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Technology Bolsters Inpatient Engagement, with Greater Focus on Well-being

6 Nov 2014 by Chuck Appleby

Dr. Karen DeSalvo, National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services, recently told me 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.”

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, has deemed the trend important enough to adopt the term “consumer” in place of “patient” as part of its overall strategic language.

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

In the hospital, technology enables inpatient engagement

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 patient engagement in a hospital 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 to help them physically navigate the complex hospital environment.

In Texas, tablets offer greater access/choices for patients

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, provides patients with touch screen tablets mounted on a swing arm near each bed in its med-surg, ICU, post-partum rooms and in the emergency department. Patients can use the Samsung tablets to access the Internet using a Google Chrome Web browser, visit their personal patient portal to view test results and medication lists, and schedule or view appointment dates.

The bedside tablets also contain special software that allows patients to adjust the room temperature, watch on-demand movies and order meals. The meal-ordering function is tightly integrated with the hospital’s Electronic Health Record (EHR), to ensure what patients order is compliant with their prescribed diets. They also can 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,” said 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. In addition to the mounted tablets, the hospital has several “floating” tablets to accommodate the more fluid environment of the emergency department. As the hospital expands this year, it will add another 20 tablets.

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

Families can locate loved ones during perioperative process

Texas Health Alliance is using other tools to bolster inpatient engagement. On the walls of its two surgery waiting rooms are 47-inch Family View Track Boards. These high-definition, flat-screen displays provide HIPAA-compliant information to families on where their loved ones are in the perioperative process — from preadmission, to postoperative recovery.

RTLS helps improve infection control and track contact

While RTLS helps caregivers and families track patients within the hospital for safety and communication, it can be used to provide 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 also is 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.

Digital displays greet visitors and honor donors

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

Texas Health Alliance has 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.