CEO SUMMARY: By sending lab test results and other data from the hospital’s electronic health record system to physicians’ smartphones, Holy Name Medical Center in Teaneck, New Jersey, is empowering physicians to manage patient care more efficiently. Today, few hospitals send information directly from the electronic health record (EHR) system to a smartphone (meaning an Apple iPhone, Rim Blackberry, or Android device). But the number of physicians interested in this feature is increasing.
GROWING NUMBERS of physicians, nurses, and other health professionals are flocking to smartphones, iPads, and similar high-touch/high-function mobile devices. Because clinical laboratories produce information, this is a trend with important implications for all labs and pathology groups.
Another notable aspect of this trend is that physicians and nurses are pushing their hospital IT (information technology) departments to make clinical data and patient health records accessible on smartphones and iPads. This is an important development.
In response to this trend, first-mover hospitals are seizing the opportunity to help their physicians use mobile computing devices for an expanded number of clinical and operational purposes. In Teaneck, New Jersey, these were the goals of Holy Name Medical Center (HNMC).
Earlier this year, it rolled out an application that enables physicians to view results and patient information on smartphones. In an interesting twist to this story, HNMC’s app was developed by its own IT staff!
Holy Name Medical Center’s 12- member software development team wrote the programming code over three months earlier this year, then launched the mobile app in June. Called MicroHIS, it allows physicians and staff to use mobile devices to order procedures and view results and patient data. Their home-grown application works seamlessly with HNMC’s home-grown EHR, called Web Health Information System (or WebHIS).
Lab Test Data on Smartphone
“It handles lab data very well,” stated Michael Skvarenina, the medical center’s Chief Information Officer, in an interview with THE DARK REPORT. “Not only does it show laboratory test data, but it also shows radiology reports and interpretations, EKG data, and vital signs—such as the patient’s temperature and blood pressure.
“Currently these are text-only views,” he explained. “However, this application can be adapted to show graphics, such as a trend line chart.
“Our mobile app also has the patient’s demographic information,” commented Skvarenina. “This includes the patient’s in-room telephone number, an emergency contact name (meaning next of kin) and that person’s phone number, as well as the name of the patient’s nurse for the current shift.”
The system is free to physicians affiliated with HNMC, and the data are available immediately when posted to the medical center’s system. On his or her mobile device, the physician simply clicks on the MicroHIS icon to then log onto the secure network, thus ensuring patient privacy. After logging on, the physician sees a list of his or her patients and each patient’s essential medical information. Any data that has not been viewed previously is highlighted and abnormal test results are flagged.
“Physicians also can search for a patient by unit, then add that patient to his or her list of patients to follow,” noted Skvarenina. “MicroHIS allows a physician to call the patient’s room, the patient’s nurse, or a next of kin directly from the physician’s mobile phone.
Tap Screen, Call the Nurse
“In our hospital, every nurse takes a wireless phone when signing in for the day,” he said. “The physician can then use that telephone number to call the patient’s nurse from anywhere. Because phone numbers are hyper-linked, the physician could be at home or out to dinner and call the nurse just by tapping the number on the screen.
“During the week of July 18, we introduced the latest version of the MicroHIS,” he added. “This new version includes the operating room schedule for our surgeons and the ability to search the master patient index, including outpatients.
“We created the outpatient feature in response to requests from our physicians,” noted Skvarenina. “This useful feature allows physicians treating one of our patients to look up any patient in the database—whether an inpatient, an outpatient, or an outreach patient who only had their clinical laboratory tests drawn and performed by our hospital lab.
“Originally we built the MicroHIS so that physicians could have data when doing inpatient rounds,” recalled Skvarenina. “But once they tried it, they wanted data on outpatients as well. Now they can get each patient’s history, physical, discharge summaries, progress notes, operation reports, and any transcribed report on the MicroHIS.”
Skvarenina also explained why HNMC created its own electronic health records system. “Over the past 25 years, we have continuously developed and improved our own EHR. This included building interfaces to other clinical software systems,” he said.
EHR Interfaces with LIS
“For example, our EHR, which is called WebHIS, interfaces with our Sunquest laboratory information system (LIS) for laboratory data and with IDX for radiology data,” Skvarenina noted. “WebHIS is the repository for all patient data. That means physicians can also track new results. In fact, some of our physicians use MicroHIS as their only form of EHR access outside of their offices.
“When the doctor logs onto MicroHIS, it presents his/her rounding lists,” he said. “A counter on the screen may show 5L and 1R to indicate that five lab reports and one radiology report are available that the physician has not previously seen.
“If the physician taps that 5L icon, it brings up those results on screen,” Skvarenina explained. “Normal results show up in blue. If any lab tests results are abnormal, the data will show as red. Once a physician views these results, that item is marked as ‘read.’ It will no longer appear on the home screen unless the physician goes back and gets it from the patient’s data file.
“Having lab test data available during a patient’s stay is significant because that’s how physicians manage most patients,” he continued. “We give them the name of the test; the date and time the sample was taken; and the date and time the test was done. If it’s a complete blood count, it will say ‘CBC’ and show the component results for white blood count (WBC), red blood count (RBC), and any other component laboratory test results the physician ordered.
“Next to the lab value is the reference range. Most doctors know what the reference range should be, but it’s there if they want it,” noted Skvarenina. “We also show an H or L for each component, meaning high or low. Any text-based data, such as readback documentation that lab personnel entered, or a critical value, also will appear with the result.
“To date, we haven’t had any requests to show trends for lab data on the MicroHIS,” he said. “However, we do show trends on the WebHIS in numerical form and also offer a graphical format.
“The MicroHIS system is designed to do—on a smartphone—all the functions that were expected to be handled by a tablet PC,” added Skvarenina. “The tablet is a handheld laptop. The benefit of smartphones is that they are always on the owner’s hip or in his/her pocket. By contrast, a tablet is too big to fit into a pocket, and physicians are more likely to have their smartphones with them.”
THE DARK REPORT observes technology makes it easier for in-house IT departments to develop smartphone applications like MicroHIS.
Lab Director Gets News Via Smartphone, Just as the Docs Get their Lab Test Results
VACATIONING IN ITALY LAST MONTH, Edward A. Torres, MPA, used his cellphone to check his e-mail. At that moment, the Administrative Director, Pathology & Laboratory Medicine, at Holy Name Medical Center (HNMC) learned that his hospital in Teaneck, New Jersey, was now sending laboratory test results to physicians’ smartphones with a home-grown mobile application.
“It’s a great advance that allows our physicians to view laboratory test results on their smartphones and similar mobile computing devices,” Torres commented. “We knew CIO Mike Skvarenina and the IT Department were working on sending lab results from the hospital’s health information system, the WebHIS, to physicians’ smart- phones. But we did not know when he would launch this exciting new service for our physicians. I found out by e-mail when I read Dark Daily while on vacation.” Dark Daily is a daily e-mail news service from THE DARK REPORT.
“At Holy Name Medical Center, our laboratory test data is stored in our LIS, which has long been interfaced with our hospital’s electronic health record (EHR) system, which is called WebHIS,” noted Torres. “It was surprisingly easy for our IT department to create the interface needed to make laboratory test data available on MicroHIS, which is the name of the mobile phone application.”
HNMC is located to the west of the George Washington Bridge, which is a major gateway into New York City. The lab staff numbers 93 full-time equivalent workers (130 total employees) and performs 1.5 million billable lab tests annually.
“The launch of MicroHIS helped our lab improve how we deliver data and lab information,” concluded Torres. “We see this as an example of how the clinical laboratory must be innovative and help physicians access laboratory test results using all the latest technology that becomes available.”