Rethinking the Mission of Health IT

Re-Imagining the mission of patient safety technology

by Jessica Lake, BSN, BS, RN

Before the mainstream adoption of today’s digital healthcare technologies, nurses relied much more on their senses, clinical training and instinct to monitor patients. Devices played a secondary role, as an aide to the nurse.

Over time, however, devices grew both more sophisticated and numerous, touted as harbingers of a new era in improved patient safety and outcomes. An unanticipated side effect of this digital explosion was that many nurses began to struggle. As electronic health records, hand-held communication devices, barcode scanners, workstations-on-wheels flourished, the alerts and notifications they sent suddenly felt unceasing and overwhelming.

As a telemetry nurse, I saw many of my colleagues struggle. Nurses on my unit were overwhelmed by all of the technology. Many of them did not leave work on time because simple tasks took longer to complete including increased documentation. There was a huge learning curve as my workplace entered the digital technology era. For the more experienced nurses, old habits were hard to break.

The role of the nurse began to evolve from patient caregiver to technology caretaker.

Healthcare’s Tech Crisis

This technology has a tendency to take the nurse away from the patient to respond to hundreds—even thousands—of alarms, pagers and texts and phone calls. Over time, these decrease nurse satisfaction and morale, disrupt the recovery of patients, and make families feel that their loved ones are cogs in an overly wired and noisy machine.

Patient safety technology, such as bed-exit alarms, IV pump occlusion alerts, cardiac monitoring alarms, ventilator alarms, was designed to be warning systems that would minimize errors and mitigate—if not eliminate—adverse events.

All of these alarm systems rely on the nurse to notice the warning, understand what is alarming, why it is alarming and its relevance. Once they have done that, they need to address the alarm and take appropriate action.

Clinical communication companies thought the solution was the ability to deliver bedside alarms to hand-held device carried by the nurse. Working on a telemetry unit I initially thought that this idea was great! I wouldn’t have to worry about not hearing or missing an alarm that sounded in my patients’ rooms, because now I could receive it on my phone.

This provided stress relief until it didn’t. I couldn’t finish a task or complete a conversation with my patients without my phone buzzing with alarms. And of course, since you can’t ignore them, you find yourself scurrying from room to room to verify that the patient was OK and then back to the original room to complete whatever task you had just started. It drove me crazy.

And worse, despite the advances in patient safety technology, medical errors continue to occur at frightening levels, and clinical alarm fatigue has not significantly abated.

Bernoulli Health—Rethinking the Mission of Health IT

This is not a broadside against technology. I believe that technology can be a major net positive for patients, their families and the nursing profession, which is why I work for Bernoulli Health.

Our mission is helping hospitals achieve comprehensive patient safety through insights drawn from multiple sources of real-time and retrospective data. In Bernoulli One™, we provide a real-time connected healthcare platform.  We do what traditional medical devices and patient monitoring can’t do – identify actionable patient events or conditions based on the aggregation of high-fidelity data from multiple measurements, including from multiple sources/devices and look at changes over time (trends) to improve patient safety and outcomes.  We also don’t do what that same legacy technology often does – inundate clinicians with false and non-actionable alarms that cause alarm fatigue.

At the human level, we are helping clinicians return their focus to bedside caregiving by transforming disparate medical technologies from antagonists to true clinical collaborators.

Re-Imagining the Mission of Patient Safety Technology

According to a new KLAS report, “Clinical surveillance tools hold the promise of giving caregivers clinically actionable insights that decrease mortality, reduce readmissions, and improve overall patient outcomes.”

The healthcare market is waking up to the patient safety and clinical workflow benefits of continuous clinical surveillance. To that end, Bernoulli Health offers a number of resources to better understand the technological requirements and clinical workflow implications of clinical surveillance.

On Thursday, Feb. 14, Leah Baron, MD, former Chair of the Department of Anesthesiology at Virtua Memorial Hospital in Mt. Holly, NJ, and John Zaleski, PhD, CAP, CPHIMS, Chief Analytics Officer of Bernoulli Health will present A Business Case & Clinical Case for Continuous Surveillance at the 2019 Annual HIMSS Conference & Exhibition.

This education session, based on an award-winning study in the Journal of Biomedical Instrumentation & Technology, will demonstrate the efficacy of advanced analytics, medical device connectivity and combinatorial alarms to provide remote centralized continuous monitoring of post-surgical patients at risk for opioid-induced respiratory depression, while also eliminating artifacts that could increase alarm fatigue in clinical staff and recovery disruption in patients.

The study found that passing multiple series of patient-generated data through a multi-variable rules engine not only reduced overall alerts by 99 percent, but successfully identified every patient at risk for respiratory depression in advance of an incident.

As you prepare your HIMSS19 experience, be sure to visit Bernoulli’s robust online Knowledge Center of white papers, case studies, blog posts and an eBook detailing emerging trends in alarm management and medical device integration, as well as real-world customer success stories using the Bernoulli One platform.  You can also request to meet with a Bernoulli representative at HIMSS19 here.

Technology has many benefits, but also pitfalls. As healthcare technology advances and flourishes in the care setting, it’s incumbent on developers to find solutions that truly benefit both patients and the professionals who care for them.

About the Author:

Jessica LakeJessica Lake, BSN, BS, RN is a Sr. Clinical Solutions Manager at Bernoulli, where she focuses on customer acquisition, implementation design and clinical process consultation, as well as assisting with defining requirements for services proposals, customer testing, training and go-live support.

Jessica has 10-plus years of clinical experience as a Registered Nurse at several acute care hospitals in the Delaware Valley area including Kennedy Healthcare, Cooper University Hospital and Lourdes Medical Center.

In addition to a strong clinical background, Jessica has worked for a variety of healthcare vendors focused on communication and workflow improvement for more than 13 years. Prior to joining Bernoulli her roles included Clinical Solutions Consultant, Clinical Applications Specialist, and Clinical Applications Specialist Manager at Vocera Communications and Clinical Product Marketing Manager at PerfectServe.

Jessica is currently a member of AONE and ANIA. View Jessica’s profile on Linkedin.