350 7th Street North, Naples, FL
NAPLES — In the not too distant future, the patient room of the future will be plugged in at the NCH Healthcare System.
Cerner Inc., headquartered in Kansas City, Mo., has merged wireless technology and medical software to create a “smart room” for improving safety and efficiency in patient care.
NCH has converted a former office in North Naples Hospital as a prototype to show visiting hospital executives. The room also is shown to potential donors who may want to help the hospital system adopt the technology, said Michele Thoman, NCH’s chief nursing officer.
This summer, NCH plans to build out the shelled fifth and sixth floors in the patient tower at North Naples and would like all 64 rooms to have the technology, she said. The hope is to roll out eventually to all patient rooms.
“We’ve shown it to about 15 to 20 individuals in the last month,” she said. “There’s a lot of interest.”
Reducing medical errors in hospitals came to the forefront in the industry after a scathing Institute of Medicine report in 1998 about adverse incidents and preventable deaths. The federal government launched a variety of programs for improving patient safety.
Tom Herzog, vice president of medical devices and information technology for Cerner, said what makes this technology different is that it is work-flow driven.
“For so long (the industry) let technology drive the work flow,” he said.
The “smart room” technology starts with an electronic box, called RoomLink, on the wall outside the door, which interacts with an electronic sensor device held by each caregiver. When a nurse, lab tech or physician walks in the room, the caregiver is introduced to the patient with a display of his or her name, picture, and title on a flat screen TV in the room. The flat screen TV is on the wall opposite the patient’s bed.
“One of the things we hear from patients is, ‘I’m not real clear who I am talking to,’ ” said Gerald McGinnis, a registered nurse and director of nurse informatics at NCH.
The RoomLink also has a small screen that displays symbols which identify medical conditions, such as fall risk or that the patient cannot take medications by mouth. The display symbols replace stickers on the room door that can be knocked off.
Another component of the RoomLink device are lights on each side that are visible to people walking down the hall. The lights turn red when a caregiver is in the room and turn green when there isn’t.
The red light helps other caregivers know it’s OK to go in the room.
“It tells me the patient is able to do things (for treatment),” McGinnis said, adding that it is a big time saver for staff. “We round in teams.”
Another part of the technology is VitalsLink, an interactive vital signs’ machine that allows nursing staff to program how often the patient’s vital signs are to be taken. The results are feed in real time to the patient’s electronic medical record.
Another piece is an intravenous pump system, where the medication order is programmed once rather than each time a new IV bag is needed. The system monitors the drip and alerts the pharmacist and nursing staff when a refill is needed to save time. Before the medication drip begins, safety checks are performed to make sure it is the right medication for that patient and right dosage.
“That comes down to safety and transcription errors we sometimes have and it comes down to time,” he said.
Behind the patient’s head on the wall is flat screen TV that displays, in real time, the patient’s medical record and latest vitals, lab results, medications and the like.
“All of this to a clinician allows me to put together a pretty good story about my patient (and treatment) and what I need to do to get them home faster,” McGinnis said.
The flat screen TV on the wall facing the patient allows the patient to interact with a host of programs. Patients are given keyboards or remotes to click on the screen to see their daily schedule for therapies, to watch educational videos about their conditions and treatments, and to learn about their medications.
That’s the component Dr. Allen Weiss, president and chief executive officer of NCH, said is his favorite part of the technology.
“When you are lying there all day looking for something to do, you (can learn) about your illness,” he said. “You will be able to do something proactive.”
Through a wireless keyboard, a patient or a family member can type notes with questions for the physicians or nursing staff, something that is especially convenient for a forgetful patient or loved one who is not present when the doctor makes rounds.
The note pad system relieves the nurse from being beckoned in the room frequently, although the patient still has the call light button to the nurses’ station, Thoman, the chief nursing officer, said. The patient’s notes are not routed to caregivers’ emails; rather they are intended to be answered at bedside.
“A lot of it is driven by anxiety,” Thoman said of why some patients use the call light often. “This empowers the patient and helps the nurse channel that energy in the appropriate place.”
Technology built in the bed, which has been in use for some time at NCH, weighs the patient while reclined and sounds an alert if a patient whose at risk of falls has left the bed or the side rails are down.
The patient can also use a remote to change the room’s temperature, draw the blinds open and dim the lights.
Besides the medical-related information that the patient can access on the flat screen TV, they can tap into the Internet, current movies, and games.
The Cerner software and related equipment costs roughly $20,000 although NCH has already purchased the programmable IV pumps and vital signs technology, at a cost of $8 million for all patient rooms at North Naples and Downtown Naples hospitals.
Moving toward the technology is not intended to replace bedside nurses, Weiss said.
“It doesn’t replace people. It doesn’t take away from having compassion,” he said. “It just makes us better.”
Reducing steps in medical care that need to be repeated frequently, such as with medications, is a big factor for reducing errors, McGinnis, NCH’s nurse informatics director, said.
“When you connect all of the parts together it helps the care team deliver the care better and lessens the risk for the caregiver, but ultimately gets the patient home faster,” he said.
Thoman said the investment in the technology is the right thing to do and helps nurses take care of their patients.
“These are things nurses have been asking for for a while,” she said.
To see a demonstration of the smart room technology, go to www.YouTube.com and type in: Cerner Smart Room Demo.