When I talk to fellow clinicians at Sequoia Hospital who are now using mobility to monitor labor and delivery patients, or view ECGs in near real-time, the reactions are uniformly positive. They praise the ability to make faster, informed assessments based on the information they access on their smartphones or tablets and the workflow improvements.
However, from a surgeon’s point of view, the most exciting developments are just starting to happen. Incorporating mobility throughout the cardiac care continuum and providing constant monitoring of patients anytime or anywhere is the real game-changer. Because we are most interested in the total care of the patient, continuity is crucial – and mobility enables this in ways that were never possible before.
Surgeons simply cannot be in the hospital 24 hours a day – nor can we be in two places at once. Yet as my fellow cardiac surgeons can attest, we’re constantly interested in rhythm changes, QRS morphology changes as well as monitoring a variety of different pressures and validity of the waveforms. Historically we’ve had to assess these measurements verbally over the phone when we are not at or near the bedside. With mobile technology, we can get up to speed in moments so that assessment and therapeutic intervention, when needed, can be made almost immediately upon logging on to the mobile device.
Two situations I’ve seen where I’ve seen mobility makes an impact come to mind:
- Post-operative rhythm disturbances are a constant source of concern for cardiac surgeons. When on call, I may get several such phone calls a week. If I can’t actually see the data, then I’m relying on somebody else’s interpretation. Sequoia Hospital has extraordinary ICU nurses, but it can be difficult for surgeons to make therapeutic decisions based on others’ assessments. When even the remote possibility of a mistake exists, giving the surgeon the anytime, anywhere ability to see the rhythm in near real-time is a phenomenal step forward. Having an experienced eye working with the rest of the care team to examine the morphology of a waveform contributes to stronger decision-making on behalf of the patient.
- If I am in the operating room and must see a rhythm strip or a pressure waveform on a patient that I previously operated on – or the patient is in the ICU or pre-operative phase – mobility allows me to immediately access that information directly in the OR without the need to go through the cumbersome process of scrubbing out to get to the patient’s bedside. Being able to keep an eye on all my patients while operating is a huge benefit for me.
Sequoia Hospital is now in the process of integrating mobility throughout the cardiac care continuum. As one who has worked through potential use cases and seen the promise of this technology up close, I anticipate a real impact on overall safety, efficiency and improved clinical decision support.
To put it in less clinical terms: we’re psyched to put mobility to work.
Dr. Adam Harmon is a cardiothoracic surgeon at Sequoia Hospital, a Dignity Health member in Redwood City, CA.