Enhancing bedside manner with iPad.
“Not only has iPad increased efficiency from a provider perspective — it’s increased engagement between the provider and patient.”
Dale Potter, Senior Vice President Strategy and Transformation, The Ottawa Hospital
Bedside care is a vital part of health care professionals’ relationships with their patients. But the staff at The Ottawa Hospital found that modern technology sometimes made those interactions more difficult. “Since the introduction of technology in this industry,” Senior Vice President Dale Potter explains, “physicians have been tethered to devices like PCs and forced to go seek information. Even a laptop wasn’t truly mobile.”
This inability to bring information to the bedside meant physicians had to constantly shuttle between patients and tethered PCs to get status updates, schedule surgeries, prescribe drugs, view X-rays and perform other important tasks.
When Apple introduced iPad, physicians at The Ottawa Hospital knew they’d found a solution. With iPad, the hospital’s doctors and nurses have bedside access to everything they need, and can remain in contact with patients and their families while viewing information that is critical to their care.
“They can answer patients’ questions immediately and make decisions about what’s going to be done, with the most current information available,” says Dr. Glen Geiger, Chief Medical Information Officer. “Nothing beats being able to use an app to pull up an X-ray on the device.”
Increased Patient Interaction
Physicians at The Ottawa Hospital have started using iPad in innovative new ways. They can use the built-in iPad camera to photograph a patient’s wound during treatment, and store the image in the patient’s electronic medical record for future reference.
Using iPad, physicians can show patients the progress of their recovery right at the bedside, Dr. Geiger notes. “I can say, ‘Here’s what your wound looked like three weeks ago.’ I’m showing them what it looked like then and what it looks like today.”
iPad fits physicians’ workflows in many ways, Potter says: “The form factor of iPad is very attractive. The screen size is optimal. There’s almost instant access to information. Battery life exceeds the length of a shift. It’s critically important for a physician to be able to know that they can rely on that device, work for an entire shift and provide the same level of care to all their patients.”
Substantial Time Savings
The Ottawa Hospital has also developed an in-house app called the Clinical Mobile App. The app facilitates three major aspects of physicians’ daily workflows: accessing patients’ clinical information, viewing clinical images such as X-rays and CT scans, and ordering clinical tests and prescriptions.
iPad and the Clinical Mobile App enable physicians to significantly reduce the time they spend reviewing patients’ cases before making their rounds each morning. “This would take several hours,” Dr. Geiger says. “We would just be sitting in the room going over each case.” The process was so time-consuming that some non-critical care patients often didn’t get to see their physicians that day.
But iPad and the Clinical Mobile App have changed all that. “Now we meet first thing in the morning, make sure we have a complete record of all the patients and immediately start to see them,” says Dr. Geiger.
By eliminating lengthy meetings and the need to shuttle between patients and tethered PCs, Potter estimates the physicians save approximately two hours per day in their clinical care activities. “Not only has iPad increased efficiency from a provider perspective — it’s increased engagement between the provider and patient,” he says.
“Developing on the iOS platform is actually fairly quick. We’re talking days and weeks as opposed to months and sometimes years.”
Valérie Gamache-O’Leary, Chief Information Officer, The Ottawa Hospital
Quick Development Times
In addition to the Clinical Mobile App, the hospital has developed three other custom apps: a pain study app to document a patient’s pain thresholds and determine proper treatment; a hand hygiene app to record and report on hand hygiene compliance; and a patient rounding app with a standard set of questions that nurses ask patients on a daily basis, so the answers are recorded in a consistent way.
“Developing on the iOS platform is actually fairly quick,” says Valérie Gamache-O’Leary, Chief Information Officer. “Compared to applications in other environments, you’re able to iterate through versions of software, get them into production and test them very, very quickly. We’re talking days and weeks as opposed to months and sometimes years.”
A Hospital-Wide Solution
The Ottawa Hospital has thousands of iOS devices in circulation. Physicians, pharmacists, nurses and executives rely on iPad, and many other employees also use iPhone and iPod touch. “A housekeeper can say, ‘I’m in this room, I’m at this bed and it’s ready for a patient,’ and that information can be immediately transmitted from their iPod touch or iPhone,” Potter says.
Among the hospital’s executives, iPad is a key part of the drive toward paper-free meetings. “Everyone has an iPad,” says Potter. “We can intercommunicate with each other. We can share documents. There really is no reason for us to have paper in our meetings.”
“I believe iPad represents the future of patient-centred care at The Ottawa Hospital.”
Dr. Glen Geiger, Chief Medical Information Officer, The Ottawa Hospital
The Future of Patient Care
As Potter walks through the hospital, he finds physicians engaging with patients the way they used to many decades ago. “As I observe the physicians doing their work, they’re at the bedside interacting with patients and family members,” he says. “There’s an intimacy there that wasn’t possible before iPad.”
In fact, he adds, “The riskiest thing I could do in my position as CIO at The Ottawa Hospital is try to take iPads away from my users!”
iPad and apps help physicians at The Ottawa Hospital interact more effectively with patients and provide more immediate, focused treatment. “iPad and apps have changed the way we deliver care,” Dr. Geiger says. “It’s the foundation for patients becoming more directly engaged with their own health care. I believe iPad represents the future of patient-centred care at The Ottawa Hospital.”
- Clinical Mobile App - provides access to patient records and order entry
- Pain Scale Survey - Assesses pain management for inpatients
- Prevalence Survey - Tracks important quality indicators
- Hand Hygiene - Real-time hand hygiene auditing app
- Patient Rounding - Used during patient interviews to document feedback