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