LEVERAGING EXISTING IT INFRASTRUCTURE FOR IMPLEMENTING & INTEGRATING A PATIENT ENGAGEMENT SYSTEM

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1 LEVERAGING EXISTING IT INFRASTRUCTURE FOR IMPLEMENTING & INTEGRATING A PATIENT ENGAGEMENT SYSTEM COAXIAL CABLE RF CAT 5/CAT 6 ETHERNET WIFI STAFF COMMUNICATION EMR NURSE CALL SYSTEM REAL-TIME LOCATION PATIENT EDUCATION ADT DIETARY SYSTEMS ENTERTAINMENT ORDERS CHARTING ENVIRONMENTAL CONTROLS

2 ADDRESSING HEALTHCARE DATA INTEGRATION TO AUTOMATE PATIENT ENGAGEMENT WORKFLOWS Improving patient engagement is increasingly important for hospitals to boost clinical outcomes and patient satisfaction levels, as well as to comply with Meaningful Use Stage 2 requirements. To accomplish this, hospitals must determine if expensive infrastructure additions are needed to support their patient engagement initiatives, or if they can better leverage their existing infrastructure to achieve their goals. STAFF COMMUNICATION DIETARY SYSTEMS ENTERTAINMENT EMR ENVIRONMENTAL CONTROLS ORDERS PATIENT EDUCATION REAL-TIME LOCATION ADT NURSE CALL SYSTEMS CHARTING What many hospitals don t realize is that raising patient engagement levels doesn t necessarily entail adding enormous amounts of costly infrastructure. Much of the infrastructure that hospitals need is already in place. Most in-room televisions that are ubiquitous at today s hospitals can be adapted to become interactive patient engagement tools. Once adapted, these TVs can deliver educational materials and help patients better manage their hospital experience. The interactive technology 2

3 also creates the foundation for next-generation patientengagement strategies delivered via patient-owned tablet and smartphone devices. Achieving this level of patient engagement with in-room TVs requires exchanging information with other solutions within the hospital to customize the patient experience. This white paper explores the data integration issues surrounding the patient engagement strategies that are of concern to hospital chief information officers (CIOs) and chief nursing informatics officers (CNIOs). ADAPTING TVS FOR PATIENT ENGAGEMENT In-room TVs are an excellent delivery method for patient engagement. With the proper adaptations, in-room TVs essentially become the steering wheel and windshield for patient engagement by creating an interactive environment. By exchanging information with other health systemowned solutions, in-room TVs can provide a customized experience for patients based upon their conditions, treatments and more. For example, patients can navigate on-screen menus to view patient education materials ordered by clinicians. Additionally, patients can use their in-room TVs to register for the hospitals patient portal for easy access upon their return home, and also obtain details about their hospital stay, such as listing scheduled appointments (e.g., rehabilitation, etc.) and information about their clinicians. Other interactive capabilities include: Ordering meals based on allergy and dietary restrictions Managing environment controls (e.g., heat/air) within their rooms Getting emotional and spiritual support through customized on-demand programming PATIENT ENGAGEMENT DRIVERS: Improving patient engagement is vital for today s hospitals to improve patient outcomes and satisfaction scores. A study sponsored by the Robert Wood Johnson Foundation, and published in Health Affairs, reported that patients who are more actively involved in their healthcare experience better health outcomes and incur lower costs. As a result, many public and private healthcare organizations are employing strategies to better engage patients, such as educating them about their conditions and involving them more fully in making decisions about their care. 3

4 Creating an interactive patient engagement environment via in-room TVs requires accessing and sharing data stored from other solutions within the hospital, which may include: Electronic health records (EHRs) Admission, discharge and transfer (ADT) systems Dietary systems Environmental controls Multimedia and entertainment systems Nurse call systems Patient scheduling systems INTEGRATION ISSUES TO CONSIDER There are hardware and software integration issues to address. To identify hardware integration issues, gap analyses should be conducted to determine if existing TVs and network infrastructure can be used for the patient engagement strategy. Although most TVs whether they are old or new can be adapted for use by adding external input devices, organizations should closely examine if these workarounds are cost effective or limit capabilities. Resolving software data integration issues requires addressing the numerous standards that are used to exchange health information. Some solutions make it easy to exchange data, while others are based on proprietary architectures, making data exchanges a challenge, but not impossible. PATIENT ENGAGEMENT DRIVERS: Patient engagement also impacts patient satisfaction scores, and several organizations administer patient satisfaction surveys as part of their focus on improving care quality. These include the Joint Commission, Press Ganey, and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Survey results are available to the public and greatly influence hospital choice among consumers and medical professionals. Hardware Software TVs Networks Interfaces Workarounds Are TVs connected via coax cable or IP networks? Do the TVs require additional external interface hardware? Can TVs connect to a broadband LAN (b-lan ) or IP network using built-in technology? Do existing network switches support both unicast and multi-cast routing? Does the existing IP network have the bandwidth to support additional capacity? What existing interfaces (ADT, etc.) can be used to support patient engagement? Are additional interfaces required? Can existing interfaces be used as a workaround to exchange data with other systems? What other data entry methods can used to achieve goals? 4

5 These data integration challenges are widespread throughout the healthcare industry and are not exclusive to the task of adapting in-room TVs for patient engagement initiatives. In fact, one of the healthcare industry s largest technology vendors has recently come under Congressional scrutiny for its alleged interoperability challenges. In essence, the scrutiny focuses on how the vendor could achieve increased sales as a result of the Meaningful Use program a taxpayer-funded program intended to increase interoperability yet still sell solutions that make it difficult to share information with other systems. The inquiries into this situation, and others, are ongoing. OVERCOMING INTEGRATION CHALLENGES Overcoming integration challenges requires a change in mindset. Rather than focusing on what types of data the hospital can get in or out of its EHR (or other systems), focus on the goals that the organization is trying to accomplish, such as: Reducing or eliminating manual entry of specific data components by nursing staff Populating specific EHR data fields Increasing patient portal registrations Automating processes that consume nursing, support staff or other resources For example, a top desire among hospitals is for their EHR to automatically chart when patients receive the educational materials ordered by clinicians. The automated process eliminates manual data entry by nurses when educational materials are delivered. Automatically recording this data also helps hospitals comply with Meaningful Use requirements. Occasionally, some EHRs make it difficult to accept inbound information from other systems or force them to purchase custom-built interfaces. This creates challenges when trying to get data into the correct field within the EHR, such as recording when patient education materials were delivered. Workarounds for this type of scenario may include leveraging the interfaces of other systems that can exchange information with the EHR more easily. 5

6 Alternative strategies may include barcoding patient education materials so they can be scanned and recorded as delivered in the EHR. In the end, it s important to be creative and look for options that better leverage the infrastructure already in place. The goal is to accomplish the organization s goals, not get bogged down with system limitations. SECURITY There are two major security aspects to address. The first is physical security. The saying goes that organizations are responsible for the information stored within their equipment. If someone can physically touch the hardware or equipment, then they can potentially access the information within it. TVs, as well as the cable terminals and IP client devices connected to TVs, have the potential to be physically exposed during their use. As a precaution, organizations need to develop strategies to physically protect these devices. The second major security area to address includes software and network security. All points of access among these components interfaces and devices need to be evaluated to comply with HIPAA guidelines. FUTURE CONSIDERATIONS Creating an interactive patient engagement environment via in-room TVs also creates the foundation for additional engagement opportunities. For example, the growing trend of delivering content anywhere, anytime has given rise to a larger number of people who want to access information from the comfort of their homes. In-home access will allow patients to access the patient education materials ordered by their clinicians. These are typically accessed via the hospital s patient portal, which requires data sharing with the patient engagement solution. Additionally, the bring your own device (BYOD) trend is driving hospitals to accommodate the desire of patients and family members to use their tablets and smartphones PATIENT ENGAGEMENT DRIVERS: MEANINGFUL USE STAGE 2 Additionally, Meaningful Use Stage 2 includes the following requirements that are intended to help hospitals boost patient engagement: Requirement: Use clinically relevant information from certified electronic health record (EHR) technology to identify patientspecific education resources and provide those resources to the patient. Threshold: More than 10 percent of all unique patients admitted to the eligible hospital s inpatient or emergency departments must be provided patient-specific education resources identified by certified EHR technology. Requirement: Provide patients the ability to view online, download and transmit information about a hospital admission. Threshold: More than 50 percent of all unique patients discharged from the inpatient or emergency department of eligible hospitals must have information available online within 36 hours of discharge. (Note: Patient portals are the key technology component to enable this information sharing. Getting patients registered to use the portal is a key function of engagement during their hospital stay.) 6

7 to access information within the hospital. This creates yet another opportunity to increase patient engagement. When evaluating patient engagement solutions, it s important to select the ones that include the technology foundation for these new content delivery methods. ABOUT SONIFI HEALTH SONIFI Health provides interactive patient technology that inspires active patient and family participation along their care continuum for positive behavior change and improved outcomes. The system is delivered across multiple technology platforms including mobile devices, computers and televisions at the bedside and in the home to improve patient and family experience while increasing hospital operational efficiencies. Through integration with multiple hospital systems the patient can view assigned educational content, complete questionnaires, order meals, view care team information, access their schedule, enjoy in room entertainment and relaxation therapy, adjust temperature controls, and interact with their care team. To learn more about integrating hospital systems with Patient Engagement Systems, contact SONIFI Health at: *b-lan is a trademark of SONIFI Solutions. 7

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