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Mobile Technology: Beyond Bedside Meds Administration at Colorado’s Parkview

July 9, 2013
by Rajiv Leventhal
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At Parkview Medical Center, patient safety and care coordination in real time is made easier thanks to a single mobile device.
Steve Shirley

In 2007, Pueblo, Colo.-based Parkview Medical Center started using bedside medication administration technology from IntelliDOT Corporation, a vendor in San Diego that specialized in healthcare workflow management solutions.  In 2009, IntelliDOT became Patient Safe Solutions, which unveiled its PatientTouch solution, created for Apple’s newest iPod touch—a WiFi-enabled device.

Now, Parkview, a non-profit general acute-care and behavioral health specialty hospital with 350 beds, has extended that PatientTouch implementation through new capabilities that unite multiple departments to enhance patient safety and facilitate care team coordination. With these enhancements, the Parkview implementation has sought to maximize the value of its existing Meditech 6.0 electronic medical record (EMR) and improve patient safety and clinical productivity.

Now, in conjunction with its migration to Meditech 6.0, Parkview has taken its PatientTouch implementation further through new capabilities including blood-gas labeling and documentation, blood and specimen collection, and HIPAA-compliant text messaging to improve care team awareness and coordination across clinical departments. Steve Shirley, Parkview’s CIO and vice president of IT recently spoke with HCI Assistant Editor Rajiv Leventhal about the process behind expanding PatientTouch, the key pieces that have gone live, and the results already garnered. Below are excerpts of that interview.

What has happened in recent years that made you want to extend the implementation of PatientTouch?

Back then, we strictly used the device for bedside medication, but over the last year and a half, we have installed different phases. The initial offering was a single-use device, and we wanted to be able to keep our nurses from having multiple devices as well as adding functionality at the same time. So IntelliDOT turned into Patient Safe Solutions and the original device turned into an iPod touch. Now, we use it for all of our blood-gas labeling and documentation, blood and specimen collection, and HIPAA-compliant text messaging. That last piece is very big for us—now nurses can text each other inside the hospital within a secure environment.

Additionally, we are working on voice deployment at this very moment, so we’ll have that working as a single device for nurses’ phone calls and messaging. This will drop one device off of their scrubs, so to speak. On the horizon, there is a full complement of nursing intervention scheduled for the system— everything from rounding to patient needs (such as needing exercise), and respiratory therapy will be put on system. Vitals and critical alerts too will also be included. There is a whole roadmap for all of these different pieces.

You mentioned how important the HIPAA-compliant messaging piece is. Why is that so?

General texting using 3G or 4G communications is generally forbidden by the Centers for Medicare & Medicaid Services (CMS). But we wanted to control it ourselves, and not only by policy. With the implementation of messaging on this device, it’s now all WiFi internal, so we aren’t on a public network. We have a complete audit trail too. If something were to happen, people often get concerned that they wouldn’t have any type of documentation and would have to go to provider to legally pursue it, and we all understand that process. We have full control here now, and we know nothing will go external from a HIPAA perspective. Since our physician community is obviously so critical to us, and as they are becoming more astute to smartphones and tablets and complimentary devices every day, my biggest challenge as CIO will be to figure out how to properly and safely deal with them with messaging in terms of regulations.

When you first started this expansion, how did you know it was working?

The first thing we looked at was the days of paper medication administration records (MARs) and treatment administration records (TARs) for the transfusion administration record. When we looked at efficiency, we were probably no different from most other hospitals in terms of errors, but the desire to get away from paper MARs and TARs and improve efficiency and accuracy was just huge. As we went forward, we are now seeing a reduction in medical errors with the transfusion administration, and that is so critical. It was a huge deal for us. And walking around talking to nurses, they have built an inner sense of confidence. In 2007, they weren’t excited, but now if I told them I was going to take it away, they would not be [happy]. We’ve also been live on Meditech 6.0 since April, and while we had our fair share of challenges during implantation, things are settling down right now. And as we all move into mobile device management, the 6.0 platform will support that very well, bringing the patient portal to bear.

What are some of the benefits you’re already seeing with the ability to put everything on a single device?

Well, every day we think about how we can give a nurse what he/she needs, as opposed to saying, “Here’s a piece of software, go make it work.” That’s one of the main things we are trying to accomplish, and it’s really become an ongoing focus for health IT every day. It sounds like a concept everyone normally thinks about, but to be honest, it’s not always adhered to. So when we look at the whole array of pieces such as reducing readmissions and improving the quality of customer service, keeping the nurse in the patient’s room is key.

We require hourly rounding at Parkview, and one of the things this system helps us do is to take care of the standard processes much quicker, which allows the nurse to get back in the room and spend more time with the patient. As we get things like critical lab results and vitals on the device, nurses won’t have to run back to the nurse’s station or grab a computer on wheels.  Instead, they’ll have a handheld [device] that will keep them in the room. We think that’s really important because we’re very convinced that the amount of time a nurse spends with the patient will certainly improve these patients.

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