Last year I had the opportunity to interview Ottawa Hospital CIO Dale Potter about his efforts to introduce thousands of iPads into the hospital’s work flow. At the time, Potter told me that the iPads and mobile apps were fitting into, rather than disrupting, clinician workflows. “When you ask physicians and nurses how much time this is saving them every day, they say hours, not minutes,” he said.
Yesterday I spoke with an emergency room physician who, like Potter, is convinced the iPad can overcome many of the problems that technology has introduced to the emergency department. Brian Phelps, M.D., an emergency department physician at Ashland Community Hospital in Oregon, said that when the iPad launched he immediately saw its potential as a tool to help ED staff overcome the disruptions to work flow that typical software packages introduce. “It’s disruptive to find a PC to log into,” he said. “It can take up to 50 keystrokes just to get to the record. Details can start to fall away during all the unintuitive clicking.”
Surprised that clinical system vendors seemed slow to jump on the iPad bandwagon, Phelps teamed up with some software developers in the Ashland area who had experience with iOS, server, and middleware architecture to create their own ED software for the iPad. The result is called Sparrow EDIS, a native iPad app that his company, Montrue Technologies, is getting ready to pilot at Ashland Community Hospital. The Sparrow system would replace a hospital’s ED software and use HL7 messaging to share data with the hospital’s other clinical systems.
Sparrow uses speech recognition software from Nuance Healthcare to allow doctors and nurses to capture a narrative, which Phelps stresses is the essence of the patient-doctor relationship. The system also offers patient tracking, physician order entry, physician and nursing documentation, discharge planning and prescribing, as well as enhanced charge capture. Physicians can take photos and share them with patients, or use the iPad to share other patient education materials available as iPad apps.
Phelps talked about the challenges he sees in getting to wider deployment, if and when the pilot in Ashland is deemed a success. The doctors and nurses who have used the product love it, he said. And other hospital officials like it as well. But getting CIOs and clinical informatics departments to sign on is half the battle, he added, and getting that first customer is the hardest step. Ashland is willing to try it because they are getting a deep discount and because much of the experimentation with it has been by doctors and nurses in its ED. CIOs have been leaning toward enterprise software from companies like Epic because they have been afraid of interoperability problems, but Phelps believes that the meaningful use effort and work toward better plug-and-play middleware is assuaging those concerns to some extent. “This offers the possibility for small and mid-sized hospitals to have the technical sophistication of a large academic medical center,” he said. “And if it can get clinicians eager to do CPOE, I think it would be hard to find a CIO that wouldn’t be interested in that.”
I told Phelps we’d check back with him in four or five months to see how the Ashland pilot is going. What questions do projects like this raise for CIOs?
Here is a video that describes the Sparrow EDIS: