DiversityNursing Blog

By Ilene MacDonald

Despite new technology and evidence-based guidelines, medical mistakes happen too frequently and may lead to as many as 400,000 preventable deaths each year.

But two new programs, launched at the University of Virginia Medical Center, offer a new approach to patient safety that may prevent medical errors, WVTF Public Radio reports.

This year the organization introduced a simulation lab in the pediatric intensive care unit. The "Room of Errors" features high-tech infant mannequins attached to monitors. When doctors and nurses enter the lab, they have seven minutes to determine what is wrong.

As part of a recent exercise, a doctor-nurse team worked together to spot 54 problems with the scenario, including the fact the ventilator wasn't plugged into the correct outlet, the heat wasn't turned on and the potassium chloride was programmed at the wrong concentration.

The interpersonal, team-based learning approach helps doctors and nurses improve their ability to make decisions together and communicate with one another, Valentina Brashers, M.D., co-director of the Center for Interprofessional Research and Education, an effort headquartered at UVa's Schools of Nursing and Medicine, told WVTF.

"Knowing that there are others that you can work to think with you and share with you their concerns as you work through difficult problems makes care provision a much more enjoyable and rewarding activity. It reduces staff turnover. It creates an environment where we feel like we're all in it together with the patient," she said.

The pilot proved so successful that the medical center intends to roll it out to the entire hospital.

In its quest to eliminate medical mistakes at the organization, UVa also launched a second patient safety initiative that calls for hospital administrators to meet each morning to talk about any problems that occurred in the previous 24 hours, according to a second WVFT article.

The "Situation Room" features white boards and monitors, where administrators review every new infection and unexpected death and then visit the places where the problems took place.

Sometimes the solutions are easy fixes, such as a receptionist who removed a mat that caused patients to trip at the entrance of an outpatient building. Others, caused by communication problems, are more complicated, Richard  Shannon, M.D., executive vice president for health affairs, told the publication. To address it, Shannon wants to shake up the medical hierarchy where the physician sits at the top.

"The physician may spend 20 minutes at the bedside a day. The nurse is there 24/7 and has about 13 times more direct contact with the patient than does the physician," he told WVFT. "You can't have someone at the head of the pyramid who is absent a lot of the time."

Finally, to encourage better communication among caregivers, patients and families, Shannon now encourages healthcare professionals to make rounds in the afternoon, when visitors are on premises.

Source: fiercehealthcare.com

By JAN HOFFMAN

How well can computers interact with humans? Certainly computers play a mean game of chess, which requires strategy and logic, and “Jeopardy!,” in which they must process language to understand the clues read by Alex Trebek (and buzz in with the correct question).

But in recent years, scientists have striven for an even more complex goal: programming computers to read human facial expressions.

The practical applications could be profound. Computers could supplement or even replace lie detectors. They could be installed at border crossings and airport security checks. They could serve as diagnostic aids for doctors.

Researchers at the University of California, San Diego, have written software that not only detected whether a person’s face revealed genuine or faked pain, but did so far more accurately than human observers.

While other scientists have already refined a computer’s ability to identify nuances of smiles and grimaces, this may be the first time a computer has triumphed over humans at reading their own species.

“A particular success like this has been elusive,” said Matthew A. Turk, a professor of computer science at the University of California, Santa Barbara. “It’s one of several recent examples of how the field is now producing useful technologies rather than research that only stays in the lab. We’re affecting the real world.”

People generally excel at using nonverbal cues, including facial expressions, to deceive others (hence the poker face). They are good at mimicking pain, instinctively knowing how to contort their features to convey physical discomfort.

And other people, studies show, typically do poorly at detecting those deceptions.

In a new study, in Current Biology, by researchers at San Diego, the University of Toronto and the State University of New York at Buffalo, humans and a computer were shown videos of people in real pain or pretending. The computer differentiated suffering from faking with greater accuracy by tracking subtle muscle movement patterns in the subjects’ faces.

“We have a fair amount of evidence to show that humans are paying attention to the wrong cues,” said Marian S. Bartlett, a research professor at the Institute for Neural Computation at San Diego and the lead author of the study.

For the study, researchers used a standard protocol to produce pain, with individuals plunging an arm in ice water for a minute (the pain is immediate and genuine but neither harmful nor protracted). Researchers also asked the subjects to dip an arm in warm water for a moment and to fake an expression of pain.

Observers watched one-minute silent videos of those faces, trying to identify who was in pain and who was pretending. Only about half the answers were correct, a rate comparable to guessing.

Then researchers provided an hour of training to a new group of observers. They were shown videos, asked to guess who was really in pain, and told immediately whom they had identified correctly. Then the observers were shown more videos and again asked to judge. But the training made little difference: The rate of accuracy scarcely improved, to 55 percent.

Then a computer took on the challenge. Using a program that the San Diego researchers have named CERT, for computer expression recognition toolbox, it measured the presence, absence and frequency of 20 facial muscle movements in each of the 1,800 frames of one-minute videos. The computer assessed the same 50 videos that had been shown to the original, untrained human observers.

The computer learned to identify cues that were so small and swift that they eluded the human eye. Although the same muscles were often engaged by fakers and those in real pain, the computer could detect speed, smoothness and duration of the muscle contractions that pointed toward or away from deception. When the person was experiencing real pain, for instance, the length of time the mouth was open varied; when the person faked pain, the time the mouth opened was regular and consistent. Other combinations of muscle movements were the furrowing between eyebrows, the tightening of the orbital muscles around the eyes, and the deepening of the furrows on either side of the nose.

The computer’s accuracy: about 85 percent.

Jeffrey Cohn, a University of Pittsburgh professor of psychology who also conducts research on computers and facial expressions, said the CERT study addressed “an important problem, medically and socially,” referring to the difficulty of assessing patients who claim to be in pain. But he noted that the study’s observers were university students, not pain specialists.

Dr. Bartlett said she didn’t mean to imply that doctors or nurses do not perceive pain accurately. But “we shouldn’t assume human perception is better than it is,” she said. “There are signals in nonverbal behavior that our perceptual system may not detect or we don’t attend to them.”

Dr. Turk said that among the study’s limitations were that all the faces had the same frontal view and lighting. “No one is wearing sunglasses or hasn’t shaved for five days,” he said.

Dr. Bartlett and Dr. Cohn are working on applying facial expression technology to health care. Dr. Bartlett is working with a San Diego hospital to refine a program that will detect pain intensity in children.

“Kids don’t realize they can ask for pain medication, and the younger ones can’t communicate,” she said. A child could sit in front of a computer camera, she said, referring to a current project, and “the computer could sample the child’s facial expression and get estimates of pain. The prognosis is better for the patient if the pain is managed well and early.”

Dr. Cohn noted that his colleagues have been working with the University of Pittsburgh Medical Center’s psychiatry department, focusing on severe depression. One project is for a computer to identify changing patterns in vocal sounds and facial expressionsthroughout a patient’s therapy as an objective aid to the therapist.

“We have found that depression in the facial muscles serves the function of keeping others away, of signaling, ‘Leave me alone,’ ” Dr. Cohn said. The tight-lipped smiles of the severely depressed, he said, were tinged with contempt or disgust, keeping others at bay.

“As they become less depressed, their faces show more sadness,” he said. Those expressions reveal that the patient is implicitly asking for solace and help, he added. That is one way the computer can signal to the therapist that the patient is getting better.

Source: Nytimes.com

DURHAM, N.C. — Before scrubbing in on a recent Tuesday morning, Dr. Selene Parekh, an orthopedic surgeon here at Duke Medical Center, slipped on a pair of sleek, black glasses — Google Glass, the wearable computer with a built-in camera and monitor.

He gave the Internet-connected glasses a voice command to start recording and turned to the middle-aged motorcycle crash victim on the operating table. He chiseled through bone, repaired a broken metatarsal and drilled a metal plate into the patient’s foot.

Dr. Parekh has been using Glass since last year, when Google began selling test versions of its device to thousands of handpicked “explorers” for $1,500. He now uses it to record and archive all of his surgeries at Duke, and soon he will use it to stream live feeds of his operations to hospitals in India as a way to train and educate orthopedic surgeons there.

“In India, foot and ankle surgery is about 40 years behind where we are in the U.S.,” he said. “So to be able to use Glass to broadcast this and have orthopedic surgeons around the world watch and learn from expert surgeons in the U.S. would be tremendous.”

At Duke and other hospitals, a growing number of surgeons are using Google Glass to stream their operations online, float medical images in their field of view, and hold video consultations with colleagues as they operate.

Software developers, too, have created programs that transform the Glass projector into a medical dashboard that displays patient vital signs, urgent lab results and surgical checklists.

“I’m sure we’re going to use this in medicine,” said Dr. Oliver J. Muensterer, a pediatric surgeon who recently published the first peer-reviewed study on the use of Glass in clinical medicine. “Not the current version, but a version in the future that is specially made for health care with all the privacy, hardware and software issues worked out.”

For his study, published in The International Journal of Surgery, Dr. Muensterer wore the device daily for four weeks at Maria Fareri Children’s Hospital at Westchester Medical Center in New York. He found that filming rapidly drains the battery and that the camera — which is mounted straight ahead — does not point directly at what he is looking at when he is hunched over a patient with his eyes tilted downward.

He also had to keep the device disconnected from the Internet most of the time to prevent patient data and images from being automatically uploaded to the cloud. “Once it’s on the cloud, you don’t know who has access to it,” Dr. Muensterer said.

Google has yet to announce a release date for Glass, and the company declined to comment on how many of its testers were doctors or affiliated with hospitals. But “demand is high,” said Nate Gross, a co-founder of Rock Health, a medical technology incubator. “I probably get asked every few days by another doctor who wants to somehow incorporate Glass into their practice.”

And already, outside hospitals, privacy concerns have led some bars and restaurants to ban the devices. Legislators have proposed restrictions on the use of Google Glass while driving, citing concerns about distraction. Doctors, too, are raising similar concerns.

The Glass projector is slightly above the user’s right eye, allowing doctors to see medical information without turning away from patients. But the display can also be used to see email and surf the web, potentially allowing doctors to take multitasking to dangerous new levels, said Dr. Peter J. Papadakos at the University of Rochester Medical Center, who has published articles on electronic distractions in medicine.

“Being able to see your laparoscopic images when you’re operating face to face instead of looking across the room at a projection screen is just mind-bogglingly fantastic,” he said. “But the downside is you don’t want that same surgeon interacting with social media while he’s operating.”

Indeed, similar technology has not always had the smoothest results. Studies have found, for example, that navigational displays can help surgeons find tumors, but they can also induce a form of tunnel vision, or perceptual blindness, that makes them more likely to miss unrelated lesions or problems in surrounding tissue. And in aviation, pilots who wear head-mounted displays that show crucial flight information can lose sight of what is happening outside their windshields, said Dr. Caroline G. L. Cao, who studies image-guided surgery at Wright State University.

“Pilots can get so focused on aligning the icons that help them land the plane,” she said, “that they miss another plane that is crossing the runway.”

One doctor who does not allow the device in his practice, Dr. Matthew S. Katz, the medical director of radiation oncology at Lowell General Hospital in Massachusetts, said that security and distractions were primary concerns. A doctor wearing Glass could accidentally stream confidential medical information online, he said, and patients might not feel comfortable with their doctors wearing cameras on their faces.

Until Glass has been better studied in health care and equipped with safeguards, Dr. Katz said, doctors should be forced to check their wearable computers at the clinic door.

“From an ethical standpoint, the bar is higher for use in a medical setting,” said Dr. Katz, who is also an outside adviser for the Mayo Clinic Center for Social Media. “As a doctor, I have to make sure that what I’m doing is safe and secure for my patients — ‘First, do no harm.’ Until I am, I don’t want it in my practice.”

Bakul Patel, the senior policy adviser at the Food and Drug Administration’s Center for Devices, said the agency would regulate only those Glass software programs that function as medical devices, the same approach it takes on health applications on hand-held devices.

“The glasses have been on our radar and we’re excited about it,” Mr. Patel said.

Hospitals that are experimenting with Glass say they are doing so very carefully — obtaining patient consent before procedures, using encrypted networks, and complying with the federal regulation that protects patient privacy, known as Hipaa.

Medical software developers say they, too, have security and privacy in mind. Pristine, a company based in Austin, Tex., createdan app that lets emergency room nurses and doctors beam in specialists for consultations. The company plans to sell a customized version of Glass directly to hospitals. It erases Google’s software and configures the glasses with its own Hipaa-compliant programs.

Another company, Augmedix, which has done pilot tests of Glass at medical centers in the San Francisco area, said patients were informed that their doctors would be wearing the device. In a study of 200 cases, only two or three patients asked that their doctors remove it, said Ian K. Shakil, a co-founder of Augmedix.

Some hospitals see Glass as a relatively low-cost and versatile innovation, much like smartphones and tablets, which more than half of all health care providers use to get access to patient data and other medical information.

But hand-held devices are not very useful in the sterile world of surgery. Because Glass is voice-activated and hands-free, it may be particularly well suited for the surgical suite, where camera-guided instruments, robotics and 3D navigation systems have been commonplace for years.

Dr. Pierre Theodore, a cardiothoracic surgeon at the University of California, San Francisco, calls wearable computers “a game changer.”

“In surgery, Google Glass is incredibly illuminating,” said Dr. Theodore, who uses Glass to float X-rays and CT scans in his field of view at the operating table. “It helps you pinpoint what you’re looking for, so you don’t have to shift your attention away from the operation to look at a monitor somewhere else.”

At Indiana University Health, Dr. Paul P. Szotek, a Level 1 trauma surgeon, is developing an app for Glass for use by paramedics.

The app streams a live feed from the glasses to the closest emergency rooms, so that doctors can see accident victims at the scene and give paramedics potentially lifesaving instructions — like when to go directly to a Level 1 trauma center.

“Last year, I lost a lady on the table from a spleen injury that was absolutely survivable because she was taken to a local hospital and then the delay was over two hours to get her to me,” Dr. Szotek said. “With this wearable technology, we’ll be able to assess patients on the scene and decrease the mortality associated with trauma significantly.”

Dr. Szotek met with Google in March to discuss his software, called 1st Sight. He and other Glass-wearing surgeons recently founded a group — the International Society for Wearable Technology in Healthcare — that is holding its first meeting in Indianapolis in July.

At Duke, Dr. Parekh performs back-to-back surgeries on most days, wearing the Glass headset as he moves from one patient to the next.

About six years ago, he founded a charity with the goal of advancing foot and ankle surgery in India. He travels there every year with a team of expert surgeons to hold clinics and training sessions for local orthopedic surgeons.

In January, at a conference in Jaipur, Dr. Parekh performed surgery and used Glass to stream the procedure on his personal website. That day, the site drew in so many visitors from India and elsewhere that it crashed.

“I’ve been even more excited about Google Glass since then,” he said.

Source: nytimes.com

by David Tennebaum

The single-use timer that will wholesale for about a dollar is designed to make a nurse’s life easier.In medicine, time isn't just money: it can mean the difference between life and death. Clot-busters must be given in the first hour of arrival in a hectic emergency room. Intravenous medications can spoil, and catheters that overstay their welcome invite infection.

The nursing profession is facing multiple challenges in the years ahead. From the Affordable Care Act and its focus on the introduction of electronic medical records, to the aging US population, many people question what healthcare will look like in the future.

What remains certain, however, is the future of nursing is bright. Nurses are a vital part of the health care system and a valuable resource for our society.

What can nurses and nursing industry expect in the years ahead?

At this point in time:

- One third of nurses are over 50 years old.
- 1/3 of the current workforce will reach retirement within the next decade or so.
- Nurses work more hours now than they did in 2000.

How the Health Care Reform Will Affect Nurses

Nurses will be prepared to take on more responsibility than they currently have.

This will be helpful, since:

- Within 15 years, the country will be short 150,000 doctors.
- Primary Care Physicians (PCP) will be in the greatest demand, with an estimated 45,000 needed by 2020.
- Millions of new patients are expected to flood the healthcare system as new insurance takes hold.
- More nurses will work in rural areas where the nurse may be the only health care provider available.

Ever-Changing Technology

As we move into the future, nursing will change thanks to new technology, such as:
- The Computerized Provider Order Entry (CPOE) will reduce medication errors by about 55%.
- Medication will be scanned before the patient takes it, to ensure correct dosage and type.
- Transcriptions can be replaced by CPOE.
- Electronic medical records will link hospitals, physician’s practices and home healthcare agencies.

To learn more about the future of nursing, checkout the infographic below created by Norwich University’s Online Master of Science in Nursing program.

The nursing profession is facing multiple challenges in the years ahead. From the Affordable Care Act and its focus on the introduction of electronic medical records, to the aging US population, many people question what healthcare will look like in the future.

What remains certain, however, is the future of nursing is bright. Nurses are a vital part of the health care system and a valuable resource for our society.

What can nurses and nursing industry expect in the years ahead?

At this point in time:

- One third of nurses are over 50 years old.
- 1/3 of the current workforce will reach retirement within the next decade or so.
- Nurses work more hours now than they did in 2000.

How the Health Care Reform Will Affect Nurses

Nurses will be prepared to take on more responsibility than they currently have.

This will be helpful, since:

- Within 15 years, the country will be short 150,000 doctors.
- Primary Care Physicians (PCP) will be in the greatest demand, with an estimated 45,000 needed by 2020.
- Millions of new patients are expected to flood the healthcare system as new insurance takes hold.
- More nurses will work in rural areas where the nurse may be the only health care provider available.

Ever-Changing Technology

As we move into the future, nursing will change thanks to new technology, such as:
- The Computerized Provider Order Entry (CPOE) will reduce medication errors by about 55%.
- Medication will be scanned before the patient takes it, to ensure correct dosage and type.
- Transcriptions can be replaced by CPOE.
- Electronic medical records will link hospitals, physician’s practices and home healthcare agencies.

To learn more about the future of nursing, checkout the infographic below created by Norwich University’s Online Master of Science in Nursing program.

The nursing profession is facing multiple challenges in the years ahead. From the Affordable Care Act and its focus on the introduction of electronic medical records, to the aging US population, many people question what healthcare will look like in the future.

What remains certain, however, is the future of nursing is bright. Nurses are a vital part of the health care system and a valuable resource for our society.

What can nurses and nursing industry expect in the years ahead?

At this point in time:

- One third of nurses are over 50 years old.
- 1/3 of the current workforce will reach retirement within the next decade or so.
- Nurses work more hours now than they did in 2000.

How the Health Care Reform Will Affect Nurses

Nurses will be prepared to take on more responsibility than they currently have.

This will be helpful, since:

- Within 15 years, the country will be short 150,000 doctors.
- Primary Care Physicians (PCP) will be in the greatest demand, with an estimated 45,000 needed by 2020.
- Millions of new patients are expected to flood the healthcare system as new insurance takes hold.
- More nurses will work in rural areas where the nurse may be the only health care provider available.

Ever-Changing Technology

As we move into the future, nursing will change thanks to new technology, such as:
- The Computerized Provider Order Entry (CPOE) will reduce medication errors by about 55%.
- Medication will be scanned before the patient takes it, to ensure correct dosage and type.
- Transcriptions can be replaced by CPOE.
- Electronic medical records will link hospitals, physician’s practices and home healthcare agencies.

To learn more about the future of nursing, checkout the infographic below created by Norwich University’s Online Master of Science in Nursing program.

A study commissioned by Herman Miller Healthcare showed that nurses walk up to four miles a day on their shift. Much of this is due to supplies not being readily available and the need for better communication, like keeping tabs patient location. Technology is beginning to make the job of the nurse easier by giving them better information, leading to less steps.

Real Time Locating Systems

Real Time Locating Systems, also known as RTLS, uses small tags attached to devices, making them easier to find. For example, a typical scenario finds the nurse walking from room to room to locate a blood pressure machine for use in their rounds. With an RTLS tag, the nurse can locate the machine on a dashboard at the nurses station. They may still have to walk to the end of the unit to retrieve the machine, but it will be a direct route.

Patient Locators

Similar to RTLS are devices that patients can wear to indicate their location, according to Villanova University. Tracking down a patient can be time consuming on a busy nursing unit. A nursing aid that has taken a patient to physical therapy and radiology calls up for the patient to come down for a test. The locator tags can prevent the hunting down of people who know where Mr. Johnson is by indicating that he is in PT.

Another use suggested for these locator tags is in monitoring patients who may wander out of their rooms and be difficult to track. Mental health units, neurology units and Alzheimer's treatment centers benefit from these devices.

Tools in Your Pocket

With smartphones and tablets, you can have a number of tools in your pocket to help you get through your day easier.

The Pocket Pharmacist is available for your iPhone, and gives you a drug reference list with interactions. Calculate by QxMD uses current clinical decision trees to determine the best course of treatment.

Other tools to help you with your nursing career include a wage calculator by Intuit to help you precisely calculate your time and paycheck amount, which is handy for those extra shifts and holiday hours you're asked to work. ShiftPlanning is a nursing shift scheduling tool that the charge nurse will find useful for tracking time and adjusting schedules.

Mobile Devices and EHR

Electronic Health Records (EHR) became mandatory as of January 1, 2014, notes USF Health. Institutions must begin making patient records available online. A study by American EHR on more than 800 health practitioners showed that 33 percent with access to EHR used a tablet to access patient information.

As tablets and mobile charts become more available on nursing units, the constant walking back and forth between patient and their information is reduced. Devices such as the iPad EHR by drChrono allow bedside status updates to be made once vitals and other observations are completed.

Patient Workflow

Nursing Critical Care highlights a software system used in a Pennsylvania hospital that helps save steps during a patient's discharge. When the patient is ready to be released, the nurse uses a workflow panel to contact the transportation department to pick up the patient. Once they have arrived and are leaving with the patient, they use the panel to contact the cleaning crew. Once the room is clean, they use the panel to contact the admitting patient, to tell them the room is ready. This keeps the nurse from walking to the room to see the status, so they can report back to admitting that the room is ready for the next patient.

Nurses earn a mean annual wage of $67,930, according to the Bureau of Labor Statistics, and
the demand for compassionate and skillful nurses is expected to grow by 26 percent between 2010 and 2020. The journey to become a nurse requires a bachelor's degree or an associate's degree, which means two to four years in the classroom as well as clinical experience in a hospital or clinical setting.

If you are a busy mom already juggling kids and work, finding the time to complete a nursing degree may seem impossible, but the wide selection of online Nursing programs available and the recent expansions in learning technologies are making this career path more feasible.

Online Degrees

There are online programs available that allow students to study both the science and art of nursing. In addition to covering diagnoses, anatomy, drugs, and other science-based topics, aspiring nurses can also learn interpersonal skills like how to be sensitive to patients and their families. These programs appeal to busy people who don't have the time to attend classes during conventional hours, but they are often used by nurses who are ready to take their career to the next level as well.

Masters in Nursing

Nurse practitioners armed with masters degrees can diagnose, treat, and manage a number of diseases and conditions, according to the National Library of Medicine. Nurse practitioners work in cardiology, women's health, or other areas of health care, and they usually earn more and have more responsibilities than their nursing peers. Some nurses even use their master's degree as a launchpad into the administration side of healthcare.

Simulation

Thanks to simulations, many student nurses can now bypass the requirement to shadow professional nurses. This makes pursuing a nursing degree easier for students who are juggling multiple responsibilities or nurses who live in remote areas with few shadowing opportunities.

Advance Healthcare Network reports that nurses can simulate oxygen delivery, work with infusion pumps, and practice other procedures in simulation learning centers. In addition to making learning more flexible for students, simulations also give nurses the chance to think more critically in a safe environment. Students can take a few moments to be extra thoughtful about a situation, without the pressure of worrying that they may lose a real patient with the wrong decision.

Apps Lighten the Load

With your bag already packed to the brim with sippy cups, extra clothing, and other kid-related supplies, you probably don't even have the energy or the strength to haul a massive bag of nursing textbooks around with you. Luckily, there are a host of apps, designed to lighten the load for nursing students.

Apps like Nursing Central have copies of essential reference books like Davis' Drug Guide, selected MEDLINE journals, Taber's Medical Dictionary, and others on them. Essentials for busy students, these apps also prepare aspiring nurses for the use of apps professionally. Recent studies indicate that 90 percent of healthcare professionals avoid misdiagnoses and prescription mishaps when they double check things with apps, according to Medlineplus. Studies like these prove that much of the technology that can help busy people to get nursing degrees will soon be popping up in professional settings as well.

By Erin Tolbert, RN, MSN for MidlevelU.com

While there are plenty of apps out there promising to make my life as a nurse practitioner easier, once downloaded to my phone they go largely unused.  Rarely do I calculate pediatric dosages with special programs, rather I go straight for pen and paper.  I don't check apps streaming medical news- the last thing I want to do after work is be inundated with more information from the world of medicine.  But, this week I stumbled across a true winner in the healthcare app world.  PingMD, an app that facilitates patient-provider texting offers real value to NPs.

When I heard about the new PingMD app, I was thrilled that someone had finally come up with a way to bring patient-provider communication into the 21st century.  The medical world is notoriously behind technologically and I was excited by the prospect of weaving my favorite form of communication, texting, in with my work.  So, I decided to contact the app's creator, neurosurgeon Dr. Gopal Chopra, to get the story behind PingMD.  Here's what he had to say about bringing texting to the patient-provider relationship.

What inspired you to develop a way for providers and patients to text?

Dr. Chopra explains that his wife is a pediatrician who initially sparked his idea for the texting app.  She described what she saw as "spillover".  Office visits with patients are getting shorter and shorter.  When patients don't retain the information they get from visiting their healthcare provider, or are unable to reach them during a time of need, they end up in the emergency department.  If she had known about the patient's problem, Dr. Chopra feels that she could have prevented the patient from going to the emergency room, and probably answered their question or given them direction for their medical problem in just a few seconds.  But, without an easy way to communicate, she is unable to avert unnecessary emergency department visits. 

Dr. Chopra also describes the experience in his own clinic. The nurse practitioner in Dr. Chopra's neurosurgery office takes about 80 percent of patient calls. He describes that it only takes this NP about 30 seconds to decide the best course of action for the patient. The problem with patient-provider communication isn't that providers don't know the best course of action for their patients, it’s the communication system that's broken.  PingMD, Dr. Chopra's new app solves this problem.

We all know HIPAA is a major barrier to streamlining patient-provider communication. Does PingMD comply with HIPAA?

When I ask this question, Dr. Chopra brings up an excellent point.  In order for communication to be secure, it must do so from both the patient and provider's end.  This is why texting between patients and providers can be difficult.  Even if the provider's phone is secure, the patient's phone may not have necessary privacy and security measures in place.  The PingMD app addresses this issue.

PingMD complies with HIPAA regulations through password protection, requiring authentication and encrypting stored information on the end of the patient and provider. 

How much does PingMD cost patients?  Providers?

PingMD creates obvious value for medical practices, so I decide to get to the bottom-line asking Dr. Copra about pricing.  I'm shocked by his reply.  The PingMD app is free!  Both healthcare providers and patients are welcome to create PingMD accounts free of charge and begin texting.

PingMD does charge for one service.  The app has the ability to integrate with electronic medical records recording the text conversation in the patient's personal medical record.  This saves you as a provider from going back to record the conversation later, well worth the expense. 

Most providers don't like taking calls from patients after-hours.  Isn't allowing your patients to text you even more intrusive to your private life?

I think I have thrown Dr. Chopra a zinger here. During my time working as a primary care nurse practitioner, I dreaded hearing my work phone ring. It meant a great deal of work to follow. First, I would talk with the patient, then possibly call a medication in to the pharmacy, followed by opening my laptop to record the interaction...on a Saturday evening.  I imagine that by making communication easier, communicating with patients will require even more of my weekend time. Quickly, I see that I am mistaken.

Dr. Chopra explains that texting patients makes being on-call a more palatable prospect. Rather than interrupting your day to answer the phone, PingMD allows you to answer a patient's questions with a simple text message. If your practice pays for PingMD, this message is then integrated into the patient's health record eliminating the need to record the interaction. Texts from patients using PingMD are confined within the app keeping your personal and work-related texts separate.  Overall, texting is a more efficient, less invasive way to communicate with your patients than phone. 

How have providers seen PingMD improve their practice?

Dr. Chopra says providers of all backgrounds, from primary care to anesthesiology clinics, love to ping.  Not only does it make communication with patients easier on the provider-side, it also increases patient satisfaction.  Sounds like a win-win situation. 

The idea behind PingMD is simple, but seamless patient-provider texting just might revolutionize your practice. 

By Jacqueline Lee

Doctors may have led the medical BYOD revolution, but nurses have followed their examples. According to a report from Spyglass Consulting group, 69 percent of nurses bring their own devices to work.

According to another survey from Absolute Software, half of hospital staff members bring mobile devices to work access e-mail and calendar applications. However, 36 percent use their mobile phones and tablets to access patient information.

The winner, in many cases, is the patient. Nurses often use their devices to access clinical reference materials right at the point of care. They also use devices to coordinate care with other clinicians.

Overall, nurses that exercise their BYOD power report a greater sense of autonomy in the workplace. They are more comfortable using their own devices, they feel a sense of control over computing and they report an improvement in work-life balance.

Many analysts predict that mobile devices will spell the end for overhead paging systems in hospitals. They may also replace nurse call systems that don't quite get the job done. To make the change as smooth as possible, however, hospitals and medical clinics will have to take an attitude of, "If you can't beat 'em, join ’em." Intel has made an interesting video on the subject:

For example, if staff members are demanding BYOD in a hospital, then the hospital's CIO and IT department need to develop a BYOD strategy that protects patient information. The BYOD strategy should be integrated hospital-wide so that staff members have a unified method of communicating with one another.

A BYOD-friendly hospital, for example, would not only be able to use smartphones to page nurses and to coordinate care. They could transmit alerts from different areas of the hospital as well as communicate lab results and radiology reports. Nurses and doctors could also use their own devices to place orders for important medical tests and to access patient records.

In a world where HIPAA violations garner heavy government fines, medical facilities have to be savvy about how staff members are using patient information. No personal mobile device, for example, should store patient records.

Hospitals that embrace BYOD can make the work of doctors and nurses much easier. In the end, happy medical staff translates to better patient care.

Source: HealthTech

by Meghan Kelly

Nurses are the unsung heroes of the hospital who navigate crappy software on outdated hardware to keep you healthy — and it needs to stop.

Executives from Cedar’s-Sinai and Kaiser Permanente explained at VentureBeat’s HealthBeat conference that technology innovators need to start focusing on new, consumer-like user experiences and better end-to-end communications software and hardware. Otherwise, nurses are going to start using their own devices, which creates obvious issues in privacy and data management.

“We’ve done a lot of ethnographic research of our nursing areas. … It’s still amazing when you walk into that environment that there’s still a tremendous amount of inefficiency, redundancy.” said Julie Vilardi, a registered nurse, as well as the executive director of Kaiser Permanente’s clinical informatics and strategic projects. “User experience it’s really critically important. Because of the consumer experience now is pretty slick, when you get into the walls of the hospital [consumer-grade experiences are] beginning to be the expectation, and we so don’t deliver it right now.”

She explained how nurses manage everything having to do with your hospital stay from the medication you’re prescribed, to food you eat, and the baths you take. They typically have four or so patients who may not even be in the same area of the hospital. These nurses often have to tote around workstations on wheels, and clunky communications devices that simply aren’t effective, but because of their ability work in a chaotic environment, they’re making due.

Darren Dworking, the chief information officer for Cedar’s Sinai Medical Center, said the center recently deployed 800 iPhones to its staff. He thought clinicians were going to shy away from using texting for communications, but he was wrong.

“A lot of our clinicians are beginning to use technology in other aspects of their life … they want to know how come they can’t have a healthcare version of that,” said Dworking. “Giving them something akin to a cordless phone isn’t going to do it for communications.”

Vilardi says she hopes to see developers create a consumer-grade iPhone experience for patient management and electronic medical records (EMR). She wants to be able to push an icon to get a patient assessment, and believes we’re very close to that reality. Dworking, however, encourages innovators to look beyond the EMR, which he says the window has closed on. Instead, he hopes that people will find a new way of displaying data and improving communications.

According to Vilardi, iOS phones and tablets really are the devices of choice in hospitals today. This is because vendors in general are taking more advantage of iOS than Android. She explained that Kaiser is looking for ways to integrate Android, however.

Nurses, speak up! We want to hear from you about your experiences with workstations on wheels, apps, and more. Comment below!

This article originally appeared on VentureBeat

Source: MedCity