For hospital communications, the future has arrived
What is in this article?
An organization transformed
We selected Mobile Heartbeat, a mobile health-care communications application suite that can deploy on any standard iPhone, iPad or Android device. It runs on our wireless network, so cellular plans aren’t necessary for internal use—a feature that provides a real cost benefit for KDH. Mobile Heartbeat had all of the features we needed and integrated well with MEDITECH, our hospital information system (HIS).
The application suite we installed offers functionality related to patient information, as well as integrated communications and alerts. The patient portion of the app will provide to a caregiver’s mobile device a live feed of pertinent data such as temperature, heart rate, respiratory rate, blood pressure and O2 saturation levels. Nurses and physicians also can instantly receive patient alerts when critical lab results are generated or notifications are sent from our nurse-call and telemetry systems. Lab results for in-house patients can be easily viewed or trended any time on the mobile devices.
Communications functionality is integrated into the app and taps the power of smartphone technology. In addition to voice capabilities, individual and group texting is enabled. Users also can receive alerts and alarms from our in-house system. A patient-centric directory helps clinical staff quickly identify and access all of the caregivers assigned to a specific patient.
Behind the scenes, apps are powered by the Mobile Heartbeat data server. This virtual server sits securely in our data center and is backed up like other critical applications. The interfaces to our VoIP phone system—and to our cardiac monitors and nurse-call and MEDITECH systems—are the key to making this an indispensible tool.
MEDITECH sends patient admission, discharge and transfer (ADT) information, lab results and patient orders, allowing the other systems to tie into the patient-centric communications device. We also are preparing the system to complement our existing workflow to provide faster response times and better patient care.
We armed our staff with iPhone 5 devices that run on our wireless VoIP system and operate with the Mobile Heartbeat application suite. These internal devices are used by the personnel in inpatient nursing, the emergency and surgery departments, pharmacy, cardiopulmonary, medical imaging, lab, rehab, nutritional services, registration, the hospital switchboard, housekeeping, security, information technology and others. It was important to our nursing staff to have mobile support personnel accessible throughout the communications system. Physicians are allowed to install the app on their personal cellular devices that operate securely, both inside and outside the facility.
Communications devices are picked up and activated when staff members start their shifts. Almost 450 employees share 240 devices that are kept at charging stations— located in multiple areas on each floor—that hold 20-40 units apiece. When a nurse comes in for a shift, he/she goes to the charging station nearest the nursing pod and holds his/her ID badge to an RFID scanner. This verifies the nurse’s hospital credentials and automatically logs him/her into the Mobile Heartbeat application. Each authorized staff member has a unique phone number that travels with him/her after logging on to a device.
For about 50 physicians, the Mobile Heartbeat app installed on their personal cell phones allows full contact and functionality, whether they are on duty or have left the hospital. This lets them send and receive patient test results, receive patient alerts and immediately contact a specific nurse by text or voice for a patient update.
Communication is now targeted and instantaneous among all of our staff; we no longer need to involve the switchboard to contact a physician or nurse. Users also have access to an online contact list that provides real-time status updates that show whether someone is available, busy, is with a patient or has left the building. And—whether a caregiver is using one of the dedicated devices or their own cell phone—all information and texting is HIPAA-compliant. Transmitted data is encrypted, and no patient information is stored on any of the hospital devices or personal cell phones using the app.
After just a few months, the new communications system has transformed our organization. The KDH staff has realized benefits that are helping us deliver superior patient care and improve workflows. For example, the pharmacy has been a strong user of the system, notifying a nurse when a patient’s medication has been delivered to the unit. Nurses also can insert patient information easily into a text message to notify the pharmacy if they are missing a specific medication.
Nurses and physicians soon will benefit from the ability to have critical lab results pushed directly to their devices for immediate attention. For our rapid-response team, overhead paging is being eliminated and replaced with group pages and texts that go directly to their devices. This helps to quiet the hospital environment and ensures that essential staff are notified and mobilized immediately.
We are developing an app that will provide an interface to our computerized physician order entry (CPOE) system, so that an alert can go directly to the appropriate caregiver when a doctor issues a new patient order. This will let respiratory and rehab therapists initiate patient care faster, rather than having to wait until they get back to their desks to get a new patient order.
Mobile Heartbeat’s flexible software means that we have a lot of opportunity to add functionality to the system through new apps. We are preparing to roll out an app that provides the ability to interface the MEDITECH system with device cameras, so that caregivers can take and download photos into the patient documentation system. We also are working with the development team on apps designed to help us improve workflows.
The use of innovative smartphone apps has created a new paradigm of care at KDH. Immediate access to patient information, regardless of caregiver location, has transformed our ability to provide the best possible care for every patient. We are excited to see where this technology can take us in the future.
Linda Darnell is director of management information services at King’s Daughter’s Hospital.