Electronic health records bring many benefits to clinicians, but Rondel Albarado, MD, did occasionally miss one benefit of the clipboard hanging at the end of the patient’s hospital bed—a one-glance look at various charted information.
“The clipboard at the base of the bed was where the nurse had trended information overnight,” says Albarado, who works for UT Physicians, part of UTHealth, teaching in a variety of programs and also is a trauma medical director for the intensive care unit at Memorial Hermann.
There, he oversees 23 beds that handles trauma and surgical intensive care, and a variety of physical conditions are monitored in real-time as clinicians work closely to preserve the lives on some of its most critically ill patients.
“The amount of information we process through there can be overwhelming for people trying to manage patients’ care simultaneously,” Albarado notes.
Assisting them in the process is a clinical care dashboard that draws medical data on patient vital signs and other information, projected on large screens over the patient. Developed by Decisio Health, the technology provides clinical decision support that helps providers manage the scope of information they face in taking care of critcally ill patients.
Memorial Hermann uses Decisio Health’s Clinical Intelligence Platform displays information that facilitates bedside treatment in the ICU, Albarado says.
The technology “is able to handle clinical information and process it continually, and it offers a way to present patient information in a succinct format that makes it ready for interpretation,” he says.
Before using the automated approach, trauma physicians and nurses would have to compile information off separate systems, which could take five to 15 minutes per patient. With the dashboard continually projected on a screen at the bedside, clinicians can get all the information they need at a glance.
“It’s not just a matter of time management,” he adds. “If you’re on call and you need to have that information quickly—say, if it’s the middle of the night, you’re in charge and you haven’t seen a particular patient—it’s important to be able to get that level of granularity of information quickly.”
The dashboard pulls together information on vital signs and lab values and, through the use of different colors, can indicate positive or negative trends, says Wallace Hallum, charge nurse of the shock trauma intensive care unit.
The information is not only important to patient care, but essential as clinicians transition care between shifts, Hallum says. “In the trauma unit, we have patients in all different kinds of shock,” he says. “As we’re talking to other persons when we are handing off care, we can see a trend of the previous 24 hours for the patient. All the clinical information we need is auto-populated. In the past, you’d have to look at the electronic medical record and you’d have to graph it yourself.”
The graphical representation is crucial in enabling other discussions between caregivers, Hallum says. “In the past, I might go to a physician and say that a patient has been very agitated and in a severe amount of pain, but that may not be what the physician sees when he walks to the patient’s bedside,” he notes. “With this platform, all these acute events are captured, and you’re able to see the spike in blood pressure, for example, what time it happened, how often it occurred and how severe it was.”
“It’s also crucial in enabling communication between teaching staff,” Albarado adds. “It gives us a chalkboard that everyone can look at easily, which facilitates teaching. We can show trends and otherwise discuss things that often aren’t trended. A lot of people are visual learners, and trying to get people to assimilate that information into one picture is easier when everything is in one spot.”
Memorial Hermann, which is collaborating with Decisio Health in developing the product, also is working on versions that could expand its use. For example, a mobile web-based version would enable critical patient information to be accessed while a clinician is in another patient room or even at home.
The system also can help by providing a tiered system with different response levels that, depending on the intensity level of a patient’s condition, may send a text message when something goes wrong, Albarado says. “There’s an ability to customize notifications, which is still being further developed.”
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