Tablets aren't just for doctors anymore


Where: St. Rita's Medical Center, a 425-bed acute care hospital in Lima, Ohio, that is part of Catholic Health Partners (CHP).

The issue: Improving patient knowledge, communication and satisfaction.

Background

A sample screenshot from the patient tablets Courtesy of Catholic Health Partners
A sample screenshot from the patient tablets. Courtesy of Catholic Health Partners.

When Stephen Beck, MD, FACP, chief medical information officer for Catholic Health Partners, heard that the medical software company Epic was working on a new technological tool to engage and educate inpatients, he was ready to sign up. “A couple of years ago they came up with this concept based on interviews they had done with patients about what was challenging with care,” Dr. Beck said.

He met with some of the developers of the software, and next thing he knew, St. Rita's Medical Center was signed up to pilot test it. “We didn't necessarily intend to be the first in the world on this, but we were,” he said.

How it works

The new software, called MyChart Bedside, runs on Android tablets. Beginning last August, St. Rita's staff began distributing tablets, loaded with the software, to patients admitted to a cardiac step-down unit who agreed to participate in the trial.

Nurses briefly trained patients on the program, which opens with a page showing the patient's diagnoses, medications and recent vital signs. Using the touch screen, the patients can navigate to features including a personalized schedule, photos of the staff caring for them, and education, including videos, about their conditions or medications. The educational materials are provided by a third-party vendor.

“In some respects, it's replacing the white board in the patient's room. They can see everything on the handheld device that used to be on the board: who's taking care of me today, what my vitals are, what my recent lab tests are, maybe even when I'm going to get my medications,” said Dr. Beck.

The device is more interactive than a white board, however. Using it, patients can make requests (for an extra blanket, a cup of coffee, or some ice chips, for example), send nonurgent questions to nurses, and add items to their schedule. “If the family was coming back and wanted to remind Mom or Dad or the team when they are coming to visit, they could add that to the schedule,” Dr. Beck said.

The devices also connect to the Internet, so patients can use them to check email and surf the Web if they want, but this feature has mostly been of interest to younger rather than older patients, Dr. Beck said.

Results

Even the oldest patients have successfully used the overall program, though. “The very first patient was technically challenged,” said Dr. Beck. “He wasn't very comfortable with computers, but he said the one thing that I wanted to hear him say: It was easy for him to use.”

Patients generally have had favorable reactions to the tool. “We had nothing but positive feedback from patients,” said Dr. Beck. Official measurements of the pilot's success, including the effects on patient satisfaction, staff satisfaction and readmissions, were to be tallied after its completion in January.

Anecdotally, hospital clinicians have noticed effects. “They're more engaged patients,” said Dr. Beck, who has practiced as a hospitalist. “We found the patients were asking smarter questions and becoming more involved in their care because they had the tools that brought them up to a higher level of understanding.”

The program has also smoothed more basic communication. “It turns out a lot of the patients were afraid to use the call button. They didn't want to bother the nurse,” said Dr. Beck. Using the tablet, patients could ask for a cup of coffee or a change in the lighting without interrupting the nursing staff.

Next steps

As the data are analyzed from the pilot, Dr. Beck and other program leaders will decide how to move forward.

“Identifying the most appropriate-use case…Is it a unit of patients that need much more focused information, like the cancer care units or cardiac units? I don't think it's a device that we'll use in every patient room,” he said.

But, he added, as the cost of tablets decreases, they may be available to a broader patient population. “Right now, my intent is to roll this out to our other facilities with the appropriate-use cases and continue to expand as budgets allow,” said Dr. Beck.

Words of wisdom

“Leveraging new technology to enhance patient interaction in their own care is an important step for all facilities,” Dr. Beck said.