Monday, November 3, 2014

Grass Roots HIT in the Hospital and Clinic

Clinicians are an innovative group. From physicians, nurses, pharmacists, administrative personell, all are users of mobile apps at home and/or work.

mHealth News reports that there are some "apps that clinicians can't quit". Patients at the Hospital of the University of Pennsylvania (HUP) 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 outside Washington, D.C.
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 refuse to let go of their phones or Cureatr. When house staff rotate 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
Another home-grown application, Connexus.(Connexus®, the Education Management  an app that allows providers to pull up patient data on their smartphones.

System(EMS). 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.".
The lesson is that iit does not take a million dollar investment to design HIT solutions for the hospital, or clinic. Individual initiative and grass roots trials are often more creative and functional than a poorly designed commercial medical app

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