-hip access to vital signs, problem lists, laboratory and imaging studies.”

“This has transformed hand-offs, allows clinicians to answer the questions of patients or other providers using accurate, up-to-date information rather than resorting to out-of-date paper printouts, having to log on to a computer or chase down a patient binder,” Hanson added.

Hanson said he's surprised at the degree to which Connexus has been adopted by various user groups for purposes beyond the original design scope: “Anesthesiologists, for example, are using it for pre-op evaluation, ancillary providers to follow the ‘thinking’ of the primary team, and consultants to quickly evaluate a new patient."

Patel and Hanson will be part of a panel at an executive breakfast at the mHealth Summit on Monday, Dec. 8, during which they will discuss ways that hospitals use mHealth to connect care teams. The mHealth Summit runs from Dec. 7-11 at the Gaylord National Resort and Convention Center.

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