Tablet-based health interventions

Following Martin's article last month comparing the genius bar at Apple to a clinicians diagnostic algorithm, it's appropriate to bring to light the recent e-prospects of Orange Health Service. Never mind that we may be 4 hours into the wild western NSW; the new Orange Hospital, which was completed in 2011, is at the forefront of enthusiasm for innovation in medical technology.

I may be speaking for a select few, or perhaps the niche personality types of JMOs, but I feel that in today's society, the marriage of slight OCD traits and a digital addiction result in an aggressive intolerance to inefficiency. These first-world frustrations are exemplified by the fact that we live in a digital world, yet once you walk through the doors of a hospital, you are entering the mid 90s. A boss tells a registrar a job, who then tells the junior, who then writes that job on a piece of paper, who then completes the job, only to then contact the registrar who then contacts the boss to confirm the job has been completed. It seems comical, not to mention the safety issues and discrepancies of the Chinese-whispers style communication, or the daily issue of JMOs dropping their lists in the carpark, leaving them at the local cafe, or even worse, in the toilet.

In 2015 the Orange executive launched a Dragon's Den competition that enabled JMOs to contribute their ideas to a panel and be awarded funding for small projects. JMOs in OHS proposed 2 concepts: iPads on the wards for task allocation, and the creation of more medical apps. We proposed to equip ward based JMOs with tablets loaded with an application for task management, which is securely backed up and replaced the need for paper lists. The concept is that nursing and allied staff will have access to this list, and can add tasks as appropriate.

The power of this solution is in reliability - paper lists and the use of either whiteboards or informal verbal handover of tasks leads to many mistakes. Furthermore, transitioning to an electronic format might also help remedy our perhaps pathological 21st century aversion to inefficiencies.

But it doesn't end there. Imagine the potential for patient education. DrawMD - a well used app in the US - could allow a cardiologist to explain atherosclerosis to patients with diagrams, or allow a patient to view their angiogram results at the bedside with the physician explaining.

Cardiologist explaining concept to a patient using DrawMD

By way of example, in 2015 OneView launched a tablet-based patient portal in Epworth Eastern Hospital, Melbourne. Their nurse rounding application has resulted in a 6% decrease in pressure ulcers and a 4% decrease in patient falls. Meanwhile patients prepare for discharge with video education, goal completion and real-time collaboration with their care teams, resulting in 6% decrease in length of stay. [1]

You are probably thinking: this all sounds fairly simple! And not exactly ground breaking... However there are critical barriers in terms of change management and data security that need to be overcome. But can the medical world really resist this digital storm?

[1] Kinmont, K. Epworth Eastern Hospital Realises Improved Outcomes with Oneview Interactive Patient Care Technology Solutions. Oct 21, 2015. News, Available from; Oneview Blog: