Health Management Technology

With everyone firmly entrenched in the digital age, it is an afterthought for our society to use computers to speed communications, manage repetitive tasks, and make short work of complex calculations. While the benefits of information technology have been widely documented, the irony of a “connected” environment is that it can disconnect us with other people.

With everyone sending e-mails, instant messages and monitoring workflow via performance monitoring software at our desks, we’re all talking and physically interacting far less. In healthcare, this “side affect” means that patients interact less with caregivers, employees interact less with supervisors and healthcare professionals engage in far less face–to–face collaboration.

The net result is dissatisfaction for patients, employees and ultimately supervisors. In recent years, healthcare workers have begun to realize that patients measure the competence of caregivers through their interaction with them. Patient satisfaction has been linked to better outcomes, higher employee satisfaction and retention, competitive market strength, better hospital profitability and reduced risk of lawsuits. Is this trade–off between greater technology and less personal interaction one we really want to make?

Confluence

The good news is we no longer have to compromise due to the convergence of technology that is capable of bringing health professionals back to the bedside. The merger of software and hardware, along with the wireless infrastructure that supports them, enables caregivers to reconnect—face–to–face—with patients. Supervisors can now leave the office and improve rapport with their staff, while administrators can return to a more personal style of management by walking around. Physicians can use PDAs throughout the day to facilitate quality patient care, make informed decisions and act on them on the spot.

Intelligent mobile channels let physicians and nurses receive late breaking medical alerts. Metrics for monitoring performance can now be updated in real–time wherever the wireless network exists. Patient documents can be transferred from the computer desktop onto a handheld device or created directly on it.

Likewise, a nurse with a handheld “bed board” can tell a patient in the ER how long the wait will be for a bed, while simultaneously informing the ICU charge nurse that several patients can be transferred out of the unit. The nurse can seamlessly move from hospital status to patient–specific information in order to display the number of people working to free up a bed.

Untethering Healthcare Technology

In the pre–mobile IT days, staying connected to the larger organization meant staying “tethered” to your desk computer while the real action was out on the floor. Mobility enables the very essence of “proactive management”— preventing the unexpected. For example, rather than waiting for alarms, alerts and crisis level pleas, supervisors can see patient bottlenecks begin to form and avert a disaster instead of just reacting to it. Rather than tell a frantic unit manager “I’ll get back to you,” they can expedite a patient transfer, a bed cleaning or a tray delivery while speaking directly with the manager on the floor.

Busy specialists making rounds can transfer patients with a few taps of a handheld device and write discharge orders without losing a step. Multiply these scenarios across many caregivers and many patient units, and the result will be streamlined performance and experience across the board, for all areas. That’s why hospitals are unplugging at the highest rate since the creation of the cordless environment.

In addition to PDAs giving nurses quick access to current drug references and medical calculators, they can also record, organize and track patient data as they work, simultaneously sharing data on treatments and assessments. Today, there are many nursing–specific titles that can be downloaded from the Internet. The near future will bring even more proven solutions from industry–specific vendors that fit the palms, lab coat pockets or clipboards of nursing professionals with PDAs.

The Future is Now

While many nurses have adopted PDA technology, the broader nursing culture has not historically embraced information technology for several reasons, one of which is that the most commonly used form of healthcare IT—the desktop computer—can keep them away from their patients several hours a day. Tech phobia and frustration also can be barriers, as well as lack of training and the perception that electronic documentation requires extra time.

PDAs can solve the disconnect issue if nurses see them as a device that will enhance their already strong information management skills and reduce the likelihood of medical errors. With prompts, alerts and biometrics, PDAs can help ensure the correct patient gets the correct medication at the correct dosage at the correct time.

One way to do this is to involve nurses during the process of defining the applications, to instill confidence that the technology meets their needs. Too often, nurses are excluded from design and planning, which can lead to systems that fall short of their potential because there is no “buy–in” by the nursing staff. Some of the mobile features nurses want are secure devices, alert alarms, biometric solutions, supervisor alerts, specialty–specific programming and confirmation that physicians have received and acted on critical messages.

A 2005 Harris poll showed 75 percent of Americans like the idea of adopting new medical technologies, such as handheld devices, for reasons of improved care and cost reduction. More than 90 percent of clinicians 35 years of age and under use handheld reference software, according to a 2003 report on Trends in Mobile Computing by Spyglass Consulting Group. Survey data from 2004 found 57 percent of all U.S. physicians regularly used handhelds, including 73 percent of residents and 71 percent of family/ general practitioners. A 2005 survey of nurse practitioner students and faculty by Stroud, et al., found that 67 percent of respondents use this technology.

The importance of enhanced patient care cannot be overstated, especially as healthcare moves toward transparency and an era of healthcare “consumerism.” Against that backdrop, patient satisfaction becomes an even more critical measure of performance. Integrated mobile information solutions that put health professionals back in front of the patient can go a long way toward improving that performance and the outcomes.

Gene Nacey is founder & chief technology officer of Tele– Tracking Technologies Inc. in Pittsburgh. Contact him at gnacey@teletracking.com