By Jennifer Larson, contributor
October 26, 2012 - These days, it seems like there’s an app for almost everything--including health care.
Cleveland Clinic in Ohio is currently exploring applications that would allow nurses and other health care professionals to use smartphones to scan barcodes at the bedside when administering medications. But that’s just one example of the types of mobile apps that health care professionals are putting to use.
In fact, there’s an ever-expanding body of mobile health resources, both free and subscription-based, that enable clinicians to access information that will help them do their jobs better. From specialized clinical content to drug interactions to pathophysiology, smartphones and web-enabled tablets can now put critical information and interactive tools literally at your fingertips.
And mobile technology is just part of the picture. With today’s growing emphasis on patient-centered care, the implementation of health care information technology, or HIT, to manage the flow of information has become increasingly important.
In June, the Healthcare Information and Management Systems Society (HIMSS) published a list of 10 best practices to help hospitals and physician practices that are working to transform to a patient-centered model that would share data with patients, who are considered part of the care team. The report noted that, with the emergence of accountable care organizations, or ACOs, the need for coordinated communication is likely to grow.
“When information is shared at the right time, and in the right format, it can completely transform care--on both the giving and receiving ends,” said Nelita Zytkowski, DNP, MS, RN-BC, senior director of nursing informatics for Cleveland Clinic.
Innovations already in use
According to Zytkowski, Cleveland Clinic is always interested in innovation in technology that will allow its nurses to enhance their ability to provide patient care.
For example, wireless, “smart” IV pumps record how much medication a patient has received and can send instant messages to the pharmacy for a replenishment when the bag is running low. In the intensive care unit, nurses are working with cardiac monitors that are integrated into the electronic medical record (EMR) system, which streamlines the recording of vital patient information. There are plans to eventually integrate ventilators and heart pumps into the system, too.
Cleveland Clinic is also piloting the use of tablet computers to assist providers in obtaining and recording information from patients--as well as to educate and share information with patients.
Imagine using an iPad to show a video to patients in their hospital room about how to care for themselves when they are discharged. Because so many people are already using this type of technology in their personal lives, they often respond well to this type of tool. That can help with information retention, Zytkowski noted.
“It’s more likely to stick,” she said.
Nursing innovation units also hold a great deal of promise, where nurses can use electronic information boards on the walls, specialized robotic systems for helping with patient care and smart communication systems that alert the staff when something is wrong.
What is still needed
Some organizations are more up-to-speed on the latest technology than others. More and more hospitals and health care systems implement electronic health record (EHR) systems, but much of the long-term care arena still needs to implement technology that allows for better communication of information between the various players, according to Rod Baird, president of Geriatric Practice Management in Asheville, NC.
Too often, the various partners--the nurse in the long-term care facility, the pharmacist, the hospital where a patient may have been admitted and the patient’s primary care provider--can’t always communicate as effectively as they would like because the technology is not yet set up to allow that. More electronic bridges are needed to eliminate those gaps, said Baird.
“The nurse is the lynchpin for coordinating that patient information,” he noted.
What’s on the horizon
Jonathan Peck is president of the Institute for Alternative Futures, which received a grant from the Kresge Foundation to explore the possibilities of primary care in the year 2025. His job as a futurist is to consider the future and help decision-makers consider possible scenarios and their implications--and to make plans.
In the not-too-distant future, Peck envisions incorporating the use of technology that includes biosensors and an individual’s personal data that is stored in “the cloud” into a tool called a health advocate avatar. This avatar could communicate frequently with patients and collect information about their behavior and their environment--anything that influences their health. The avatar might exist in the corner of a person’s computer screen (or wireless device) and check in with them periodically; and it could even share information about them with their health care providers.
This has possibilities in the field of preventive medicine. Deploying this avatar could help patients stay healthier by keeping tabs on them and not letting a potentially dangerous condition go undetected until it’s a problem. This information presents an opportunity for nurses to work with patients to stay healthy, Peck said.
Some technology experts are considering devices that make use of the cloud to share information. For example, Baird said he could envision cloud-based CPOE (computerized physician order entry) in the future--another method of information-sharing that could potentially benefit the long-term care industry and others.
Where health technology is headed
In just a few years, the technology that seems cutting-edge today may seem old school, Baird added. But that should be cause for optimism about the potential that we can’t even fathom yet.
“It’s only by doing something that it gives you the platform to go see what the next challenge is,” he said.
Zytkowski said she expects to see more mobile devices and mobile solutions used in the workplace--by both nurses and patients. She also said she hopes that nurses will take an active role in the design of future health care technologies.
“Nurses are the caregivers that spend the greatest amount of time with patients,” she said. “They literally have their fingers on the pulse of how technology can best be implemented to enhance both the nursing profession and the patient experience.”
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