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GDS International - Next - Generation - Healthcare - Payers - Summit - US - 8

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Mobility Advantage: Health Care Made Easier
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  • 1. MobilityAdvantage:HealthCareMadeEasier WHITEPAPERwww.sybase.com

2. Contents:Time,Motion,andHealthCare:ACaseStudy .......................................................................................... 2WhatIsSoTransformativeaboutMobility? ............................................................................................. 3MobilizingHealthCare:ChangingtheWayPeopleWork......................................................................... 4 AcceleratingDeliveryofMoreAccurateCare .......................................................................................................4 TakingHealthCaretothePatient .........................................................................................................................5BuildinganIntegratedHealthCareEnvironment ..................................................................................... 6PlanningforMobilityThroughouttheHealthCareOrganization ............................................................. 7 Notes .....................................................................................................................................................................9 MobilityAdvantage:HealthCareMadeEasier 3. Time,Motion,andHealthCare:ACaseStudyIntodaysclinicalsetting,electronicmedicalrecords(EMR)arerapidlyreplacingpaperandbecomingthecentraltouchpointforeveryoneinvolvedinpatientcare.WhentheUniversityofCaliforniaSanFrancisco(UCSF)MedicalCenteradoptedanEMRsystem,theyrecognizedearlyonthatmobileaccesstotheEMRwasanessentialpartoftheequation.Initially,accesswasavailablethroughcomputersatnursesstationsand,inafirststeptowardmobility,throughCOWs(ComputersonWheels).ACOWisacartequippedwithawirelesscomputer.HealthcareproviderscouldwheelCOWstothepatientsbedsideasneeded,viewmedicalrecords,andenterdata.OncetheirEMRwasfullyimplementedusingaCOWstrategyformobileaccess,themedicalcenterconductedadetailedtimeandmotionstudytounderstandexactlywhatpeopledidwiththetechnologyduringatypicalworkday.Theymadesomeinterestingdiscoveries.Forinstance,theylearnedthatittookanurseonaverage30secondstologintothesystem,andduringatypicalshift,nursesloggedin45times.COWshadsomedisadvantages.Nursesparkedtheminhallways,addingtotheproblemofhallwayclutter.COWsalsoprovedtobedangerousobstacleswhenparkednexttoabedduringamedicalemergency.UCSFdecidedtoconductapilotstudy.TheyequippedanumberofhealthcareworkerswithhighlyportabletabletPCtypedevicescalledmobileclinicalassistants(MCAs).Thentheyconductedthesametimeandmotionstudyontheseworkers.Thisiswhattheydiscovered:1EquippinghealthcareworkerswithmoremobiledevicesresultedinbetterpatientdatathatwasmorecurrentintheEMR,andabetteruseofthehealthcareproviderstime.Thisoneexampleprovidesaglimpseofthetruepowerofmobilityinhealthcare.Letsseewhy. 2 MobilityAdvantage:HealthCareMadeEasier 4. WhatIsSoTransformativeaboutMobility?AlthoughtheUCSFMedicalCentercasefocusesonhownurseswork,itrevealsthefundamentaladvantagesofamoremobileclinicalenvironment.Theseadvantagesextendwaybeyondthenursingstaff.Everyoneinteractingwithmedicalinformation,includingdoctors,technicians,specialists,andevenpatientsthemselves,benefitsfromtheadvantagesrevealedintheUCSFMedicalCenterstudy.Howeverthisstudyshowssomethingmore.Itshowshowmobilityisuniquelyabletomakeclinicalprocessesmoreefficient,anditshowshowthoseprocessimprovementstranslatedirectlyintohigherqualityhealthcare.Peopleworkingintheclinicalenvironmenthaveinstantaccesstomedicalinformationandtoeachother.Mobiledevicesareconvenientandalwayson.Becauseofthis,healthcareprovidersaremorelikelytoenterrelevantinformationimmediately,andtheyspendlesstimedoingit.These,then,arethekeyattributesofmobilitythattakentogether,enableittotransformtheclinicalenvironment:Thesesameadvantagesextendtopatientsaswell,makingthemmoreactiveparticipantsintheirownhealthcare.Mobileapplicationsenablethemtoviewtheirownhealthrecords,beinformedabouttheirprescriptions,andinsomecasesparticipateinremotepatientmonitoring.Sohowdoesatrulymobilizedclinicalenvironmentreallywork?Letstakeacloserlook. MobilityAdvantage:HealthCareMadeEasier 3 5. MobilizingHealthCare:ChangingtheWayPeopleWorkByprovidingbetteraccessandinsightintoinformation,aswellasgreaterconvenienceforprovidersandpatients,mobilitynotonlystreamlinesthedeliveryofhealthcare,butitresultsinhigherqualitycareandbetteroutcomes.Thefollowingscenariosillustratethesepoints.AcceleratingDeliveryofMoreAccurateCareEarlyoneeveningamiddleagedbusinessmanvisitingatowninupstateNewYorkclimbsintoataxicab.Thecabproceedstotakehimtohisdestination.Whileridinginthecab,themanbecomesdisorientedandstartsbehavingstrangely.Thecabdrivergrowsconcernedanddecidestotakethemantoaregionalmedicalcenterthatislocatedinthetown.Bythetimetheyarrive,themanhasdifficultygettingoutofthecab.Thedriverhelpshimout,andastheywalkintotheemergencyroom,themanfallsandhitshisheadonahandrail.SeveralEMTswhohappentobethereliftthemanontogurneyandwheelhimintotheER.Thetaxidriverleaves.TheERpersonnelseeasemiconsciouspatientwithableedingheadwound.Themanisunabletocommunicate.Nursesexamininghimfindhiswallet.Theyidentifyhim,andfromhishealthinsurancecardtheyidentifyhisprimarycarephysician,whohappenstohaveapracticeinNewYorkCitywherethemanlives.ThisregionalmedicalcenterisconnectedtoalargestatewideEMRnetwork.InlessthanoneminutetheyhavehiscompleteelectronicmedicalrecorddisplayedonanMCAdeviceatthepatientsbedside.Theyquicklydiscoverthismanisadiabeticandsuspectheishypoglycemic.TheEMRshowshehashadepisodessimilartothisinthepast.TheattendingphysicianordersaglucoseIV.Themanrespondsquickly,andwithin15minutesheisabletoexplainthatheneglectedtoeatlunchordinner,whichnodoubttriggeredtheepisode.TheERphysicianisconcernedaboutthenastygashonthemanshead,andhewantstobesuretherearenootherneurologicalcomplications.HeordersaCTscan,althoughthereisnoradiologistondutyatthishourtoreadtheresults.Thishowever,isnotaproblem.TheregionalmedicalcenterusesateleradiologyservicethatprovidespreliminaryreadsonCTscanswithin30minutes,anytimedayornight.Asthemansheadwoundiscleanedandbandaged,theattendingphysicianreceivesthepreliminaryradiologistsreadoftheCTscan.HereviewsthereportandtheimagesonhisiPadwhiletalkingtothepatient.Therearenoadditionalproblems,andthemanisfeelingcompletelynormal.Onehourand30minutesafterarrivingattheERbleedinganduncommunicative,themanisreleased.Thedoctorgiveshimthenameofagoodrestaurantandordershimtogoeatdinner.Bythetimethemanleaves4 MobilityAdvantage:HealthCareMadeEasier 6. thebuilding,thedoctorandnurseshaveusedtheirmobiledevicestodocumenttheentireeventdirectlyinthismanselectronicmedicalrecord.TakingHealthCaretothePatientMobilitycanalsomakepeoplemoreactiveparticipantsintheirownhealthcare,asshowninthefollowingscenario.Soonafterthediabeticmanfromthepreviousepisodereturnshome,hehearsfromhisdoctorsoffice.TheofficehadreceivedautomaticnotificationfromtheEMRsystemthathewastreatedinanemergencyroom.Theyinformhimthathisdoctorhasalittlegiftforhimandthatheneedstostopbytheofficetogetit.Whenhearrivesattheoffice,heisgivenacontinuousglucosemonitor.Itisasmalldevicethatfitsinhispocket,andithasabluetoothtransmitterthatenablesittocommunicatewithamobileapplicationtheyhavehimdownloadtohissmartphone.Theyhelphimconfigurethedevicesandsetuptheapplication.Theyshowhimhowtoapplythesensor,whichneedstobereplacedeveryfewdays.Thisdevicecontinuouslymonitorshisglucoselevel.SeveraltimeseachdayhisphoneautomaticallylogsintohisEMRanduploadstheglucosereadingstoaspecialchartintherecord.Ifhisglucoselevelsgotoolow,analarmgoesoff.ThedoctorordershimtologintohisEMRfromhisphonewheneverheeatssomethingandmarkitonthechart.Thedoctoralsosuggestshelookatthechartatleastonceeachday.Theideaistogethimtopaycloserattentiontowhatheeatsandtoseehowitaffectshisglucoselevels.Afterusingtheglucosemonitorfortwoweeks,themanbecomeshighlyawareofeverythingheeats,andhebecomesmoretunedintoearlywarningsignsoflowbloodsugar.Longafterhenolongerneedstheglucosemonitor,heisabletoavoidhypoglycemicepisodes.MobilityAdvantage:HealthCareMadeEasier5 7. BuildinganIntegratedHealthCareEnvironmentMobilenetworksanddevicesgivemedicalprofessionalsfasteraccesstocriticalinformation,reducetransitiontimes,andenablethemtospendmoretimeonpatientcare.Newmobiletechnologyallowsthemtopaymoreattentiontotheirpatientsandoffermorepersonalcareevenifthatcareisdeliveredremotely.Patientsthemselves,manyofwhomarealreadymobiletechnologyusers,candirectlytapintothebenefitsofhealthcaremobilityaswell.Infact,manyaredemandingatleastminimalmobilecapabilitiesfromtheirhealthcareproviders,eveniftheyareassimpleasautomaticappointmentandprescriptionrefillreminders,easyaccesstotestresults,oremailanswersfromtheirphysician.Thefollowingillustrationshowshowmobilitycanimpactthewayhealthcareisdeliveredacrosstheclinicalsettingandbeyond.6 MobilityAdvantage:HealthCareMadeEasier 8. PlanningforMobilityThroughouttheHealthCareOrganizationAsmorepowerfulmobiledevicescometomarket,andwithhigherspeedservicecarriernetworks,innovationinhealthcaremobilityisgoingtoaccelerate.Newmobilemedicaldeviceswilltakeincreasingadvantageofnewdevicecapabilitiessuchas: Morecameraandimageenabledapplications Realtimeanywherevideoconferencing Accuratevoicerecognitionthatvastlyalters Peoplefirst:thedatainputcapabilitiesofsmartphonesandDeployingMobilityAcrossothermobiledevices NewdeviceformfactorstheEnterprise Moreintegrationbetweenmobiledevicesand Peoplefirst, operated by Kindredbackendinformationsystems(handhelds,Helathcare Services, is one of themobilemonitoringdevices,diagnostic largest contract rehabilitation serviceequipment,EMRandimagingsystems)businesses in the U.S. Employing Higherspeednetworks over 8,000 people, most of whom work directly with patients, Peoplefirst Unifiedcollaborationapplicationsspecifically delivers rehabilitation therapy in moredesignedforbothsynchronousand than 600 locations.asynchronousmedicalconsultsThismeansthatplanningformobilityisplanningfor Typically a Peoplefirst therapist mightchange.Anymobilesolutionthatbecomespartofthesee 10 patients in one day. Therapists would make hand-w

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