Visiting Nurses Cure Their Mobility Ills

By  Teresa von Fuchs — December 10, 2009

As with many new mobile deployments, the 600 nurses and field staff of the Visiting Nurse Association of Central Jersey (VNACJ) were skeptical four years ago about how carrying around a laptop and learning a new software system was really going to help them improve the way they do their jobs.
 
Once the solution was deployed, however, the staff quickly couldn't image how they ever did their jobs the "old" way. But the story doesn't end there.
 
Though most nurses were pleased to eliminate paper forms and hours of data entry, there were still issues with the then-new solution. While nurses loved the automation of forms, they complained about the weight of the hardware, unreliable connectivity and a much-too-short battery life.
 
Headquarters was also not entirely pleased with the high total cost of ownership involved in deploying and supporting laptops and aircards.
 
Not even six months into the new deployment, IT was already looking around for a different option. It was then that VNACJ discovered Homecare Homebase, a Web-based software system designed by home health care professionals specifically for homecare agencies.
 
Homecare Homebase uses customizable, on-screen forms to collect patient data and then seamlessly synchronizes the data with a backend data center. Proprietary compression technology keeps the sync fast (about two minutes).
 
Transmitted data is encrypted and meets all HIPAA security standards. Homebase is designed to work with Microsoft's Windows Mobile platform, which prompted VNACJ to look into using more affordable smartphones to replace laptops. They chose HTC Touch Pro PDAs.
 
For the last three years nurses, and field staff have used the Homebase software while visiting patients all over central New Jersey. According to John Albright, director of IT for the VNACJ, "most of what used to be paperwork is going through forms and answering questions.
 
Visits vary, but the initial visit is usually the most data entry heavy, especially with patients on Medicare. Medicare requires pages and pages of forms, as well as the initial physical assessment, and initial care sheet."
 
Once the initial assessment is completed nurses use the system to look up patient information, including health records, previous nurse notes, treatment plans and medication information. Patients also sign off at the end of a visit, right on the screen of the handheld. Nurses and field staff also use their handheld for scheduling.
 
When a nurse is ready to start the day, he or she views the scheduled jobs, including patient information, address and directions, and then accepts the first assignment. Albright says this function is essential in ensuring that all patients are seen in the most timely fashion. Should a visit take more or less time than expected, or if traffic suddenly backs up on the highway, no one is waiting around for schedules from a dispatcher.
 
While field staff was happier with handhelds compared to the laptops, issues began to arise about screen and keyboard size. While the mobility of the handheld made it a nimble solution, nurses were having trouble reading and writing detailed field notes on the small screen and thumb-based keyboard.
 
"Nobody was making a device in-between a PDA and a laptop," explains Albright. The company tried wireless keyboards, but that didn't solve the issue of reading on a small screen. "We actually were asking our carrier partners if they knew about a solution and Verizon [Wireless] introduced us to Celio and its RedFly mobile terminal."
 
The RedFly is a 'companion' terminal that looks like a laptop with an 8-inch screen and full-sized keyboard, but without the actual guts of a laptop. Instead the RedFly is simply a screen and keyboard extension of your handheld. VNACJ can connect their HTC Touch Pro PDAs via USB cable or Bluetooth, and away they go.
 
Since the RedFly has no hard drive, patient data stays entirely secure, and without having to pay for a CPU or OS, Celio can keep the RedFly's TCO very low.
 
The VNACJ initially deployed about 350 RedFly units to its field staff, with another 100 on the way. "Some, mostly younger staff, don't want to carry around another device, but they are also the ones most comfortable typing and reading on small devices," says Albright, "the largest percentage of our staff is really pleased with the RedFly, some are even ecstatic."

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