One of the main issues faced by Penn Medicine and the inpatient consult service at the Perelman School of Medicine at the University of Pennsylvania is accurate, rapid, reliable transfers of information between teams.
THE PROBLEM
Whether sharing information between a team of primary care doctors during the handoff process, communicating with consulting specialties or gathering information across multiple hospitalizations of the same patient, seamless and consistent data sharing is paramount for providing the highest level of care.
While electronic health records have their place in the IT ecosystem, they lack the usability necessary to meet clinicians' needs in these areas, said Dr. Misha Rosenbach, director of the inpatient consult service at the Perelman School of Medicine at the University of Pennsylvania and associate program director of the dermatology residency.
"The interface requires multiple steps to understand a cohesive patient history with lengthy, often difficult-to-read progress notes that do not really fit into the clinical workflow, often adding to duplicative administrative work and taking clinicians away from patient care," he said.
PROPOSAL
Penn Medicine decided to partner with care coordination technology vendor TrekIT Health, which was initially developed in 2016 at Penn as a product called Carelign to reduce clinicians' reliance on paper in clinical workflows and communication.
It has been successfully adopted by almost all inpatient services at Penn Medicine's four urban hospitals. This year, the clinical lead for the project has since co-founded TrekIT Health to commercialize the product as TrekIT.
TrekIT helps in each of the aforementioned settings – knowing where patients are in the hospital, who is seeing them, what the clinicians are thinking, and then communicating all of that information safely, securely and simply among and between various healthcare teams, Rosenbach explained.
It does so in a way that's "easy to read, review and visualize, even while walking around doing rounds in the hospital, or when called to see an acute patient, because you can readily see the important data you need, and read about the active issues on your phone while you are walking to the patient's room," he added.
TrekIT gives providers a collaborative space to put their thoughts together and intuitively pairs them with the chart so they can see the doctor's notes without a lot of "fluff," use copy/paste, use repetitive text, and handle billing/medical-legal documentation, said Rosenbach.
"You get the core information, paired with the most updated labs, paired with the patient location, and you get it in real time, in a way that you can easily digest it and find what you are looking for on a mobile device," he said.
MARKETPLACE
There are a variety of care coordination technologies on the health IT marketplace. Vendors include Cipherhealth, eQHealth, GSI Health, Imprivata, Microsoft, Optum and pMD.
MEETING THE CHALLENGE
TrekIT's platform is integrated into Penn Medicine's Epic system, but it is also available in a browser from any desktop or, more important, from any mobile device. The tool brings real-time vitals, labs and medications, critical elements clinicians need to see.
Because of the technology, physicians now are able to coordinate and collaborate between all members of the clinical team, from doctors to nurses, therapists and others.
"You get the core information, paired with the most updated labs, paired with the patient location, and you get it in real time, in a way that you can easily digest it and find what you are looking for on a mobile device."
Dr. Misha Rosenbach, Perelman School of Medicine, University of Pennsylvania
"Our group is a primary consulting service, so our role is to see hospitalized patients and add our thoughts on our organ-system and how it impacts their hospitalization," Rosenbach explained.
"We are moving toward using TrekIT as our main handoff tool, for example, during service changes, to use this as a way to conveniently convey our team's thoughts and active treatment plan/issue management on our consult service from one team to another," he added.
Click on page 2 below to read how Penn Medicine reduced readmissions and risk-adjusted length of stay, and more.
RESULTS
According to preliminary findings, the technology has led to a 50 percent reduction in pneumonia readmissions, a 7 percent reduction in risk-adjusted length of stay, and a 9 percent improvement in HCAHPS scores.
"We are using the technology to help with team-to-team coordination and access to clinical data," Rosenbach stated.
Groups using the technology during clinical rounds access real-time data about their patients 50 percent more often than teams that don't, but spend 25 percent less time logging into their devices, TrekIT research showed.
The care coordination technology also reduces the time spent on documenting/cutting-pasting information from the chart because it supports a workflow that is more in line with how caregivers actually practice medicine, instead of trying to emulate paper charts.
"Additionally, given that it is real time and does not rely on paper, it is more HIPAA-compliant and easier to update than most EHR-based handoff systems," he said. "This makes it easier to maintain key patient information from setting to setting and one hospitalization to another."
80 percent of users report that the technology saves them time and three out of four users believe it has reduced errors, TrekIT research showed.
ADVICE FOR OTHERS
Everyone wants doctors to spend less time typing at a computer and more time with meaningful patient engagement.
"Most EHRs are clunky, slow and cumbersome," Rosenbach said. "This, on the other hand, is a tool that has been nimble, secure and efficient. It boosts clinicians' morale, helps ease transitions across teams and clinical sites, while at the same time reducing complications and readmissions. Bottom line is it saves money, improves outcomes and improves physician burden."
Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com
