As more health systems and hospitals across the country invest in digital health resources, initiatives have been launched in an attempt to ease all aspects of patient care.
Becker's reached out to healthcare leaders on the clinical and IT sides to get their perspectives on how the industry's digital shift is affecting patients and providers. Nine leaders shared their insights with Becker's via email on the effects of digital innovation on patient care.
This is part one of a two-part series. For part two, Becker's asked executives how such initiatives are perceived by clinical leaders.
Note: Responses were lightly edited for length and clarity.
Q: How have tech initiatives made patient care easier to provide?
Chero Goswami. CIO at UW Health (Madison, Wis.): As the COVID-19 pandemic stretched the resources of many hospitals, UW Health expanded the use of a program started in 2008 where intensive care nurses and doctors "beam" into hospitals with little or no ICU capacity to treat patients requiring intensive care. UW Health nurses and doctors virtually monitor every aspect of a patient's care from a specially designed room in coordination with nurses and doctors in the partner hospital. Each virtual ICU station has a bank of video monitors that show information like vital signs, patient medical records, and the ability to enable live, remote-controlled camera feeds to visualize the patient. From the beginning of the COVID-19 pandemic in 2020 to July 2022, the eICU program helped about 1,700 COVID-19 ICU patients at partner hospitals, reducing transfers and allowing patients to stay closer to home.
We are also currently testing a process to improve the admission process for surgical patients through technology. UW Health is piloting programs to have a nurse call the patient or have patients fill out the assessment online in advance. This is in the beginning phase, but early data show this innovation is reducing the intake time by approximately 15 minutes per patient, which is not only satisfying to patients but also provides a significant leap in efficiency by dealing with some of the workforce shortage challenges and allowing clinicians to operate at their highest form of license.
Geeta Nastasi, RN. Chief Nursing Informatics Officer at NewYork-Presbyterian (New York City): There is no end in sight to the digital disruption occurring in healthcare or consumerization. NewYork-Presbyterian has embraced this opportunity thoughtfully from an integrated systems perspective with clinician and consumer centricity and quality outcomes in mind. Having a clear digital vision and mindset guides health technology investment, which ultimately benefits patients.
Application rationalization and platform integration have made it easier to take care of patients across the continuum of care. An example of this is the shift from seven to just a single electronic medical record, which also serves as the standardized registration and revenue-cycle system for the enterprise. This harmonizes care for both employees and consumers of care at our facilities. A large-scale technology initiative like this that brings people, processes and data together is powerful in itself, but its true potential is that it's a strategic building block to reimagine care with other transformative innovations.
For instance, telehealth accounted for about 60 percent of outpatient visits in early 2020 and around 18 percent of the current monthly volume. Notable among our virtual offerings, the pharmacy department recently launched a telepharmacy program focused on discharge medication counseling. Pharmacists are notified of pending discharges and provide remote patient counseling to patients and family members.
Rollout of an interactive patient engagement system with TVs is underway across our 4,000 beds. This has integrations with numerous systems such as dietary and the EMR. It will include a streamlined patient whiteboard designed to foster collaborative care by engaging patients and families and the entire staff during an inpatient stay by sharing information.
Clinical mobility using mobile devices at the point of care is a game changer. Moving away from a shared to a 1:1 mobile device strategy, NYP has deployed about 35,000 smartphones equipped with administrative and patient care apps. Portable and convenient, it has improved workflow efficiencies by enabling real-time access to clinical alerts, clinical information such as lab results, retrieving and performing documentation and greatly enriching communication. Staff can quickly launch the interpretive services app at the bedside and collaborate using secure chat and voice calling. To put this in perspective, NYP end users send over 200,000 secure chats daily, and about 72 percent of conversations are attached to a patient.
Jonathan Austrian, MD. Associate Chief Medical Information Officer, Inpatient Informatics. Adam Szerencsy, DO. Medical Director of Ambulatory Clinical Informatics. NYU Langone Health (New York City): Technology has given us the flexibility to provide world-class care to our patients both while hospitalized and in their homes. Secure messaging among members of a patient's treatment team within the EHR unites clinicians. Communication and coordination are critical for interdisciplinary teams caring for complex patients with urgent needs, and ensure consensus toward a safe discharge.
After discharge, our patients connect with us both physically and virtually. Telemedicine and remote patient monitoring allow us to track patients' health most effectively as they return to their daily lives. For example, we can now send certain patients home with blood pressure cuffs, which integrate readings into the EHR, allowing for the real-time fine tuning of their medication regimen remotely instead of waiting for the next office visit. We can also keep a close eye on our postoperative patients using electronic tools for pain assessment, monitoring progress and escalating any issues to their care team.
Justin Singer, MD. Director of Vascular Neurosurgery at Spectrum Health Medical Group (Grand Rapids, Mich.): Earlier this year, Spectrum Health was the first in Michigan and among the first in the nation to begin using robotics in neurointerventional procedures. The Corindus CorPath GRX will help us drive and steer catheters into the brain to treat devastating diseases like stroke or brain aneurysms. And while the technology helps our neurosurgeons do their jobs more efficiently and effectively, what's truly exciting is the long-term potential of the technology. Through research and continued development, the equipment can be used remotely. Time is of the essence when treating a stroke or aneurysm, so the technology could save lives, particularly in remote or rural areas where treatment often is delayed because patients must be transferred to larger hospitals for this type of care and expertise.
In addition to robotics, we are seeing new digital technology being implemented and refined within our hospitals. Artificial intelligence platforms like Viz.aI and Rapid are helping physicians diagnose life-threatening strokes and more quickly enabling doctors to provide lifesaving therapies.
In the operating theater, we are seeing increased utilization of virtual and augmented reality technology, which helps surgeons better visualize and diagnose conditions like brain tumors or brain aneurysms and deliver more precise and definitive interventions. Last, to bring it full circle, virtual and augmented reality platforms are also being utilized for rehabilitation, assisting in recovery following stroke or brain injury.
Kirsten Langdon, PhD. Associate Director of Brown-Lifespan Center for Digital Health and Director of Strategy and Research Development at Rhode Island Hospital (Providence, R.I.): The uptake of digital healthcare, delivered in the form of telehealth, mobile apps and remote monitoring, has had a profound impact on improving access to urgently needed services. Leveraging technology-based platforms allows healthcare professionals to reach, monitor and treat patients in unprecedented ways by enabling clinicians to be more efficient in the provision of services, augment standard care with evidence-based support in between appointments, systematically measure health-related outcomes, and overcome traditional patient-level barriers to treatment (e.g., transportation). This has the potential to reduce clinician burnout, support under-resourced systems, and ultimately, improve patient-centered care.
Max Maile. Senior Vice President of Digital Health at Parkview Health (Fort Wayne, Ind.): Modern tech continues to radically evolve and elevate care delivery in so many wonderful ways, easing the provider experience, enhancing the patient journey. From remote patient monitoring devices and software, to the dynamic delivery and access of virtual care, to immersive medical simulation technology for clinical training, the vast innovations available today are reasons for excitement toward the important work of minimizing barriers and simplifying how healthcare is shaped for patients and providers.
Murielle Beene, DNP, RN. Senior Vice President and Chief Health Informatics Officer at Trinity Health (Livonia, Mich.): We are using technology to support nursing colleagues in patient care. Recently, our health informatics team began an initiative to use technology to reduce documentation burden. This initiative utilizes data to purposefully create and measure clinician efficiency improvements. Our team identifies ways to reduce the time nurses spend on the EHR and increase the time available for delivering patient care.
Through evaluation of best practice advisories (BPAs), our team found nurses were receiving more than 2.5 million BPAs per quarter. Listening to nurse feedback on which BPAs need improvement, the team created a plan for improving workflow, reducing the time spent, and eliminating nuisance alerts. This truly makes patient care easier to provide and improves nurse satisfaction. Our nurses are true partners in improving efficiency and we are dedicated to providing them more time with those who need them most: their patients.
Nigam Shah, PhD. Associate CIO for Data Science at Stanford (Calif.) Health Care: The use of technology (devices, computation and various forms of data) makes patient care better in two primary ways by offering the ability 1) to identify conditions that patients have sooner, faster or both, and 2) to identify what worked for other similar patients.
The ability to identify risk of conditions patients have (or will develop) allows timely risk stratification to identify those who would benefit from certain kinds of care. For example, faculty at Stanford have built algorithms to identify patients who are malnourished, who might have underlying genetic disorders, who might have undetected peripheral artery disease and more.