Emerging Systems develops iPad, iPhone app for hospital use

Emerging Systems has developed a new iPad and iPhone app that will allow clinicians to both view and update patient details while on the move.

Emerging Systems, which supplies the EHS clinical information system to St Vincent's & Mater Health in Sydney and throughout public hospitals in South Australia, is trialling the new app with clinicians at St Vincent's before a general release later this year.

Emerging Systems' commercial director Richard Hutchinson said the app was designed on the basis of giving clinicians the ability to capture information and have ready access to it when they need it.

“We created the app to be something that was highly usable for the clinicians, not only to view information, which is very important as obviously you want access to the right information for the right patient when you need it, but we also wanted it to be a tool for clinicians to interact such as creating clinical orders online if you want them,” Mr Hutchinson said.

“The app has the ability to generate any kind of clinical order, be it pathology or radiology, and we can make that happen straight away. Conversely, as you can order things you can also get the results back. You can get them in number or tabular format and you can see lab results over time. Obviously anything abnormal is highlighted in red and we can graph those same results over time in numbers and in graph format.”

The app will allow users to instantly view a snapshot of the patient's clinical details, enabling a quick care review. It also includes functionality to input patient observation data, view patient lists, view medication and allergies, and create and view progress notes and clinical messages using text or voice recognition.

While it is mainly doctors who have taken to the iPad with enthusiasm, Mr Hutchinson said the app had been designed with nurses and allied health professionals in mind as well.

“Nurses and allied health professionals are the people who are very interested in carrying something with them to tick off their care guides and pathways,” he said. “They also want to actually sit down with and involve patients in their care. This app allows for undertaking risk assessments as well as recording a range of observations such as vital signs.”

Any new data uploaded to the app is immediately synchronised with the patient's EMR, he said. The EHS clinical information system is web-based and can be accessed from work stations around the hospital. The same database is underpinning this app, so any information generated through it will be fed immediately back into the database.

Another driver behind the creation of the app was to allow consultant physicians, particularly those in private hospitals, to record their progress notes whenever they like. “This will take the information outside the four walls of the hospital,” Mr Hutchinson said.

“Clearly there are security implications and we are very much aware of those, and we are building security features into the application, but the doctors, particularly in the private hospital setting, spend little of their time actually in the hospital. This is about giving them access to their patient information wherever they are.”

Emerging Systems has also taken advantage of the increasing reliability of voice recognition software and has added a voice to text function to allow users to create and view progress notes and clinical messages using text or voice recognition.

Voice recognition software specialist Nuance Communications has provided Emerging Systems with its specialist medical dictionary and online voice dictation systems.

“We have the ability to generate a progress note or a clinical message and we can compose it and it brings up a keyboard, so they can go to the trouble of typing if they so wish, and if they have a Bluetooth keyboard attached to their iPad that would make it a bit easier,” Mr Hutchinson said.

“But there is also a little red button at the top of the keyboard where you say what you need to say, it goes away and brings back hopefully most of what you've said. It brings it back on screen and you have the ability to edit that and do what you need to do.”

The app also allows users to send clinical messages and to view information generated by diagnostic and medical devices such as ECGs. “We've done some work with Welch Allyn and we can actually take a feed automatically from those sorts of devices straight into our system now, so in that case the iPad would just be a viewer of our information without you having to record it,” he said.

“We are also trying to take on board what the Australian Commission on Safety and Quality in Health Care [recommends] about noticing the deteriorating patient and doing something about it quickly. We've got this concept within our system of setting up parameters and if something falls outside parameters with the patient, we can automatically generate alerts and messages. Within our main app we can automate alerts to a number of places so it's not just the treating physician, maybe it's a care team be they doctors or nurses."

Emerging Systems has also built functionality into the app to allow users to follow NSW Health's “Between the Flags” clinical emergency response procedure under its pre-arrest criteria for escalation (PACE) policy.

Mr Hutchinson said new Apple-based developments were expanding the use of iPads and iPhones for clinical applications, including a docking station he saw at HIMSS in Las Vegas in February that can hold and recharge up to 30 iPads at a time. Emerging Systems is also exploring the use of a heavy-duty case to protect the delicate iPad device when dropped.

“We've tended to be agnostic on the devices that people use so we've been through iterations with things like tablet PCs. We don't care what people use as long as they are using our system. There has always been weight issues, cleanliness issues and dropping issues and obviously the cost of the device primarily. I think more and more the iPad is something that is becoming a lot more ubiquitous.”

Emerging Systems is currently in beta testing of the app with clinicians at St Vincent's Hospital in Sydney, aiming to get feedback before a general release. Mr Hutchinson said he expected this would take three to six months.

Posted in Australian eHealth

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