Mount Sinai improves patient experience with bedside tablets

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Healthcare leaders know patients often feel nervous and uncertain while they’re at the hospital, and addressing these concerns can significantly improve the patient experience. Leaders at Mount Sinai Health System in New York City turned to mobile healthcare technology (bedside tablets) to help comfort, educate and address their patients’ needs.

Compassionate care is an essential part of the healthcare journey, and so is information. Patients at Mount Sinai Hospital can now pick up (Equiva) bedside tablets for quick access to their medical records and answers to their questions. Bedside tablets are now available in more than 450 patient rooms, and Mount Sinai Hospital leadership is exploring the possibility of expanding the solution to other hospitals in the Mount Sinai Health System.

How bedside tablets work

One of the oldest and largest teaching hospitals in America, Mount Sinai has always been at the cutting edge of digital innovation — they introduced electronic health records (EHRs) into their operating rooms in 1991. For this project, the hospital partnered with a software vendor that put all of their chosen apps and mobile content onto one tablet.

Mount Sinai Hospital leaders wanted to give patients real-time access to MyChart Bedside — an intuitive healthcare app from Epic Systems that lets patients view their medical records, lab results, daily schedules, medication information and care team member profiles. The hospital also wanted to provide access to disease-specific educational content, entertainment, spiritual resources, videoconferencing and social media.

With a leading mobile configuration tool, the software vendor customizes the tablet’s user experience for each area of the hospital — so pediatric patients, new mothers and cancer patients all see different content that’s relevant to them. The tablets are containerized and locked down, so patients can’t change the device’s settings and can only access hospital-approved apps and content.

The tablet sits in a basket at the patient’s bedside and is kept plugged in so they’re always ready to use. Most apps are accessible with one tap, but anything that contains sensitive patient information requires the patient to log in with a four-digit PIN. Any time the patient touches the home button or leaves the tablet idle for more than a couple of minutes, all patient data is wiped from the device.

This bedside healthcare technology puts Mount Sinai Hospital one step closer to full-featured smart patient rooms. Patients in recently renovated units (more than 50 rooms and counting) have “digital whiteboards” — smart TVs that display information including their daily schedule, care team members and care goals. The hospital plans to integrate the bedside tablets with these TVs so patients can stream content from their tablet onto the larger screen.

Improved care provider experience

Sometimes screens can impede human connection, but not in the case of Mount Sinai Hospital. “This solution allows us to be both high-tech and high-touch,” says Robert Freeman, the hospital’s vice president of clinical innovation. “Instead of having to press the call bell for something nonurgent, the patient can ask us a question or make a request through the table. The next time the care team is heading into that room, they’re prepared. Patients get basic information from the tablets, so nurses get freed up to have deeper conversations.”

Thanks to a mobile translation app, the tablets also help clinicians communicate with patients who speak another language. Meanwhile, nonverbal and intubated patients can use the device to write, draw or point to what they need.

Enhanced human connections

The tablet solution lets hospital patients connect with their support systems and share information with their families. “Hospital patients are confronted with so much information — medications that are hard to remember and laboratory values they might not understand,” says Freeman. “It can be overwhelming. So, they can use a tablet to talk to their trusted community and family members. Being able to share that information creates a certain level of comfort.”

In some cases, the tablet can even connect them with fellow patients who’ve had similar experiences. For example, when a Mount Sinai Hospital patient has ostomy surgery — a lifesaving but life-altering procedure — they’re welcomed back to their room with a video of someone talking about their own experience with the surgery, providing a firsthand account of what to expect during the healing process.

Engaged patients

Informed patients are engaged patients, and engaged patients have a better hospital experience — and an easier time staying healthy when they return home.

Patrick Healy, associate director of clinical innovation at Mount Sinai Hospital, recalls a perfect example: “We had a young patient who needed emergency surgery. When we first admitted him, I got him set up with the tablet. Initially, he appeared to be anxious. When he logged on the tablet, had access to his medical information and received details about his stay, the patient had a greater sense of calm. He also called his cousin, a nurse, who explained everything we did and reassured him we were doing all the right things.”

According to Healy, “The patient went from scared and uninformed to informed and engaged. Then he just played chess and entertained himself for the rest of the stay.”

Nurse productivity boost

Nurses are the front line of patient care, but they spend much of their time filling out paperwork, responding to less urgent patient requests and answering simple questions. Tablets alleviate some of that burden so nurses can have more in-depth conversations with their patients.

“For example, in our mother-baby units, patients would fill out a paper log about the baby — how often they’re feeding, how often they’re changing and diapering the baby. Then the nurse would have to enter all that information into the computer,” says Healy. “Now patients can log it all through the tablet.”

Improving the patient experience is a team effort

Two years into the bedside tablet program, the Mount Sinai Hospital has improved its HCAHPS scores and decreased readmissions. The secret to their increased success has been seeking feedback from everyone involved — including nurses and patients.

The clinical innovation team realized early on that the project would need to engage nurses to succeed. So they formed a group of “champions,” who have advised them throughout the process. “The nurse champions are doing peer-to-peer education and also coming up with use cases,” said Freeman. “They work closely with our IT colleagues and medical record colleagues, and they help us design the future workflows. That nurse engagement has been the key to scaling this across a very large hospital.”

Mount Sinai Hospital also polls patients about their tablet experience using a five-star rating system — the tablet program’s rating is currently over four stars — and asks patients to suggest future improvements. Hospital leaders take this feedback very seriously. One patient suggested a meal ordering option accessed from bedside tablets; the hospital recently implemented it.

Healthcare technology that empowers patients

“We needed devices that met our security standard and worked well with MyChart Bedside,” says Freeman. “We wanted the ability to wipe data, and we needed tablets that were durable enough to be sanitized between patients. Our hardware partner met all those requirements and has given us a lot of ideas, including the digital whiteboards. And having a software vendor that manages the tablets has allowed us to leverage new technology and scale efficiently.”

Dr. David Reich, the hospital’s president and chief operating officer, echoes these sentiments and says the solution is helping his organization meet 21st-century healthcare needs. “Hospitals have a habit of buying static blocks of equipment, and then the technology fully deteriorates over time. With the tablet-based solution, we really have a much better maintenance approach because it refreshes itself over time.”

This approach also aligns with the hospital’s vision to eventually have smart patient rooms across the hospital. Dr. Reich believes this will take the patient experience “to the next level.”

“There’s a need for hospitals to focus on new and improved means of engaging patients. The federal government has recognized this by creating standardized patient satisfaction surveys and holding hospitals accountable financially. It’s our belief at Mount Sinai that if we create a full ecosystem where the staff and the patients feel engaged with one another using technology as the platform, we can get to the next level, where people feel safe, engaged and empowered by the data they receive.”

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