Transcript Slide 1

Real World Benefits and
Challenges of Deploying Mobile
Applications in an Acute Care
Setting
e-Health 2013: Accelerating Change
Sandra Moro – Senior Manager, IMT SickKids
May 28th, 2013
Faculty/Presenter Disclosure
Nothing to disclose
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The Hospital for Sick Children
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Founded 1875
Tertiary Care University Hospital
350 Paediatric beds
Annual:
• 14,092 Admissions
• 386,864 Clinic Visits
• 58,761 Emergency Visits
• 11,340 OR Cases
Inpatient
6,248
Day Surgery 5,092
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Specialty Areas
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18 Bed Med/Surg ICU
18 Bed Cardiac CCU
48 Bed Neonatal ICU
Haem/Onc - 35 beds
• 275 new cancer cases annually
(20 per cent of all new Canadian
paediatric cancer cases)
• Other Specialities
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Electronic Record
• Laboratory results 1970’s
• Computerized Provider Order Entry 1992
• PACS 1999
• SCM Phase 1 - 2005 Patient Lists – Labs
• SCM Phase 2 – 2008
• Order entry
• Nursing Care Plans and eMAR
• Clinical Documentation – limited
• ICUs on SCC – Order entry on Paper
• Hybrid Electronic/Paper Record
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Core Electronic System
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Allscripts – SCM version 5.5
(Upgrade to version 6.0 Summer 2013)
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Ambulatory Clinics (2013/2014)
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Critical Care (2014)
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Patient ADT System (Fall 2013)
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Pharmacy bi-directional Interface
(2014)
Modules:
• SCM Acute Care
• Order Reconciliation Manager
(ORM)
• Rx Writer
• Health Manager
• Secure Health Messaging
• Facility Tracking Board
• Registration & Scheduling
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Point of entry for clinical
information
Platform for the hospital wide
Electronic Patient Record:
Order entry
Laboratory results
Clinical documentation
Access to data from other
sources
• Radiology reports and
images
• EPC
• Clinical decision support
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Mobile Application Strategy
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Mobile Application Framework
• A five-step process, which outlines how to get started with key contacts,
development guidelines, developer resources, and instructions for mobile
device use
Industry experts are recommending that all organizations develop a framework
as it is important to ensure alignment with the organization strategic directions
and the IMT strategic plan
For key clinical applications, work with vendors to understand their strategy and
roadmap for mobility
For other applications (do not exist), develop in-house or partner with third
parties
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• Agile development approach is used to develop applications as quickly as
possible
• Due to the dynamic environment which is rapidly changing with respect to
both hardware and software, development approaches have to change
Currently have 48 mobile solutions at various stages of development
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Mobile Application Deployment - Pilots
• Two vendor supplied clinical applications were deployed as part of the
mobile efforts at SickKids:
• GE Centricity Mobile Access (Mobile PACS) and Allscripts Sunrise Mobile
MD
• Both applications were implemented and deployed in a pilot phase, to
clinicians across the organization
• The goal of each project was to assess the ease-of-use and
intuitiveness of the specific mobile application, and to assess the
integration of mobile technology/devices into the clinician workflow at
SickKids
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Mobile PACS
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Provides access to view radiology images and reports from Centricity
PACS
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Supports a broad range of modalities
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Facilitates consultation with colleagues, review of information with
patients/parents, and access to images during rounds
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Application was piloted with a group of 15 clinicians in the Diagnostic
Imaging department
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Collaborated with the vendor and volunteered to be the beta site which
resulted in getting a better version of the application
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SickKids was the first hospital in Canada to implement
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Mobile MD
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Integrates with Sunrise Clinical Manager (SCM)
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Provides users with access to patient information and lab
results
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Initial deployment view-only
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Pilot deployment included 20 participants from a crosssection of health care providers
• Physicians
• Nurse Practitioners
• Pharmacists
• Dieticians
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Approach
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Standard project management methodology was used to deploy
mobile clinical applications
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Information Services collaborated with Diagnostic Imaging and
clinician leads to leverage existing technology already proven, and
in-use at SickKids
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The clinician leads were instrumental in promoting the application to
other clinician users which resulted in quick adoption and acceptance
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The applications had to meet the clinician requirements and address
requirements for security and privacy
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Project management methodology and integrated quality
management processes provided a robust structure to help the
project team achieve the desired result and meet deadlines
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Benefits
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Access to information at the point-of-care
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Intuitive, easy to use
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Portability
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Real-time access to information from anywhere in the hospital; improved efficiency
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Facilitates inter-professional collaboration in the delivery of care
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Supports resident teaching workflows
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Increases ability to discuss and review information with patients and their families
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Compliance with privacy legislation; no data retained on mobile device
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Challenges
• Health care provider expectations
• Mobile version of the application should have all the functionality
available on the desktop version
• Health care sector should be aligned with other sectors given the
proliferation and use of mobile devices and apps
• Hospital’s wireless infrastructure should be ubiquitous
• Pressures on health care application vendors to rush to market their
mobile app
• Limited functionality is available on the mobile version
• Need for flexibility with application design
• Rapidly changing and expanding mobile market (multiple device
vendors, multiple platforms)
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Lessons Learned & Conclusions
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Deployment of mobile technology has become an organizational priority and a
necessity to provide superior services, effectively respond to evolving patients
and care givers needs and achieve strategic goals of the organization
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Successful introduction of new mobile technology requires:
• Organizational focus on key priorities
• Meaningful staff involvement and teamwork
• Collaboration with internal and external stakeholders
• Effective communication
Smart technology and smart devices provide organizations the opportunity to
implement innovative solutions to optimize the delivery of patient care
Need to leverage smart mobile technology and the opportunities it brings to
deliver higher quality care, more efficiently and effectively, which will enable
“the right care, at the right time, and in the right place”, and ultimately improve
the health system overall
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