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Mobility in Nursing: An Ongoing Evolution

July 24, 2012
by Gabriel Perna
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Why providers are investing strategically in nursing-friendly mobile solutions

In any kind of provider setting, the importance of nurses cannot be overstated. For those on the front lines, nurses are usually the “glue,” a term that Shannon Hubler, R.N., director of contact center operations at the Minneapolis-based seven-hospital healthcare system, Fairview Health Services, has appreciatively bestowed on the profession.

“In my experience, nurses are the closest ones to the patients and the families,” Hubler says. “They are the link between everything, the glue that holds everything together. They are speaking with the docs. They understand the physical therapy, the occupational therapy, the speech therapy. They interface with the social workers about what patients will need when they get home. They work with the family enough to know about dynamics. We often treat things episodically, but the truth is those patients will go home and they’ll either have a support system or none at all. The nurses are an important part of understanding that.”

For that reason, Fairview is one of many providers across the country that has invested significant dollars in mobile technology to improve nursing at the point of care. Mobile computing in healthcare is not a recent phenomenon—it’s an evolving one, and this especially holds true for nurses.  From beepers to computers on wheels to PDAs, a variety of mobile systems, with a range of nursing capabilities, have come down the pipe over the past few decades.

With the rise of mobile health (mHealth) through smartphones—recent research from Rockville, Md.-based Kalorama Information indicates that the market for mobile medical apps was worth about $150 million in 2011 and will compound annually over the next five years—many industry leaders say the evolution will only continue, while becoming more integrated and more integral to nursing care. Currently, the rising tide of investments by providers across the U.S. is evidence of how much mobility has impacted nursing.


Long-standing communication problems, due to an old call center system and other connectivity issues, are the main reason why Hubler’s Fairview is in the early stages of implementing an enterprise mobile solution from Eden Prairie, Minn.-based Amcom Software. At the center of this implementation is Amcom’s mobile event notification middleware, which Fairview is integrating into its Ascom (Morrisville, N.C.) and Vocera  (San Jose, Calif.) mobile devices for nurse call requests. The middleware has the ability to process alerts straight to the nurses’ devices, which are supplied by the hospital.

“If you’re on a nursing unit and you’re being assigned four to six patients on any given shift, you’re spread pretty thin. You might geographically not be next to the room. You may not hear beepers beep. There’s a lag in hitting that call light, the message goes to the front desk and then somebody is finding the nurse by pager,” Hubler says. “The ability to push those alarms or patient pushbuttons directly to the nurse who can prioritize and get to you as quickly as possible saves time, it’s more efficient, patients are more satisfied, and it’s safer.”

Hubler would like to see further additions down the line, including the ability for patients’ families to connect to a nurse’s point-of-care mobile directly. He also foresees nurses at Fairview bringing their own devices and using Amcom’s software to send encrypted messaging.


Across the country, at the Rochester, N.H.-based Frisbie Memorial Hospital, an 87-bed acute care community hospital, investments have already been made in mobile-based text messaging among nurses. Much like Hubler, Sally Gallot-Reeves R.N., healthcare project director at Frisbie, understands the criticality of time. Thus, as projects director, she oversaw the implementation of iPhones and a point-of-care application from Voalté (Sarasota, Fla.), initially for the nursing and emergency staffs and then later for the rest of the ancillary providers.

Sally Gallot-Reeves R.N.,

The application combines voice, alarm, and—most importantly, Reeves says—text messaging onto a single platform. She says text messaging is a good way for nurses to quickly say something to other nurses or care providers and coordinate with them, rather than talking on the phone, which usually opens up a time-consuming discussion. Since Frisbie first rolled out the app in the fall of 2010, 80,000 texts have been sent per month across the enterprise. Texts, she says, can be sent from mobile device to mobile device or from mobile device to a web-client.

“The first week, we had many early adopters, because of course, with the younger staff that’s their life,” Gallot-Reeves says. “They use it all the time. Then we had other people, who probably don’t have a cell phone. They said, ‘This will never work, I’m never going to do it, etc.’ Then an interesting thing happened. It became apparent that if you weren’t using a [cell] phone and you weren’t responding to messages, you didn’t know what was what going on. By the second week, if you didn’t have an iPhone, you were going to senior management and asking, ‘When can I get mine?’”