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September 15, 2014

Hospitals, docs experiment with mobile apps to speed, improve care

PHOTO | Contributed St. Francis Hospital and Medical Center Chief Information Officer Linda Shanley said she receives a lot of calls from healthcare app vendors looking to sell their products. Ultimately it's the hospital's doctors who dictate which apps will be adopted by staff.
Image | Contributed Connecticut hospitals are using the TigerText app above for instant doctor communication.
By Alexander Soule

When St. Francis Hospital and Medical Center officials searched last year for a mobile app to track employee flu clinic activity, they couldn't find one tailored to their specific needs.

The cure? They developed one of their own.

With mobile apps entrenched in the daily lives of consumers and increasingly many industries, Connecticut hospitals and doctors are adopting apps in varying degrees, some as the need and opportunity arises, and others with an eye toward improving medical operations.

St. Francis is looking to add apps where it can solve an obvious problem or deliver a better way of doing things, said Linda Shanley, the hospital's chief information officer. For example, this fall St. Francis is debuting an app it developed in-house to handle flu clinic registration for its employees, replacing a cumbersome paper process it used previously that made it difficult to quickly determine which employees received vaccinations or had an exemption.

“When we set out to see if there was a vendor that had something that already exists, we found kind of an empty marketplace,” said Dreux Namnoun, assistant director of enterprise services at St. Francis. “So we decided to build our own.”

As of 2013, iTunes included some 7,400 mobile apps that serve a legitimate health or medical role for practitioners in hospitals and clinics, according to IMS Health, a Danbury-based company that tracks the industry.

When St. Francis needed an app to allow physicians to exchange medical information via text message, while maintaining privacy protocols under the Health Insurance Portability and Accountability Act (HIPAA), the hospital adopted a ready-made app called TigerText.

The app's appeal, however, goes well beyond security; it also allows physicians to exchange medical information like electrocardiograms at a patient's bedside, said Dr. Tom Turbiak, associate director of St. Francis' emergency department. Such quick and easy access to patient information allows for speedier decision-making when every minute or second might count in a medical crisis, he said.

“This isn't just a convenience thing or a techie thing,” Turbiak said. “It can save lives.”

To the public, Hartford Hospital has played up consumer-oriented apps like MomMe, which allows expectant mothers to calculate fertility cycles to determine “the best times to get down to business,” in the hospital's words. The app also tracks contraction cycles during labor and provides baby feeding time reminders.

Hartford Hospital physicians, however, are increasingly adopting apps depending on their comfort levels with technology, said Dr. Vasanth Kainkaryam, whose specialties are internal medicine and pediatrics, and who is pursuing a master's degree in medical informatics from Northwestern University.

Kainkaryam estimates he uses some 20 apps today, including TigerText and UpToDate, which provides medical information doctors can pull up at the point of care.

“[TigerText] has been profound for me,” Kainkaryam said. “If one of my patients has gone to the ER, I can text the ER physician and tell them what is going on … Before I would have to call, but that can be an interruption.”

Eight in 10 physicians nationally use smartphones in their practices and six in 10 use tablets, according to a 2013 survey by Wolters Kluwer Health. Of those who use devices, 72 percent did so to access drug information. The next biggest function is to communicate with nurses and other staff, with 44 percent of those polled saying they use devices to text or email.

The Connecticut State Medical Society offers the free messaging app DocBookMD to its members, CSMS spokeswoman Kelly Raskauskas said. The app is also used by several area hospitals. Separately, CSMS has a relationship with Massachusetts-based athenahealth Inc., whose ePocrates software can be embedded in a mobile app to help doctors assess correct drug dosages and safety information like potential adverse reactions to a drug.

At St. Francis, Shanley says she gets many queries from mobile app vendors, but she relies on hospital doctors to dictate the speed at which her information technology department will add them.

“You can put out a lot of apps and they can sit on people's mobile phones and devices, but … you have to find a clinical champion that finds a need,” Shanley said. “We can support whatever the clinicians and the business units need, but it really needs to be driven from that area.”n

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