Devices & Technology

Mobile Clinical Assistant Connects Clinicians and Patients

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By Suzi Birz, principal, HiQ Analytics, LLC

Intel and Motion Computing recently announced the availability of a new product aimed at connecting clinicians to comprehensive patient information on a real-time basis. The device is designed to allow wireless connectivity to access up-to-date, secure patient information and physician’s orders; has a built-in barcode reader and radio frequency identification (RFID) technology; a digital camera to enhance patient charting and progress notes and to keep track of wounds as they heal; and technology to help capture patients’ vital signs.

Ann Williamson, Ph.D., RN, interim chief nursing officer at UCSF Medical Center in San Francisco, California, explained that UCSF brought together the vendors of the Mobile Clinical Assistant (MCA), Intel and Motion Computing, and their electronic medical record vendor, GE Healthcare. The vendors worked with UCSF to pilot the MCA on UCSF’s acute care transplant unit.

The pilot study was designed to measure the before and after times for log-in, charting and documentation of vital signs. These measures were used to calculate the impact of the MCA.

“The study provided a compelling argument for UCSF to expand the deployment throughout acute care units,” Williamson said. “Our documentation goal is real-time entry of nursing assessments and vital signs.”

“The nurse reaction has been favorable,” she added. “There was a slight learning curve adopting the new device into the workflow, but the features of the device are appealing.”

According to Williamson, the favorite features include a handle for portability and an attached stylus, as well as the built-in barcode reader, RFID and camera. The device is also lightweight, sealed to prevent damage from spills, drop-tolerant and easily disinfected.

“It is evident that a lot of thought went into the design, including input from infection control practitioners,” she added.

Designed specifically for use in the health care environment, the MCA communicates directly with the electronic health record. Information in the electronic health record is available to the nurse through the MCA and information entered by the nurse into the MCA is immediately sent to the electronic health record.

“No information is stored on the MCA,” Williamson explained. “The information entered into the device is transmitted wirelessly and in real-time to the electronic medical record.”

The MCA is used by nurses for the ongoing documentation of the patient, including assessment and vital signs. The MCA is connected directly to the vital sign monitors. Therefore, when the vitals are registered, the nurse quality reviews them to assure the readings are consistent and then the data, like other data entered by the nurse into the MCA, is sent directly to the electronic health record.

At the start of a shift each nurse is assigned an MCA to use for the entire shift.

“This allows the nurse to remain logged in throughout the shift,” Williamson explained. “It is a tremendous time-saver; the unit locks the screen to prevent unauthorized use, but once the nurse enters her or his password, the computer session continues in the same place.”

The nursing workflow remains largely the same with the added benefits of real-time data collection and automated input of vital signs. The MCA eliminates some of the barriers to meeting these goals with the design of the device.

“The computers on wheels were clunky and required nurses to enter the data using the keyboard,” Williamson continued. “Nurses have various keyboarding skills leaving the nurses with different comfort levels of wheeling the computer into the patient’s room and entering the data, resulting in nurses inventing workarounds. Some workarounds involved the collecting of data and entering it later.”

In comparison, the MCA has no keyboard; all entry is done with a stylus and the MCA’s handwriting recognition software.

“Nurses are more comfortable entering data in this manner,” she added. “The MCA runs exactly the same as the other computers that the nurses use to access the electronic medical record, except that there is no keyboard.”

Even with the similarities, some training was required. UCSF used the “train the trainer” approach, which focused on the stylus and connecting the device to the vital signs monitor.

Although the MCA is still in pre-production, it is expected to be commercially available later this summer. Once it is ready, UCSF will expand the deployment throughout acute care and continue to monitor its overall value.

Williamson is enthusiastic about the use of technology in the acute care setting.

“While technology may have been more available in the ER and ICU, nurses in medical-surgical units are now facing more complex and more refined protocols and nurses can take an active role in making technology deployments successful in benefiting the patients and the nurses,” she concluded.

For more information visit the Web sites of UCSF Medical Center, Motion Computing or Intel.

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