Inpatient Innovation

This past week was South by South West (SXSW) in Austin.  During the event there was a challenge by the University of Texas Dell Medical School to come up with innovative ideas to transform healthcare.  There are some amazing ideas and you can read about them more on twitter #healthhive or @dellmedschool.  I wasn’t at SXSW, but the challenge started my creative brain working.   Here is one idea worth considering.

Increase engagement for hospital INPATIENTS!  There is lots of talk about opening outpatient medical records so patients have access to their care plans.  This is a good idea.  Unfortunately, it has been side-tracked and slow to develop because of barriers.  First, outpatients are busy.  We have work, kids, church, and other social obligations to take care of.  All of that adds up to less time to decipher an outpatient record, or figure out access.  Second, outpatient records are technically complex.  You’re combining multiple sources from geographically disperse areas and different platforms.

Now think about these problems in an inpatient context.  Most patients and their families have a massive amount of unused time in their hospital rooms.  We’ve improved patients’ satisfaction by giving them restaurant style menus and on demand TV.  We haven’t capitalized on the opportunity to use this time to get them involved in their care.  Let’s give patients tablets with their medical records, copies of radiology reports, lab results, and lists of their medications.  Sure, most people will not have the medical literacy to understand every detail, but isn’t that what we’re trying to improve?  This is our opportunity to get patients interested in increasing their medical literacy.  In addition to technical resources, we have disease educators on staff who can reinforce information or answer questions regarding the data patients are reading.  We have a captive audience, let’s teach them.  Let’s encourage them to ask questions while they are in our care.

Today, if you order an item on Amazon here is what happens.  Instantly you receive an order confirmation.  Followed shortly by a status e-mail through which you can track the package through the system.  The application will update you every step of the way through delivery confirmation at your doorstep.  Why can’t the same happen in the hospital setting?

During consultation with the provider a patient asks for “something for pain”.  The provider verbally agrees to write the order.  As soon as the order is written the patient receives a notification.  Now the patient has an expectation of what they will receive as well as a chance to confirm this is what they agreed on.   Additionally, it provides the patient with confirmation that they are being cared for even when a provider is not in the room.  Next, the patient will receive a notification that the order has been received by the pharmacy and is processing, processed, and ready for delivery.  All of these can be paired with expected transaction times.  Finally, when the nurse receives the medication to the floor or removes it from a medication cabinet, the patient is notified that the medication will be to them shortly.

If one thinks about the primary causes of medication errors, we can see that many of them have just been mitigated by making the patient an active participant.  All accomplished simply by providing the patient more education and awareness.

Of course there are hundreds of opportunities to increase patient visibility.  What’s the wait time to get to MRI?  Why is my nurse not answering the call button? Is she in a different room?  When is my provider planning on seeing me today?  When do I need to order lunch?  When will lunch be to my room?

Sure the white board in each patient’s room is nice, but we have much better technologies we can provide the patient to fully engage in their care.  These technologies are accessible today and the barriers which persist on the outpatient side are reduced with in house care.  If we can review, purchase, and track pillows from Amazon, we can do the same with healthcare.