How Technology Is Stepping Up Patient Care in the ER

Share By Julie Jacob

In many hospitals, the emergency room experience can be chaotic, stressful and inefficient.

Your medical records are often inaccessible to staff on short-notice and it’s easy for important information about your history and medications to fall through the cracks.

But what if your medical history was readily available to physicians and staff with the touch of a button?

Integrating more information technology into emergency departments can drastically improve patient care and safety at hospitals, according to the American College of Emergency Physicians.

In its 2014 report card, the ACEP gave a grade of “C” for overall patient care and safety in emergency departments, ruling that ERs need to increase their use of information technology. The changes would improve the accuracy and availability of medical records, keep better track of patients and transfer patients to beds more quickly.

Technology is already being used to help emergency departments run more efficiently and effectively, according to emergency medicine physicians and health care technology experts, but implementing it comes with some drawbacks.

Here are a few examples of how information technology is being used in hospitals around the country:

Electronic health records (EHRs)

The American Recovery and Reinvestment Act of 2009 allotted funds to the Centers for Medicare and Medicaid Services to award financial incentives to doctors and hospitals that adopted EHRs that met the organization’s standards for meaningful use. In 2013, 85 percent of hospitals in the United States had EHR systems that met the CMS’s Stage 1 criteria for meaningful use, according to the Department of Health and Human Services.

EHRs have numerous advantages over paper records, noted Dr. Andy Kahn, an emergency physician at Baylor Medical Center at Garland, Texas, where EHRs were adopted in fall 2012. EHRs don’t get lost, they can be viewed by more than one health care professional at a time, doctors can quickly look at them on their tablets or smartphones, and they can even assist physicians in their decision-making through automatic prompts and questions based on the data that physicians enter.

However, EHRs do have some drawbacks. For one thing, it takes more time to type in data and click on dropdown menus than it does to scribble handwritten notes, noted Kahn.

In addition, EHRs generally are one-size-fits-all systems and are not customized for the emergency department, noted Dr. Liudvikas Jagminas, vice chair and associate professor for emergency medicine at Yale School of Medicine.

“There are EHRs that are “best of breed” for ED (emergency department) use; however, many hospitals want one system that “does it all” for all aspects of the hospital IT needs which many times means compromises on the ED module,” Jagminas said in an email.

EHRs should also be designed to push information to busy emergency department physicians, rather than requiring them to pull it up, he added. The health records could alert physicians to prior scans, he said.

Finally, many EHR systems are not yet interoperable, meaning that staff in health system A cannot access a patient’s EHR from health system B. However, the CMS’s next stage of meaningful use requirements (Stage 2), which will be phased in over the next two years, requires EHR systems to be able to exchange patient medical information with other health care providers. States have received federal funds to establish health information networks, and in some states, such as Delaware, health information networks are already functioning.

Real-time tracking system

A real-time tracking system serves as a sort of air traffic control system for emergency departments. Using software that converts signals from the sensors into data points on a grid on a computer screen, the system pinpoints the location of each staff member, patient and piece of equipment at every moment.

Sensors attached to beds and equipment and worn by staff emit radio signals that are transmitted to the system, explained Alan Lipschultz, a clinical engineer and president of Healthcare Technology Consulting LLC in North Bethesda, Md.

“You know where all the players are,” said Lipschultz.

In addition, real-time tracking systems generate valuable long-term data that can help improve safety, quality, and patient flow, he said.

However, real-time tracking systems can cost hundreds of thousands of dollars to install, and a hospital’s computer infrastructure may not be compatible with the system, he noted. And because many small companies are selling these systems, hospitals may be reluctant to invest in one until they are sure that particular system will be around for a while.

Moreover, many health care professionals balk at having to wear sensors that track everywhere they go, he said.

Bed management systems

Finally, bed management systems make transferring patients from the emergency department to beds elsewhere in that hospital quicker and more efficient, thus reducing waiting times and patient backlogs. Instead of checking on the availability of a bed through a series of phone calls or messages between the emergency department and the department where the patient is going to be admitted, the emergency room staff can consult the computer to check the availability and estimated wait times for beds.

Over the long term, the system also compiles data on the average time it takes to discharge a patient, clean a room, and admit a new patient, which helps the hospital figure out steps in the process where backlogs occur.

Despite the cost, infrastructure challenges, and organizational resistance to change that create obstacles to using information technology, Lipschultz said that emergency departments will continue to embrace advances in information technology because it “removes bottlenecks and improves safety and is more efficient.

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  1. Blues and Twos

    real-time tracking systems can cost hundreds of thousands of dollars to install, and a hospital’s computer infrastructure may not be compatible with the system, he noted.


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