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Mobility helps our docs provide faster, better care

Posted Jun 25 2013 5:11pm

by Mony Weschler

Here at Montefiore Medical Center we incorporate leading-edge healthcare technology systems. Our clinicians handle a high volume of patients and rely on information systems to maintain and consistently strengthen the quality of care.

In the 1990s, we were one of the earliest adopters of electronic medical records (EMR) and computerized physician order entry (CPOE)--driven by the expanding continuum of care and an increasing number of clinicians working across multiple facilities, as well as government requirements such as Meaningful Use.

Today our challenge is to reliably deliver that data to physicians regardless of their physical location in ways that fit and enhance their workflow.

As an integrated healthcare delivery network spanning four campuses and more than 130 locations, our physicians frequently travel across sites and work remotely from their medical offices. This creates an obvious and critical need to effectively mobilize patient data to ensure our physicians can provide the right care decisions at the right time, whether they are in the hospital, at their remote office or virtually anywhere else.

We believe when leveraged effectively, mobility can result in a host of benefits--including the faster, more informed clinical decisions that can lead to shorter diagnosis and treatment times. We put this belief to the test when we implemented a mobility strategy in the cardiology department.

When we started this undertaking, we knew we needed to provide clinicians with a user experience on their tablet or smartphone that matches their experience sitting at a workstation. We initially used a portal-based remote access solution for a large portion of viewing data on tablets, but saw the opportunity to provide a smoother experience with native applications to view diagnostic-quality, near real-time patient data on any mobile device.

To evaluate mobility solutions, we identified the core requirements to be security and availability on virtually any device. To achieve the highest level of security, we did not want patient data to be stored on the device, but available in near real time with authentication for access. We also needed the application to be compatible with the most popular platforms, including iOS, android and Windows, to support the bring-your-own-device approach that is commonplace with our physicians, as well as across the healthcare industry.

After an exhaustive search, we were able to deploy mobile applications to deliver patient data, including ECGs, to physicians on smartphones and tablets.

Having anytime/anywhere ECG access for cardiologists improved patient throughput and flow in the emergency department, telemetry and critical care areas. Our mobile strategy had a particular impact on acutely ill patients with complex dysrhythmias. Timely cardiology involvement in such cases has reduced time to treatment and contributed to a reduction in false positive activations of the cath team.

With ECGs available more quickly than ever before, the cardiology department can make more informed decisions in ways that can improve public health by minimizing damage during the acute phase of illness.

Identifying and deploying the applications best suited to give our physicians an on-the-go experience that could match the usability of a mouse and keyboard without being tethered to their workstations was only phase one of our mobile strategy.

In our ongoing mission to improve patient care, we already are looking to the next phase, which will include connecting mobile applications so physicians have a single sign-on for all patient data sources, eliminating the need to launch each application separately. We also are planning to connect EMR and medical device data in one mobile solution, further improving how our physicians access data--and ultimately resulting in higher quality care.

Mony Weschler is chief applications strategist and architect at Montefiore Medical Center in the Bronx, N.Y.

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