Background: Caring for patients involves multitudes of moving parts – from teams of physicians, nurses and radiologists to tests, medications and an array of electronic health record (EHR) systems. However, as medical care has evolved, instead of these components working together seamlessly, they often work in silos – both at the provider and patient data levels. EHRs have become more and more specialized, forcing providers to look in many different places to gather the necessary data to care for one patient. Additionally, access to this data is usually limited to stationary desktops with aging operating systems, causing prohibitive delays in patient care. This separation between patients, their providers and the medical record only adds to the asynchronous nature of medical care.
Purpose: To address these growing gaps in medical care, we provide caregivers with real-time access to patient data from 3 different EHRs and primary team handoff information into one seamless, intuitive mobile app.
Description: Our mobile web app is designed for a smartphone yet is accessible from any internet capable device. It brings vital patient information from multiple different EHRs into providers’ hands giving almost instant access to essential information. Designed by a practicing hospitalist, residents and an experienced group of IS analysts, it gives an intuitive display of patient information to compliment and enhance workflow. Built in less than a year, it was launched for our entire health system (4 institutions, 1700 beds) in the beginning of August. With no training and only one email notification, uptake of the application has been steadily increasing. It has launched a surge of innovation around HIT and patient care. Using an agile development system and rapid-cycle iteration, we have already released two additional updates implementing feature enhancements with more planned in the coming months. The app is revolutionizing inpatient workflow in several ways. Users have fast access to comprehensive, live data and no longer have to wait to access it. Time motion observations during the pilot showed teams using the app accessed patient data twice as often as those not using it, yet spent less time looking for and logging into devices. Login time for our app is 22x faster than for desktops, saving users on average 20-30 minutes daily. Teams review patient vitals, medication with administration history, labs and studies in real time during rounds and in patient rooms. This information is often used to answer patient and consultant questions, leading to quicker decision making and more efficient workflow. Providers are also more readily communicating in real-time, with care team contact info readily accessible. Additionally, non-physician providers are regularly viewing the primary team’s handoff history, problem list and daily tasks to better understand patients’ plan and coordinate care.
Conclusions: Providing mobile, real-time, fast access to comprehensive patient data for all care providers leads to improved workflow and efficiency, more well informed and timely decision making, and increased user satisfaction. Future directions of our app will include incorporating a physician and nursing handoff tool and systems based data presentation. Our app takes a big step towards leveraging technology to improve patient care and user satisfaction and will hopefully continue to transform patient care.