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Hospital App Helps Patients After Surgery

Posted on March 15, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Patients are very vulnerable after surgery. If they don’t follow post-surgical instructions, they may be readmitted (never a good thing for hospitals these days), and far worse, may suffer real harm.

Unfortunately, many patients don’t retain or follow doctors’ instructions on how to best recover from surgery, particularly if these instructions aren’t documented well.  For example, a 2015 study appearing in Anesthesiology concluded that only 60% of 519 surgery patients who got verbal post-operative instructions or annotated EMR records complied with medication instructions.

In an effort to improve stats like these, Chicago’s Rush University Medical Center has introduced an app designed to support patients in their post-surgical recovery process. The app, SeamlessMD, prompts patients to ask for reminders about their surgeon’s instructions, according to a HIMSS Future Care article.

Anthony Perry, MD, vice president for ambulatory care and population health at Rush, told the publication that his facility had already implemented protocols for enhanced recovery after surgery before the app was created. But the app has potential to move patients’ post-surgical recovery to the next level, Perry said. “It’s not only a neat technology, but a neat technology that’s truly aligned with our own goals,” he noted.

Dr. Perry believes that presenting prompts and reminders via a personal mobile device offers benefits traditional care instructions can’t, particularly when the app is placed on a patient’s phone. “There’s a bridge that a smartphone gives us into a person’s everyday life that we don’t have when they come visit us in the office,” he said.

Rush’s initiative comes as hospitals around the world consider the benefits of rolling out patient-oriented apps. For example, four National Health Services hospitals serving the United Kingdom are testing apps that monitor patient health at home.

The hospitals are testing two apps, one focused on managing gestational diabetes treatment and the other addressing COPD monitoring and care. (As one might expect, the diabetes app collects blood glucose readings and the COPD app oxygen saturation levels.) The pilot, which is still in its initial stages, has already seen some success. For example, the number of office visits by patients with gestational diabetes has fallen 25% since the app was released to such patients.

This may be the dawn of a new age for hospital use of mHealth apps, which has been at best at a trial-and-error stage for several years. While most hospitals and health systems have toyed with apps to some degree, in the past there was neither a clinical nor technical approach for them to adopt. So many initial app projects went nowhere.

But with evidence piling up that at least some approaches work – such as remote patient monitoring for chronic disease management, as described above – hospitals are beginning to see apps as a practical tool for improving outcomes. Meanwhile, as they’ve adopted mobile-friendly infrastructures, hospitals have become more capable of supporting hospital-developed apps effectively.

Of course, there’s probably a number of functions apps can perform which nobody’s pursued just yet. But with some early successes in place, my guess is that hospitals will try lots of new app projects going forward.

E-Patient Update: Hospitals Need Virtual Clinicians

Posted on July 20, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Hospitals have a lot to lose if patients are readmitted not long after discharge. But in most cases, their follow-up care coordination efforts post-discharge are perfunctory at best.

My husband’s experience seems to be typical: a few weeks after his discharge, a nurse called and asked perhaps five or six very broad questions about his status. I doubt such as superficial intervention has ever done much prevent a patient from deteriorating. But this dynamic can be changed. As an active, involved e-patient, I think it’s time to bring artificial intelligence technology into the mix.

In recent times, AI platforms have emerged that may offer a big improvement on the, well, largely nothing hospitals do to prevent patients from deteriorating after they leave the facility. In fact, artificial intelligence technology has evolved to the point where it’s possible to provide a “virtual clinician” which serves as a resource for patients.

One example of this emerging technology comes from AI startup Sense.ly, which has developed a virtual nurse named Molly. According to the company, Molly is designed to offer customized patient monitoring and follow-up care, particularly for patients with chronic diseases. Its customers include the UK’s National Health Service, Kaiser Permanente, San Mateo Medical Center, University of California San Francisco, Microsoft and Allscripts.

Molly, an avatar-based system which was designed to mimic the bedside manner patients crave, can access data to assist with real-time care decisions. It also monitors vital signs – though I imagine this works better with a remote connected device — and tracks patient compliance with meds. Molly even creates custom questionnaires on the fly to assess patients, analyzes those responses for risk, and connects patients directly to real- life clinicians if need be.

While this is admittedly a groundbreaking approach, some independent research already exists to suggest that it works. Back in 2011, Northeastern University researchers found that patients who interacted with virtual nurse Elizabeth were more likely to know their diagnoses and make follow-up appointments with their doctor, ZDNet reports.

And if you’re afraid that using such a tool exposes your facility to big legal risks, well, that’s not necessarily the case, according to veteran healthcare attorney David Harlow.

“The issue is always in the terms of use, and if you frame that properly – and build the logic properly – you should be OK,” Harlow told me. He concedes that if hospitals can be sued for patient care problems generated by EMR failures — which happens now and then — a cause of action could arise from use of virtual clinician. But my sense from talking with him was that there’s nothing inherently more dangerous about deploying an AI nurse than using any other technology as part of care.

Speaking for myself, I can’t wait until hospitals and medical practices deploy a tool like Molly, particularly if the alternative is no support at all. Like those who tested Elizabeth at Northeastern University, I’d find it much easier to exchange information with an infinitely patient, focused and nonjudgmental software entity than a rushed nurse with dozens or hundreds of other patients on their mind.

I realize that I’m probably ahead of the market in my comfort with AI technology. (My mother would have a stroke if you asked her to interact with a virtual human.) But I’d argue that patients like me are in the vanguard, and you want to keep us happy. Besides, you might be pleasantly surprised by the clinical impact such interventions can have. Seems like a win-win.