Accurate documentation is critical to delivering improved outcomes and patient safety. Yet for many physicians and nurses, the realities of their jobs can get in the way of charting or ordering in real time, long considered optimal to achieving accuracy.
The typical medical/surgical nurse walks more than four miles in a 12.5 hour shift. Constant disruptions and a job that takes them all over the hospital means most either wait to settle in at a nearby nurse's station or bulk load patient information into the electronic health record at the end of their shift. Many even opt to take home their charting, documentation or dictation duties in order to catch up.
Clinicians report that the process of accessing records is a time-consuming barrier; their computers are slow to respond, and the number of clicks required to navigate to the point of entry can be mind-numbing. An emerging technology called "awareness computing" is removing that barrier. When clinicians tap their badges and authenticate their identities, the workstation intuitively recognizes the user, their role, location and relevant applications including patient records already in use. It presents their virtual desktop, so they may immediately enter their data and "tap out" to securely move on to the next patient or location.
Turning a computer from a blank instrument to one that already knows what a clinician needs and what is required to do it has many advantages. The following five reasons explain why healthcare leaders should make themselves aware of awareness computing:
1. Increased staff satisfaction. A 2013 HIMSS study revealed three in 10 providers believe healthcare technology doesn't positively impact efficient patient care or information accessibility. By making record and application accessibility quick and easy at any device stationed across the hospital, awareness computing allows physicians and nurses to spend less time struggling with cumbersome logins and more time helping patients. As clinicians roam, the technology automatically updates the default printer to the one nearest that location, eliminating the need to scroll through a lengthy printer list to hunt for the appropriate printer. It also minimizes the need to stay late or take work home to complete the documentation. One hospital reports awareness computing has cut nursing documentation time at the end of the shift from 105 minutes to 15 minutes.
2. Increased data accuracy. Real-time data entry at the bedside or workstation means charting occurs while it is still fresh on the minds of clinicians, reducing the amount of after-the-fact interpretation of notes or reconstruction from memory they must perform later. The near instant speed-to-desktop promotes greater focus and reduces opportunity for interruptions, ensuring the clinician's train of thought is unbroken and, in fact, enhanced when entering critical facts into a patient's chart.
3. Improved clinical collaboration and throughput. Granting real-time data access to the next clinician participating in the patient's care plan promotes collaborative communication and ultimately smoother care continuity. Patient transitions of care to other settings are better coordinated — for example, from the emergency department to admissions, the imaging center to the surgical recovery floor, the ICU to a step-down unit or discharge to home. Additionally, the expedited appropriate treatment, thanks to the up-to-date information shared across the care continuum, helps achieve effective throughput.
4. Securer protected health information. Clinicians often attempt to save time by leaving sessions open while going on rounds, checking patients or performing other tasks. Unsecured devices put PHI at significant risk. With the instant access of awareness computing, providers can securely shut down each session following charting completion, confident the next computing session will launch quickly. Additionally, since all data resides in a centralized data center instead of being stored on individual devices, there's no risk to PHI if a device is lost or stolen.
5. Maximized current hardware and teamwork. While sharing devices is an effective way to save on hardware costs and a practical answer to ergonomically challenged clinical space challenges, it can lead to battles over who has priority, or result in lost work if one user unintentionally logs another out mid-session. Awareness computing automatically saves current sessions when another user taps in, preserving the work already performed. Providers can easily tap over and between each other's sessions, securing the previous clinician's work and launching the applications necessary to meet their needs. At the same time, nurses and physicians report the unexpected benefit of enjoying increased collaboration and productivity due to the fast access.
Bonny Roberts, MHA, PMP, Clinical Liaison, Aventura, has worked on both the provider and vendor side in healthcare information technology. She has assisted academic medical centers with strategic application selection, development and implementation, as well as supported startup healthcare software companies. Roberts is a member of the HIMSS Innovation Committee.
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