Critical lab results can be delivered sooner and patients can be discharged more quickly by delivering lab results immediately to physicians’ smartphones, according to recent research.

The study found that chest pain patients whose attending emergency physicians received lab results delivered directly to their smartphones spent about 26 minutes less waiting to be discharged than patients whose lab results were delivered to the electronic patient record on the hospital computer system. The research focused on lab results for troponin levels, which are measured to differentiate between unstable angina and myocardial infarction in people with chest pain or acute coronary syndrome. (An abstract of the study is available online at: http://bit.ly/2sKf7So.)

The smartphone process did not significantly shorten overall length of stay, but the 26-minute improvement in ED discharge was noteworthy, says study author Aikta Verma, MD, MHSc, FRCPC, director of clinical operations in the Department of Emergency Services at Sunnybrook Health Sciences Centre and assistant program director with the Emergency Medicine Residency Program at the University of Toronto.

The overall median interval from final troponin results to discharge decision was 79.7 minutes. For the control group (no smartphone), it was 94.3 minutes, and for the intervention group (smartphone), it was 68.5 minutes. The difference of 25.8 minutes is statistically significant, Verma notes. The system at Sunnybrook Health Sciences Centre also pushes critical lab results to the smartphones in addition to the troponin levels.

The smartphone push alerts deliver the status of the results without the physician having to find the time to inquire.

“There is that lag of time when all the results are back and the patient is ready to be discharged, but the physician is busy doing other things and may not be aware that the results are ready and the patient is waiting for discharge,” she says. “Without sitting at a computer and constantly refreshing, there is going to be a lag time between when the results are sent and the physician realizes they are ready. Pushing that information to the smartphone makes physicians aware immediately, so that he or she can read the results and act on them at the first opportunity.”

The physician does not necessarily act on the results immediately when the push alert is received, but at least is aware much sooner that the information is available. In Verma’s research, physicians acted on the information more quickly than they would have without the push alerts.

Implementing a push alert system first requires overcoming concerns about patient privacy and HIPAA compliance, Verma notes. The hospital addressed those concerns by providing dedicated smartphones to the ED physicians for use only on the premises, with software that enables remote wiping of the phone data if they are lost or stolen.

The phones stay in the hospital and are not dedicated to individual physicians. The doctor signs out a phone at the beginning of the shift, which can be used in all the normal ways a smartphone is used, in addition to receiving the push alerts. They are loaded with useful apps for ED physicians and can be used for calling or receiving calls from other doctors for consultations.

SOURCE

  • Aikta Verma, MD, MHSc, FRCPC, Director of Clinical Operations, Department of Emergency Services, Sunnybrook Health Sciences Centre, University of Toronto. Email: aikta.verma@sunnybrook.ca.