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As recently as a few decades ago most patient information resided in a paper folder in a slot at the end of each bed. The information required for physicians and other caregivers to make decisions and execute these plans was literally located at the feet of each patient.
Over the years, as technology and information systems have been introduced in health care, the health information of patients has been moved further and further from the bedside. This disrupted the natural workflow of caregivers, with most care planning taking place far away from the patients and their families.
The introduction of tablet technology in 2010, beginning with the iPad, allowed a practical tool for physicians and other care providers to get ‘back to the bedside’ and engage the patients in decisions about their care. The key enabler is the ability for caregivers to have all of the information they need, wherever they need it, whenever they need it, and in real time.
The Ottawa Hospital aggressively implemented the iPad tablets for physicians and other care providers in the fall of 2010. Now most care is delivered at the bedside and patients are able to more actively participate in decisions in their care plans.
There is now no doubt in my mind that having physicians back in their natural workflow, providing care by the bedside, is here to stay. It has significantly improved the timeliness, safety and quality of care for our patients. We now have a strong platform to improve care delivery in even more innovative ways, while ensuring privacy and security.
Dale C. Potter
Senior Vice-President, Information Services & Chief Information Officer
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The Ottawa Hospital
I’d be interested to know more about the criteria used to select a tablet platform
The criteria used was that the iPad was the only choice at the time in early 2010. It seemed to meet the needs and since then there has been no platform that has been introduced that our clinicians have indicated has a significant advantage in solving the business problem of allowing physicians to deliver more effective care at the bedside. It is not about the technology in my mind… It is about use of technology to improve quality of care and the experience of our patients.
The iPad technology we have deployed is about providing tools to allow clinicians to provide more effective care for patients.
The advancement of the modern hammer has not evolved that significantly over the recent years. There is price point and durability as considerations for purchase decisions. In our space, utility, security and form factor are considerations we need to keep our eyes on but the iPad has persisted as an effective tool for the clinical outcomes we are looking to enhance patient care. Back to the hammer, choose your tool based on the relevant criteria but if your objective changes to putting a screw in a wall you should reconsider whether the tool is the best choice.
D
Great insight!
But I must say, the next step is how to utilize the cloud to a more secure, cost-effective, and highly available information-critical environment.
Imagine what it’ll do for the physicians who left their iPad in the kitchen! Forgot your tablet? Pick a spare one in the nearest office, and sync your backup profile into it.
The cloud. Also the way of the future 🙂
Dale, what you have accomplished at the Ottawa Hospital is very impressive. Do you have a native iOS app for emergency department workflow (tracking, order entry, documentation and prescribing)? If not, please take a look at what we have done at montrue.com. It looks like we might be able to learn from each other.
I agree with the insight that the cloud will play a big role in healthcare in the future. As you described but mores even when patients start to directly take ownership of their health data and more actively participate in care decisions and health promotion.
We are doing final testing on our Emergency Department tracking system. It has been PC based for some time but will make a huge difference when they don’t have to go and physically look at mounted monitors to understand the next step in their workflow.
D
We are about to start a research project in which clinical nursing instructors will use iPads as a resource for their teaching. We are concerned about the sanitation of the iPad in the clinical environment. How does the Ottawa Hospital keep iPads clean and antiseptic?
We have a cleaning protocol that is issued with each iPad – e-mail the Webmaster and we’ll make sure you get a copy.
Mine handles Virustat on a daily basis. I do think the anti-smudge protection has been very slightly diminished over several months, but otherwise no untoward effects.
The use of iPads is very impressive. I have a few questions on the logistics if you don’t mind my asking. How were you able to justify the costs, especially for the initial purchase? How are the iPads allocated to each department? Is there still a role for paper notes in the hospital?
Kind regards
We are starting a clinical project using iPads for teaching and thought that adding a protective case could introduce more surfaces that could contain infectious agents.
Do you put the iPads in a case to protect them from damage? If you do, which case and is sanitization of the case an issue?