• April 2008 FEATURE ARTICLES •
POC/Mobile Computing
Solution Evolution
The maturing market for wireless point-of-care solutions demands a higher level of purchase involvement from healthcare IT leaders.
By Jeffrey Chochinov
The availability of mobile computing solutions
like computer and medication carts is dramatically changing the
face of healthcare by streamlining workflow and clinical record
keeping leading to improved patient care and safety. Yet the
role of mobile computing in many hospitals and health systems
today is being re-evaluated as healthcare leaders such as
directors of IT and nursing assess an expanding range of
options.
This movement has been prompted in part by
the realization that as technology itself evolves, so must
internal selection and implementation strategies. The maturation
of available products and the recognition that different devices
are needed to meet varying demands across the enterprise are two
trends in particular that are prompting technology leaders to
consider adopting alternative approaches when choosing mobile
computing solutions.
Sophisticated Tastes
When mobile computing was introduced a number
of years ago, healthcare leaders were quick to embrace
cart-based technology. They could easily see how "computers on
wheels" might increase nursing efficiency and productivity. In
addition, the availability of clinical information at the point
of care was clearly beneficial to the patient. As facilities
selected their first mobile solutions, they often gathered a
sampling of vendor products in a large conference room and
invited nurses to take a "test drive."
Decision-makers subsequently chose a solution
based on units their nurses found easiest to handle. After using
these early solutions for a time, however, both nursing and IT
staff became more discriminating. They discovered features they
liked, and noted areas where the technology fell short of
expectations. Users began to identify both "nice to have" and
"need to have" features.
Suppliers responded by developing mobile
computing solutions that were lighter, easier to move and more
capable of withstanding the demands of the healthcare
environment. As the market continues to mature and available
products become more advanced, healthcare IT professionals in
particular have begun to look beyond the rudimentary
functionality of computer and medication carts. Second- and
third-time buyers, for instance, may be assessing more than
mobility and ergonomics.
These purchase decision-makers may be
considering additional factors such as vendor support, extended
warranties, long-term service and maintenance options. Because
they rely so heavily on technology, healthcare facilities cannot
afford to experience the effects of prolonged down time. These
organizations increasingly are seeking vendors that offer
scheduled maintenance for troubleshooting and minimizing
problems, in addition to more responsive service when necessary.
Likewise, some have begun to critically
assess the extent to which various mobile computing solutions
address common pain points. For instance, are they easy to
implement, set up and service? How well do they integrate with
existing healthcare IT infrastructure? Do they feature a
reliable, long-lasting power supply? Are they equipped to
provide an electronic advisory to notify users when batteries
need to be recharged? Can the power supply be easily changed
when needed?
These factors can simplify the demands on IT
and nursing staff, reduce aggravation, and ensure that these
mobile computing solutions function seamlessly within the
healthcare environment.
Right Tool, Right Job
Many IT professionals are critically
examining the deployments of mobile computing devices throughout
their facilities and identifying the tasks nurses utilize the
technology to accomplish. Decision makers also are becoming more
aware of the complexity of nursing duties and are grappling with
the best way to support nurses' needs across the enterprise.
Medication administration, providing patient education and
clinical documentation are but a few examples from the list of
common tasks assigned to nurses, each presenting its own set of
challenges.
In the past, leadership may have assumed that
a single type of mobile workstation would meet all care-giving
requirements. However, as healthcare facilities introduced other
technologies (such as bar code scanning, for instance) they also
began investigating whether a one-size-fits-all approach was the
most effective. Perhaps a hand-held device would be more
appropriate for certain processes, such as recording the
administration of medications and fluids, and the tracking of
supplies.
A larger mobile computer, on the other hand,
may be best suited for documenting patient history and other
detailed information shortly after inpatient admission. The
facility may even need a variety of options for these data-dense
point-of-care computing processes. In a critical care unit, for
example, a wall-mounted computer may work best, considering the
intensity of patient care and limited availability of floor
space. On a medical-surgical floor, nurses may prefer simply to
use a secure medication cart with a tablet PC, rather than use
both a med cart and a full-sized computer cart.
A Mobile Computing Plan
Healthcare IT professionals and nursing
leadership have begun to view the selection of mobile computing
solutions more strategically than in the past. They are
evaluating the needs of specific floors, units and departments,
to ensure that they are able to support and simplify the full
range of nursing responsibilities. The result is, nurses get the
tools that are best suited to specific tasks.
Not only does this make caregivers' jobs
easier, and increase productivity, it also may improve staff
satisfaction — an important consideration during this period of
nursing shortages when retention and recruitment is key.
Likewise, a customized mobile computing plan can help ensure
that nurses will actually use the technology available to them.
This can increase patient safety as well, and provides the
facility with an electronic paper trail documenting that
processes and procedures were followed, in the event of
litigation.
For example, many healthcare facilities are
setting high targets (greater than 95 percent in some instances)
for use of bar code scanning with medication administration.
With the policies of a mobile computing plan in place, however,
a facility assumes liability to ensure they are followed. If a
patient suffers a negative outcome and the technology was not
used appropriately, the organization may be exposed to
unnecessary liability risk.
As all of these factors continue to coalesce,
healthcare IT professionals are rethinking their approach to
mobile computing solutions. Rather than relying upon a single
device, they are investigating the benefits of adopting a
best-of-breed strategy. The overarching goal is to implement
mobile computing solutions that provide the functionality and
ease-of-use required by the nursing staff, and to ensure that
these systems likewise support and advance their overall
technology plan.
Taking this approach toward supplying
clinicians with tools that streamline their workflows and that
increase user satisfaction will place healthcare leaders in a
better position to improve the integration and acceptance of
technology into the patient care process. By improving the
efficiency of point-of-care processes, patient safety will be
improved, liability risk reduced, and those responsible for
ensuring that patients receive the highest quality of care will
be free to turn their attention toward setting further strategic
goals.
Jeffrey Chochinov is a senior
product manager for Rubbermaid
Medical Solutions. Contact him at
Jeffrey.Chochinov@rubbermaidmedical.com.