mHealth Apps: Real-Time Patient Information for Transitions-of-Care

June 13, 2013
In this interview with Healthcare Informatics Associate Editor Gabriel Perna, Matthew Mombrea, CTO and co-founder of Cypress North, creator of Smart Sign Out, talks about how the app came to life and what terrible incident partly inspired him. The app helps clinicians by giving them real-time patient information, so they can better coordinate care during shift changes or department transfers.

In the final part of a four-part interview series with various mobile health (mHealth) app developers, Healthcare Informatics Associate Editor Gabriel Perna speaks with Matthew Mombrea, CTO and co-founder of Cypress North. Cypress North has created Smart Sign Out, an app that gives clinicians real-time patient information, no matter where they are, so they can better coordinate care during shift changes or department transfers.

The idea for Smart Sign Out, Mombrea says, partly from his own personal experience. Mostly though, he says it’s about ensuring every member of a patient’s provider team is on the same page during a period of care transition, and there aren’t any failures in communication.

Cypress North/Smart Sign Out is in contention along with 14 other apps for the Allscripts’s (Chicago,) open app challenge. If chosen as the winner, the Cypress team will win a $250,000 prize. The winning app will be chosen on usability, innovation, integration, ease of installation, and most importantly, the clinical, financial, or performance improvement impact. The app must all use Allscript’s application programming interface, to tie into the organization’s open source electronic medical record (EMR) software.

Below are excerpts from the last interview in this series of four. Part 1, Part 2, and Part 3 can be found here.

Smart Sign Out Credit: Cypress North

1) Explain what your app is and what it does?

Smart Sign Out is a safe, accurate, and efficient way to transition a patient's care from one doctor to the next during a shift change. Doctors are able to update patient lists immediately, or when it’s most convenient for them -- at the bedside, during rounds, even at home. The app synchronizes with a mobile-friendly web application to ensure every member of the team can access real-time patient information instantly -- so you can feel confident knowing everyone is on the same page.

2) What was the inspiration behind this app?

If you or someone you love has been in a hospital, they have likely been subjected to shift changes or departmental transfers. During these care transitions, the opportunity for failure in communication rises dramatically. The result is that vital information is stale, wrong, or just plain lost.

Personally, my mother was in a terrible accident where she was crushed under a horse. She was taken to the hospital with a broken back and neck along with internal organ damage. She was scheduled for an MRI and CT scan in one of the basement floors of the hospital. After the tests were completed she was wheeled into the hall to wait while a shift change occurred. During the shift change, her care instructions were not transferred and she was left in the basement, essentially paralyzed, for over an hour. Since her voice box was crushed she couldn't yell and, eventually, she was able to get the attention of a passing maintenance worker to find her help.

3) How do you envision clinicians using this? (Either directly or indirectly if it’s a consumer-based solution)

We envision every member of a care team using Smart Sign Out to stay in sync with their patients. They are able to access the patient data at home before their shift and can be up to speed before the face to face handoff occurs which will save time and reduce errors. They can also access and edit the patient data at the bedside ensuring they have the most accurate data available. With Allscripts integration, patient data will be automatically pulled from the EMR [electronic medical record] reducing duplicate entry and human error. While there is no replacement for face to face communication during handoff, keeping the data synchronized across all team members will serve to enhance that experience.

4) If this data uses PHI [protected health information], how does it safeguard data for HIPAA [Health Insurance Portability and Accountability Act] regulations?

The application is power by our dedicated HIPAA compliant servers and all communication is secured by 256-bit SSL encryption. The iPad and web applications both have an idle timeout period of 20 minutes per HIPAA regulations, after which the user is logged out of the system and all of the patient data is destroyed. Additionally, our system is equipped with geo-location based security which allows an administrator to define a radius around an address where a user is allowed to log into the system. This is useful when an organization only wants users to access the sign out data at the facility.

5) What would you do with the Phase 2 prize money if you won? How would you enhance the app?

The money would go toward adding more ambitious features to our software, promoting the system, and expanding the dedicated device support to other operating systems like Android and Windows 8. We’ve got a lot of ideas on how to improve the transition of care even further with our application, including plans to enhance communication between hospitals and primary care providers after a discharge. We also want to add features such as real-time, secure messaging, push notifications, and more.

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