RNs and LVNs What's in your pocket? ?

 

CA Hospital Jettisons Nurse Communications Gear For iPhones

The transformation of medical care with mobile apps has become so ubiquitous that hospitals are discarding conventional devices such as overhead paging, pagers and telephones with smartphones.

USC-KECK  nurses will no longer use standard hospital communications gear.  In an effort to simplify and improve communications, the academic medical center is rolling out an initiative placing specialized adapted iPhones in the hands of each nurse.  Keck’s IT leaders  have ordered 300 “specialty” iPhones for  use by the nursing staff. “The idea is to give them one device to do everything,”

KECK chose to go with the iPhones when the firm installing its EMR said that they could link it with the smartphones. (The EMR is in the process of being rolled out, the paper reports.)

When the devices are completely functional, nurses will be able to receive secure messages from patients and other nurses, as well as emergency alerts, the article notes. The devices, which come with enhanced batteries and a tough casing, will also be able to show when a specific nurse is available.

Nurses are not going to be given their own phones, but instead, will pick up a phone at the start of their shift, entering their user ID and password to activate the device.  At the end of their shift, they’ll be asked to return the phones to a charging station. The phones they obtain will be assigned by work shift with individual logins for users. The devices will be ‘hardened’ to decrease the likelihood of physical damage.

One way in which the phones are unique is that they won’t have cellular capabilities. The modified iPhones will function only on the Keck campus, with calls made over the facility’s secure Internet infrastructure. This feature addresses HIPAA concerns for privacy and confidentiality

As we’ve previously reported, few smartphones are secure enough to meet even half of Meaningful Use or HIPAA requirements, according to ONCHIT. So it makes sense to run voice communications through a hospital-controlled voice-grade Internet network if you have the option (which Keck obviously did). But to date few hospitals (that I know of) have taken the plunge.

BYOD’S may be a thing of the past (bring your own device). These have caused concerned about reliability, and security, also few hospital IT departments support these devices.

These new devices invade the conventional hospital communications devices, such as Vocera. Incremental changes such as this may announce disruptive innovation and also influence market share for vendors.

Despite this early trend you don’t hear about a stampede of hospital IT departments rushing to establish support policies and deploy enterprise-class mobile management tools. I must say, I’m not sure what they’re waiting for.

Hospitals and medical facilities have a lot to gain by integrating mobile into their businesses. As it has done with other industries, a properly implemented mobile program can help medical facilities by increasing efficiency, accuracy, and consistency of care.

Some of this article was taken from: Hospital EMR and HER and Hoverstate

Patient Generated Health Data Project

 

At the inception of Digital Health Space I described it’s mission:

“DIGITAL HEALTH SPACE The distance between providers represents the space that Digital Health Space is attempting to close using virtual applications, websites, social media, email, web portals and telehealth.” Attend HealthSpace 2013 October 2013.The conference will include Social Media Learning events, and Start up Presentations. Equity and Venture Capital firms will be in attendance.Subscribe to digitalhealthspace@blogspot.com - See more at: http://digitalhealthspace.blogspot.com/#.dpuf

The vision is becoming a reality as patient-centered medicine moves into the digital health space.

Patient generated data will be an essential component of the medical record. The National eHealh Collaborative’s report is timely as meaningful use state III approaches. MU 3 adds patient engagement,

The Patient Generated Health Data Project includes evidence and reports by The Patient Generated Health Data Technical Expert Panel - See more.

These results were extracted by the  Panel Convened by NeHC on Behalf of ONC offers Results of Environmental Scan on Existing Practices - See more

The report is available as a ‘white paper’ (pdf)

On the consumer side of engagement is the CeRT (Consumer eHealth  Readiness Tool) 

The Ultimate  Business Intelligence Tool

The Patient Engagement Framework

Patient engagement is the blockbuster drug of the century. – according to Farzad Mostashari, National Coordinator for Health Information Technology.

 

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CAeHQ---The Status of Health Information Exchanges in California

 

California is large enough to be called a ‘nation-state’ with 35 million citizens, it is larger than many sovereign states in the world.  The diversity of it’s demographic is challenging not only for health systems and providers, and with social engineers as well.

The development of health information exchanges in California is a microcosm for what must take place nationally in regard to health reform and ObamaCare.

Early study and planning for HIX began in 2004 with a major impetus by the newly formed Office of the National Coordinator for Health Information Technology (ONCHIT). Rather than forming one monolithic organization a model for regional information exchanges evolved over time.

Simultaneous interoperability standards were developed to ensure a common system of harmony between disparate EMR system, laboratory systems, pharmacy systems and more.

Federal incentives in the form of the HITECH Act has fueled significant growth in HIT since 2009.

The most recent meeting of the CAeHQ nicely summarizes the progress of health information exchanges, and it’s relationship to the national plan. It is anticipated that as the system matures individual HIOs may vanish to be replaced by the national HIE.

The development of each individual health information exchange has been sporadic and dependent upon local interests and the development of sustainable business models. Other items include trust agreements among the users of the exchanges.

Whilst some HIXs are working well, each one delivers different data fields and the comprehensiveness of it’s data. Some are simple messaging functionality, some allow transmission of continuity of care records, while  others are more complete.

As yet there is little if any transparency from an electronic medical record. Rather than true integration of the data into a trusted partner’s EMR a separate portal must be engaged to retrieve patient data.

The ONCHIT Direct program remains a national infrastructure, while each region has it’s own network.  There is no uniformity of size.  The current size appears to be guided by the hospital systems and the individual state. Few cross state jurisdictions except for a few.

The CAeHQC recent stakeholder meeting took place on July 18,2013 via a webinar.

The slide deck of the meeting (24 slides) is linked here. (may take a moment to load)

ref: CAeHC Webinar July 18,2013  Recorded TBA available at www.ehealth.ca.gov

 

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The Advances in Mobile Health/Smartphone Apps

 

January 22, 2013: The iExaminer System from Welch Allyn, an iPhone app and peripheral device that allows doctors to use the iPhone camera to take photographs of the interior surface of the eye receives 510(k) FDA clearance. It builds on the company’s existing PanOptic Opthalmoscope, a device that lets a physician see into the back of a patient’s eye

Timeline: Smartphone-enabled health devices:

Mobile health has come a long way since the start of 2009 when Apple demonstrated on-stage at its World Wide Developer Conference how blood pressure monitors and blood glucose meters could connect to the iPhone 3G via cables or Bluetooth. MobiHealthNews has tracked health-related wearable devices from their infancy as research projects at university labs to the commercially available products they are today. The past three Consumer Electronics Shows, especially, have yielded a wide range of smartphone-enabled health and fitness devices, from smart forks to connected pulse oximeters and, of course, the numerous wearable activity trackers.

As I have noted in previous posts, “It’s All in the Wrist'”. If you play tennis, that is a non-sequitor.

Whether it is worn on the wrist, finger tip, tatooed on the skin, swallowed,or injected subcutaneously, Wi-Fi and/or cell phone connection can connect you directly to your doctor’s EMR or your personal  health record.  Eventually if you have a pacemaker it will be able to signal your cardiologist when your heart stops and get a shock in return.

Some of these were science fiction less than ten years ago.

Although smartphone are usually thought of as consumer devices, they offer computing power far in excess of what is used for the original missions to the moon.  Even the space shuttles digital computing power is meager as compared to an ordinary Android or iOS device.

Even Steven Colbert will submit to an iPhone invasion of his auricular orifice.

Beginning in 2009 there were few mobile applications, however by 2013 the list has grown.  The uptick in smartphone apps has drawn the attention of the FDA and congress in an ATTEMPT to classify health apps/smartphones as a medical device.

Within the spectrum of medicine and science expensive lab equipment costing $ 50,000 or more can be replaced by a smartphone. In one case a spectrophotometer designed by researchers at the University of Illinois at Urbana-Champaign have developed a versatile iPhone-based biosensor that, with about $200 worth of parts, is just as accurate as a $50,000 laboratory spectrophotometer.

The system, consisting of an iPhone cradle and an app, can detect viruses, bacteria, toxins, proteins and even allergens in food using the smartphone’s camera as a spectrometer and the powerful processor to make calculations.

The advances since 2009 are remarkable.

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