Wireless Technologies Answer the Call for Better Care
Cordless gadgets and smartphones have undoubtedly changed the way we live. Now, more physicians and facilities are welcoming wireless technology as another toolset for delivering better patient care. They’re tapping into time savings, low costs and easy access that wireless devices can offer. And with oncoming EHR adoption requirements, wireless technologies will play a greater role in clinical care as more patients remotely access their health data.
New York University (NYU) Langone Medical Center recently rolled out the first phase of its EHR system at its Trinity Center in Manhattan. The Langone Medical Center encompasses three hospitals with about 1,100 beds and 14,000 employees.
The center uses a single platform database system powered by Epic Systems, says Paul Conocenti, MD, senior vice president, vice dean and CIO at Langone. “Epic enables clinical access across the whole continuity of care that brings hospitals and doctors together,” says Conocenti. “Now we are creating mobility around that connectiveness and that’s where wireless technologies really come in.”
Langone uses unified communication on a single platform, which not only enables physicians to electronically share secure EHRs with other healthcare professionals across hospital floors and Manhattan city blocks, but also enables the wireless network to know which providers, in terms of proximity, would be more appropriate to contact should an emergency arise.
Physicians at Ball Memorial Hospital (BMH), a Clarian Health Partner in Muncie, Ind., use smartphones to send clinical care alerts through text messages. Dylnn Melo, director of clinical informatics at BMH, a Clarian Health Partner, says physicians in her facility receive notices through text messaging in 20 seconds or less when a patient needs immediate clinical care.
This is no small feat, considering that BMH’s 300- to 400-bed facility spans 1.2 million square feet. Ball employs a Cisco wireless network and centralized telemetry through a GE monitoring system, recently installed in the basement of the $120 million BMH South Tower, to monitor patient activity across the entire campus.
At BMH, Melo says, GE’s CARESCAPE mobile viewers provide authorized caregivers with remote access to monitoring data from a bedside unit or telemetry transmitters worn by the patient. Data are constantly transmitted to a central server that can be seen across the network via the mobile viewers, according to Melo. In an emergency, such as if a patient’s ventilator disconnects, messages from the ventilator will be sent over the wireless network to alert the assigned RN or RT by wireless voice over IP phone that he or she needs to care for a patient with a disconnected ventilator, Melo says.
Richard Pollack, MD, vice president and CIO at Virginia Commonwealth University (VCU) Health System, says advanced communications technologies are in use at VCU’s new Clinical Care Hospital, a $1.3 billion, 15-story healthcare academic medical center in Richmond, Va.
Using a converged distributed antennae system (DAS) from InnerWireless instead of relying on point solutions, “we are guaranteed 95 to 100 percent coverage wall to wall, floor to ceiling, with very little bleed over outside the building,” says Pollack. The system can support power as low as 400 MHz to 600 GHz covering telemetry, encompassing RFID tracking and injecting a cellular signal into the building for voice-over-IP wireless phones, according to Pollack.
VCU’s neo-natal intensive care unit went from having an open floor plan, “where an experienced nurse could tell from a glance that there’s an emergency situation, to having closed doors,” Pollack says. “We had to work with middleware companies such as Unite and Emergen to ensure alarms from GE monitors would be transmitted to the voice-over-IP phones that [alert the nurses] to emergency situations. It turned out well.”
Pollack’s facility, like Melo’s, is an academic medical center which employs computers-on-wheels (COWs). Using COWs and the wireless network, Pollack says, residents and staff are able to make rounds by wheeling the computer through the hospital floors and grabbing patient health data from the network as they walk from room to room.
James Walker, MD, chief health information officer at Geisinger Health System, notes that patients love to be involved with their clinical care process once they are invested in it. Geisinger Health System serves 42 clinical sites in 31 counties in rural Pennsylvania. Using an Epic EMR system, patients have access to a customized health record at any internet-capable computer.
“This technology ends up empowering the patient in ways that weren’t feasible before,” Walker explains. Patients are able to schedule flu shots, keep track of appointments and refill medications without leaving their home—a huge benefit to some patients who might otherwise drive one to two hours to receive chronic care at Geisinger.
In addition, empowering the patient and electronically storing health information lets physicians previously unaware of a patient’s medical history understand the patient more thoroughly in a time-efficient manner, says Walker. “For example, when an 82 year-old woman went to an emergency room several states away, physicians were able to look at her EMR,” he says. “The physicians understood her better and were able to administer appropriate care right away. Patients love that.”
The facilities at NYU have begun using Epic’s SmartChart portal as a means for patients to engage in their own clinical care. “Unless the EMR includes the patient, you are losing a valuable resource in the care process,” says Conocenti.
Both Conocenti and Walker claim patients save time and money by cutting out redundant tests. With electronic health information available to all of their health system’s physicians, the results are readily available.
Walker believes that patients’ increased use of their electronic health information also can lead to better care. A flu-shot notification initiative provides anecdotal evidence of this, he says. Geisinger automatically sent notifications to patients reminding them to get their flu shot. Although the healthcare system already beat the national average for patients getting flu shots, says Walker, “after we initiated electronic notifications, we increased our numbers by 15 percent.”
“Ward driving,” the practice of driving around hospitals and hacking into network systems, doesn’t worry VCU’s Pollack. “The distributed antennae system at the Clinical Care Hospital, unlike conventional point wireless bubbles, ensures there’s no leakage outside the hospital’s walls,” says Pollack.
Most facilities are keenly aware of the security issues surrounding the storage of sensitive, personal information online and are taking steps to safeguard patient data. At Geisinger, for example, the facility audits the people who can access personal health records using a guiding question, according to Walker: “Do they have a need to access that patient’s information?”
Conocenti at NYU says a single platform improves security. “There’s no doubt that there is unencrypted data in e-mail. With a single platform, the physicians and patients are connected through portals, therefore eliminating the need for e-mail,” he says. “So people are interacting in a more secure manner.”
With the rapid advances in wireless technologies, NYU is pondering global capabilities, says Conocenti. One of the facility’s next phases for its EMR implementation is to come up with ways its research mission can foster better care and engage patients who consent to share their electronic data to collaborate with national and world researchers.
“Research is becoming a team science,” says Conocenti. “This is just the beginning of a decade of advances in healthcare.”