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It’s Inpatient Engagement in the Hospital

8 Oct 2014 by Insight Editor

In a recent interview I did with Karen DeSalvo, MD, National Coordinator for Health Information Technology at HHS, she said one of her goals regarding patient engagement was a shift in emphasis “to thinking about folks as individuals and consumers and move them out of the patient box.”

That makes sense. In healthcare’s transformation to a value-based model, wellness and population health management demand that people become more engaged in their own health management with the goal of not becoming a patient. The big ships of the industry are beginning to steer the same course. CHE Trinity Health, a Livonia, Mich.-based integrated health system with 86 hospitals in 20 states, has deemed the trend important enough to adopt the term “consumer” in place of patient as part of its overall strategic language.

Thinking about folks as individuals and not just patients also implies a focus on people’s well-being, including social and genomic factors that account for as much as 80 percent of a person’s overall health.

That said, the term patient engagement makes sense in a hospital, for obvious reasons. Engaging patients in a hospital is as important as in a home or mobile environment, albeit more highly controlled, technology-and-care-intensive. Perhaps we need a new term to differentiate it from the ambulatory and mobile sector: inpatient engagement.

Like consumer engagement, inpatient engagement is more often than not IT-enabled. Hospitals and health systems are using tablet computers, high-definition video displays, kiosks and RFID-based real-time-location systems (RTLS) to not only engage patients at the bedside but help them physically navigate the complex hospital environment. RTLS, for example, helps caregivers and families track patients within the hospital for safety and communication. The result is better quality and efficiency of care, improved patient safety and satisfaction.

Engaging patients in Texas

Texas Health Harris Methodist Hospital Alliance (Texas Health Alliance) offers a case study in how the most advanced hospitals are using technology for inpatient engagement. Texas Health Alliance, a 56-bed hospital in Fort Worth that opened in 2012 as the newest in the Texas Health Resources system, provides it patients with touchscreen tablets mounted on a swing arm near each bed in its medsurg, ICU and post-partum rooms and in the emergency department. Patients can use the Samsung3 tablets to access the Internet using a Google Chrome web browser, visit their personal patient portal to view test results and medication lists or schedule or view appointment dates.

The bedside tablets also contain special software from a vendor of interactive TV services that allows patients to adjust the temperature of the room, watch on-demand movies and order meals. The meal-ordering function is tightly integrated with the hospital’s electronic health record (EHR) so whatever patients order is compliant with their prescribed diets. They can also call for a nurse, read health-related articles or watch patient-education videos.

“We also have the ability to incorporate their personal Netflix or Skype accounts,” says Rudy Loremo, IT special projects manager at Texas Health Alliance. “Initially we wanted to have a corporate Netflix account, but Netflix had never done that before. So, they’ve added it to their R&D docket.”

Texas Health Alliance has staggered the rollout of the tablets, starting with the post-partum floor 11 months ago. Besides the mounted tablets, the hospital also has several “floating” tablets to accommodate the more fluid environment of the ED. As the hospital expands this year it will add another 20 tablets.

It’s difficult to quantify the tablets’ specific impact, but Loremo says using the devices has helped raise the hospital’s HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, nationally standardized measures of patient satisfaction. He notes the tablets have also provided a convenient interactive tool for patients to participate in such surveys.

Locating a loved one

Texas Health Alliance is using other technological tools to bolster inpatient engagement as well. On the walls of its two surgery waiting rooms are mounted Family View Track Boards—47-inch, high-definition, LED-backlit, flat screen displays that provide HIPAA-compliant information to families on where their loved one is in the perioperative process, from preadmission to post-operative recovery.

RTLS is another technology that has come of age at the hospital. While not directly engaging patients, RTLS provides the eyes for a hospital to track staff and equipment in real time. Using a map-view computer display nurses can locate patients, staff or equipment anywhere in the hospital to facilitate timely care. The technology is also effective in infection control as it helps track contact with patients or equipment.

I recall the early pioneers in RTLS, who were split between two solutions: infrared and radio frequency. Texas Health Alliance has resolved the issue in favor of infrared, employing a system of wearable or embedded infrared tags on equipment or people and ceiling sensors located throughout the hospital. Special software interprets the data compiled by the array.

Finally, it wouldn’t be an all-digital hospital if it didn’t digitally welcome you.

Texas Health Alliance has also installed digital display technology for public-relations purposes. Giant touch-screen TVs sit in the lobby allowing curious visitors to review at a touch rosters of individual and corporate donors, honored contributors who have enabled the hospital to stand at the technological forefront of inpatient engagement and IT-enabled healthcare.