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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.

Rush University Medical Center Rolls Out OpenNotes

Posted on November 18, 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.

Back in 2010, a group of primary care doctors from three different healthcare organizations across the US came together to launch a project in which they’d begin sharing their clinical notes directly with their patients. The doctors involved were part of a 12-month study designed to explore how such sharing would affect healthcare. The project was a success, and today, 10 million patients have access to their clinicians’ notes via OpenNotes.

Now, Rush University Medical Center has joined the party. The 664-bed academic hospital, which is based in Chicago, now allows patients to see all of their doctor’s notes through a secure web link which is part of Epic’s MyChart portal. According to Internet Health Management, Rush has been piloting OpenNotes since February and rolled it out across the system last month.  Patients could already use MyChart to review physician instructions, prescriptions and test orders online.

If past research is any indication, the new service is likely to be hit with patients. According to a study from a few years ago, which looked at 3,874 primary care patients at Beth Israel Deaconess Medical Center, Geisinger Health System and Harborview Medical Center, 99% of study participants wanted continued access to clinician notes after having it for one year. This was true despite the fact that almost 37% of patients reported being concerned about privacy after using the portal during that time.

Dr. Allison Weathers, Rush associate chief medical information officer, told the site that having access to the notes can help individuals with complex health needs and under the care of multiple providers. “Research shows that when patients can access their physicians’ notes, they better understand the medical issues and treatment plan as active partners in their care,” she said. “When a patient is sick, tired or stressed during a doctor’s visit, they may forget what the doctors said or prescribed.”

I think it’s also apparent that giving patients access to clinician notes helps them engage further with the process of care. Ordinarily, for many patients, medical notes from their doctor are just something that they hand along to another doctor. However, when they have easy access to their notes, alongside of the test results, appointment scheduling, physician email access and other portal functions, it helps them become accustomed to wading through these reports.

Of course, some doctors still aren’t OpenNotes-friendly. It’s easy to see why. For many, the idea of such sharing private notes — and perhaps some unflattering conclusions — has been out of the question. Many have suggested that if patients read the notes, they can’t feel free to share their real opinion on matters of patient care and prognosis. But the growth of the OpenNotes program suggests to me that the effect of sharing notes has largely been beneficial, giving patients the opportunity not only to correct any factual mistakes but to better understand their provider’s perspective. As I see it, only good can come from this over the long run.