Mobile Situational Awareness Tools = Fewer EHR Log-Ins

Oct. 28, 2015
Clinicians who can access real-time patient data from several sources in smartphone apps are less frequently logging into the EHR system itself. Could these tools replace discharge summaries as well?

Several presentations at the Oct. 23 Mid-Atlantic Healthcare Informatics Symposium in Philadelphia focused on in-house solutions developed to streamline the data that clinicians and health system execs see on their mobile devices to help with situational awareness. One of the key takeaways is that as clinicians are relying more on these smartphone apps, they are relying less on logging into the EHR system itself.

In January I interviewed some Penn Medicine executives working on a mobile patient dashboard that helps clinicians quickly access patient data from several clinical information systems as well as identify and easily reach out to others on the care team. The tool is especially valuable in patient handoffs.

At the Oct. 23 symposium Subha Airan-Javia, M.D., who is assistant chief medical information Officer at Penn’s Perelman School of Medicine, gave an update on the Carelign product’s evolution. Version 1 was rolled out in August 2014, and Version 2 is set to begin piloting this November. The app is designed to work on any smartphone and is role-based. A provider can click on a patient name and drill down on any vital sign or lab data. The vital signs are in real time. “It puts the bedside chart back into your hands,” Airan-Javia said. Users can look back one day, three days or a week in vital signs. Labs are the most commonly accessed feature. She said the biggest difference is that care teams access real-time data more often. As they use it on rounds, they access patient data 50 percent more often than when not using the app, she said. App users “spend 25 percent less time logging into devices,” and they find it 22 times faster to log into the app and get information than to log into a workstation and get it. “We have seen a15 percent decrease in EHR log-ins among users,” she said. “Now we can get data on the phone, and save that time spent at the workstation for order entry.”

She mentioned that the Penn Center for Innovation has just started to form a startup company called Handoff Health to commercialize the mobile tool.

Clinical unit leaders also need tools to be able to more easily visualize what is happening at an institutional level and make adjustments. EHRs lack tools to allow for that kind of observation, even though much of the data is flowing from the EHR. As I wrote about earlier, Cincinnati Children’s Hospital Medical Center has created a situational awareness tool called GARDIANS (Global Automated Risk Detection Interface and Network System) for Operational Excellence. It serves as a tool that comprehensively presents information to enable front-line leaders to identify and mitigate risk for flow failures, patient and family experience failures, and safety events. “It is a real-time web-based application that aggregates situational awareness data around safety, patient flow, and patient and family experience and is used by clinical leaders on secure mobile devices,” explained Eric Kirkendall, M.D., associate chief medical information officer, speaking at the Philadelphia symposium.

He said the hospital built a custom technology framework to leverage any vendor API. “It gets key data points to the right audience at the right time, in the right format.” For instance, for patient flow, an executive can quickly look unit by unit and scroll the whole hospital for hot spots, which patients are on high-risk therapies, the number of beds per unit and a predictive number for the end of the day. They can drill down to a patient-level view.

So it sounds like mobile tools that pull data from lots of different sources of patient information are becoming indispensable to clinical teams. And Dr. Airan-Javia mentioned that although the initial focus of Penn’s work was on inpatient shift transitions, they are hearing from people all throughout the health system who want to use it. “Outpatient clinicians and homecare providers want to use it,” she said. It may be valuable for handoffs between inpatient and outpatient facilities instead of a discharge summary.

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