Recent deployments of tablet computers in hospitals are improving the patient experience in many ways.
"I really enjoyed my week at the hospital," said no one ever. Hospital stays are not anyone's idea of a good time. It is possible to make the experience less unpleasant, though, with the help of technology. Hospitals are already making progress in that direction by providing patients with bedside tablet computers that provide information and communication options. However, there really is far more that hospitals can do with technology that integrates systems to improve efficiency and create a more patient-friendly environment.
Using tablets for updates and information
Having spent too many days in a hospital recently, I realize that not all hospital caregivers are consistent about updating the whiteboard with the names of those assigned to a patient, and some fail to introduce themselves to all their patients when they come on shift. The value of patients knowing who is on their team by name and face was pointed out in a study undertaken by the New York-Presbyterian (NYP) Hospital titled A Tablet Computer Application for Patients to Participate in Their Hospital Care. That's why the apps on the tablets at NYP -- as well as the Android app MyChart Bedside used by St. Rita's Medical Center -- show patients and/or their family members who's on their team.
Sending alerts without making noise
One of the most unpleasant aspects about hospitals is the constant noise, most of it from beeps and alarms. Bedside tablets can cut down on the beeps caused by patients calling nurses by offering direct messages with calls or texts. These direct messages deliver information more precisely and directly without the back-and-forth entailed in calling for a nurse, having someone come in to ask what is required, and then finally getting it.
In response to my questions about the tablets deployed at St. Rita's, Michelle Burtchin, the nurse and clinical manager who headed the pilot program for their use, explained that they make it possible for the patients to "alert the staff for simple, non-emergent requests" like a request for ice chips. That request will then appear on the computer screen at the nurse's desk without the need for any noises to alert them to a request. That's good, but it's not quite as effective as being able to reach a nurse on the floor on her own device, which is something that New York Presbyterian has set up for its tablets.
NYP's Corporate Director of Information Services in IT, Helen Kotchoubey, reports that the communication tools built into the tablet include "call your nurse" or "message your nurse" options. There are also a number of canned text messages patients can use to expedite simple requests, such as asking for another blanket. Such messages go straight to the nurses' cell phones. Kotchoubey says that the nurses insisted they wanted to be the first contact for patients. Only if the nurses are busy would the call or text be routed to the desk at the nurses' station.
The right data
Dr. Peter Fleischut, Associate Chief Innovation Officer at NYP, said that such routing is designed to get "the right data to the right person at the right time" for optimized "operational efficiency." One more advantage of using technology in an integrated system is that is automatically records events, which provides valuable data on response times and correlations between experiences and patient satisfaction rates. These data points can be used to plan for improving patient care.
Better alarm possibilities
The connectedness offered by this technology should also enable alerts from medical machines to go directly to the nurses' phones as well as to a central system, rather than setting off piercing alarms. While in the hospital, I heard IV alarms clamor on for several minutes just to be ignored by nurses on the floor. Most memorably, one jarred me awake at 2:15 a.m. and continued its unrelenting noise until I walked over to the nurse's station to get someone to come into the room and turn it off. If each machine communicates with the central system, both the alert and the time taken for response could be tracked, and that should result in improved accountability as well as a quieter environment for patients who need rest.
More options and less noise
As for generally improving the patient experience, tablets can be helpful as sources of quiet entertainment in place of noisy televisions. Like the individual screens for films that are now standard on flights, the tablets can operate with earphones so that one's roommates don't have to hear TV shows they are not watching. I haven't seen this use of hospital tablets considered yet, though there's no reason not to, especially when the tablet give patients full access to the web.
The feasible future
The full range of tablet usage described in this column is not yet a reality based on the information the NYP representatives gave me. The rosy picture painted by this article from the Wall Street Journal this past September about tablets being used by patients for surfing the web and making Skype calls has not yet been realized. However, the vision is expected to become reality soon, and there's also the possibility of other technological solutions coming online to improve the patient experience coming in the not-so-distant future.