Hospitals want to increase patient satisfaction and remain guardians of infection control. Patients want to be informed, they want access to the internet, they want to connect with their family at home. All the things you would expect if you went to a coffee shop.
Up to now, this has been the domain of large service providers, however thing are changing in the USA and Europe. The iPad is the dominant tablet and new software now allows the iPad to work seamlessly in a hospital environment.
It is now possible for patients to access their Epic My Chart record from an iPad and view movies while they are waiting for a scan. French hospitals use this with children to reduce the their tension before an operation.
So, if you are a hospital and want to get started. Here how you do it:
Trying it out in a small wing of the hospital is the way to go. If you have 10 iPad Air 2’s or the iPad Pro 9.7″ we can help. We provide the FlipPad which is a medical grade case for the iPad. In the USA, we will offer Trial FlipPads free for 30 Days. This web link is offered for people who want to get started immediately.
The most common issue that you may encounter. “people will steal the iPads!” we can lock them in the case and cable them to a bed if required. Some hospitals want an integrated solution. We are interested in your opinion of a new product in the picture below. We have combined the solution into a lockable bedside stand.
We think hospitals in the USA and Europe are moving in this direction.
If you work in a hospital and want to understand how you can build the solution.
In an industry that changes by the hour, how will the shift to mobile healthcare affect you?
1. Interacting with patients
It seems that patients don’t remember much of their verbal communication with healthcare workers, in fact in one study, recall after consultations was only14%. Using an iPad, clinicians can show rather than tell, using professionally produced images and video to communicate medical information more effectively and memorably—that 14% recall rose to 85% when visual aids were used. The relatively recent jump in processing power that came with the iPad Pro is being thoroughly exploited by interactive anatomy apps like those by 3DMedical. Amazingly detailed 3D representations of the whole body can be displayed and manipulated, and using the Apple Pencil, the clinician can precisely cut away tissue to demonstrate an injury or surgical procedure—they can even add lumps and bumps to simulate various pathologies. All of this, along with annotations and a voice recording of the consultation, can be stored and then shared with the patient in their copy of the app or integrated into their electronic records.
2. Making decisions
The way healthcare workers make decisions is changing and that is likely to continue thanks to the multitude of iPad apps designed to make their decisions more informed, accurate and reliable. One of the most popular of these clinical decision-support apps, UpToDate, was found by Harvard researchers to reduce hospital stays and mortality by small (−2% and up to -0.6%, respectively) but significant amounts (372,500 days/year and 3833 lives/year). Other apps are created to help doctors with specific issues as they emerge. For example, in response to recent controversy over statin intolerance and side-effects, the American College of Cardiology produced an app to help doctors make systematic, evidence-based decisions when faced with patient concerns over these issues. In an increasingly complex and systematized future, such support apps, whether general or specialized, will become increasingly effective and increasingly essential for healthcare workers.
3. Handling healthcare-associated infections
Despite their benefits, iPads and other mobile devices represent a challenge for the control of healthcare-associated infection—a huge problem affecting around 1 in 20 patients. For example, a recent US study across two hospitals found that around 25% of the tested ‘portable electronic devices’ (mainly tablets) were contaminated with pathogens, and a smaller US hospital study from 2013 found that 3 out of the 20 iPads (15%) they tested were contaminated with MRSA. Luckily, such pathogens can be removed by wiping the device with bleach; however, it appears that very few healthcare workers clean their mobile devices regularly. This will need to change, and with the arrival of iPad covers specially designed for clinical use, there are no more excuses. The FlipPad protective case, for example, is waterproof, resistant to chemicals like bleach, and incorporates an antimicrobial coating into the screen protector. Cultural, procedural and technological shifts will all be important in ensuring that progress toward a paperless, device-enhanced future can continue in parallel with progress in infection control.
4. Spending time and money
Less miscommunication, less paperwork and less time acquiring and entering information should mean serious time savings for healthcare workers, and a 2012JAMA study agrees. It found that 78% of resident physicians reported increased efficiency after receiving an iPad, saving about an hour a day, and 68% of house staff noted that delays in patient care were avoided thanks to the iPad. Time being money and all that, financial savings should follow for healthcare providers—or at least better value for their money. Other savings can come from switching to electronic textbooks and training materials and replacing dedicated medical-image viewers with much cheaper iPads (where possible). Furthermore, in the US, providers now face financial penalties for not making the transition to fully electronic health records, which will likely drive a corresponding transition towards iPads and their like.
5. Doing paper(less)work
Major healthcare providers throughout the world are pushing a transition to paperless record systems, and iPads are facilitating this huge change. After all, they are the obvious replacement for the countless charts, files and forms flying about every hospital and clinic—many of which have to be later transcribed into a computer anyway. Some might think that signing documents would be present a problem here, but electronic signatures have been legally binding for over a decade in most countries. On the other hand, patient information is highly sensitive and protected by law, so mobile devices and their clinical users will need to adapt to constraints and concerns relating to privacy and cyber security.
This post is sponsored by the FlipPad – The antimicrobial iPad case for the Apple iPad Air 2 and 9.7inch Pro.
Smart phones, tablets and other mobile devices are everywhere you turn in a modern healthcare facility, and although they can provide great benefits for how staff and patients interact with healthcare information, they can also provide homes for wandering pathogens.
When we consider mobile technology’s widespread use by both patients and healthcare workers, inside and outside of healthcare facilities, and their regular and extensive contact with the hands —and even the ears, mouth, nose and hair for phones— it becomes obvious that they could present aproblem for infection control. Nearly all mobile devices will contain detectable levels of microbes unless recently disinfected and a number of studies have demonstrated the presence of pathogens (including multidrug resistant bacteria) on the mobile devices of patients and healthcare workers. For example, a Turkish study from 2011 found that mobile-phone contamination rates were 39.6% and 20.6% for patients and healthcare workers, respectively; and a UK study in the same year found that 12% of patients’ phones harboured pathogens known to cause HAIs. Although less well studied, the situation is similar for tablet devices, which are a recent US study across two hospitals found that around 25% of the tested ‘portable electronic devices’ (mainly tablets) were contaminated with pathogens, and a smaller US hospital study from 2013 found that 3 out of the 20 iPads (15%) they tested were contaminated with MRSA; the latter also found that wiping the iPad with bleach removed all the pathogens under examination, including C. difficile spores.
Despite the potential effectiveness of such disinfection methods, a recent systematic review found that only 8% of healthcare workers regularly cleaned their mobile phones, and a the above study of ‘portable electronic devices’ found that only 35% cleaned their devices at least weekly. The fight against HAIs will need to include a significant cultural shift and much stronger implementation of mobile-device-related protocols. To facilitate these changes, various products have been developed to make mobile devices more compatible with infection-control procedures via the use of antimicrobial materials and watertight, protective casings —see our own FlipPad for example. Further development and adoption of such procedures and technology will be key to maintaining the current downward trend in HAI incidence.
Healthcare-associated infection remains a massive problem that is continually evolving in terms of both pathogen biology and the ways in which infection is spread through clinical environments. However, it is also a highly manageable problem when appropriate systems, behaviours and equipment are widely adopted. This is, of course, a lot easier said than done, but it’s definitely worth the effort!