October 19, 2011
If a hospital room could speak, it would say things like: Keep my patients safe. Make my bed foolproof so that patients don't fall out. Keep those Latex gloves away from allergic patients. And make sure the patient on the left side of the room doesn't get the medication intended for the one on the right.
A recent visit to a digitally enhanced "smart room" at University of Pittsburgh Medical Center convinced me that some hospital rooms can, in fact, deliver on these priorities. These rooms, which are jointly funded and operated by UPMC and IBM, are called SmartRoom and use real-time location tracking devices to bring patient information from the EMR to computer screens in the patient's room. At the UPMC hospital I visited, clinicians were recognized by the room with the help of ultrasound-enabled badges, which then allowed them to access patient data. [ Which healthcare organizations came out ahead in the IW500 competition? See 10 Healthcare IT Innovators: InformationWeek 500. ] Smart room technology consists of three components: -- a patient screen, which lets patients identify their caregivers, see a list of the day's activities (scheduled lab tests, for instance), and access educational materials. -- a caregiver screen, which gives clinicians access to essential information, including allergies and medication regimens. This system also lets nurses and aides quickly document vital signs and complete basic tasks on a touch screen, which then updates the EMR. The system is intelligent enough to give different sets of patient data to different categories of providers. An aide responsible for turning a patient, for instance, would be told that the patient is allergic to latex and get reminded to put the bed rails up, but she would not see any details on medication dosages. -- the SmartBoard, which replaces the conventional dry erase board at the nursing station. It lists patients' names and their associated caregivers, and it updates the staff on new physician orders. These smart rooms also promise to speed up workflow. According to Smartroomsolutions, the technology is designed to eliminate between 50% and 70% of the "unnecessary effort associated with documenting routine clinical care." While I can't confirm those percentages, my visit to one of UPMC's smart rooms clearly demonstrated that they save time documenting interventions. In a typical medical surgical unit, RNs would have to write down all the steps they've taken on the patient's paper chart. If they have an EMR, they would still have to log in, enter a password, and start typing. No need for those steps in a smart room, which has already confirmed who the nurse is. And because the nurse is often checking off boxes on a touch screen, there's less need to write copious notes. Taking the technology to the next logical level, Smartroomsolutions has added some business rules that help prioritize a clinician's tasks. It is developing a workflow analytics module to let clinicians and managers know when staffers are falling behind. No, there aren't any robotic nurses to give the patient a bath. Nor should there be. But this technology can improve patient safety. It belongs in more hospitals.
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