2013 Mobilizer Awards Business Apps

By  Stephanie Blanchard, Digital Editor & Lori Castle, Editor in Chief — November 04, 2013


Dignity Health, one of the nation's five largest health care systems, is a 21-state network that provides patient-centered care at more than 300 care centers, including hospitals, urgent and occupational care, imaging centers, home health and primary care clinics. Founded in 1986, the company has 56,000 employees and 10,000 physicians.
To harness innovation and solve crucial issues, the organization has an internal Greenlight Challenge where technology can "make a difference at the bedside." Dignity Health CEO Lloyd Dean sets the bar high: What specific ways should the organization use emerging mobile technologies to improve the quality of care, lower cost, grow and/or expand access to communities?
As a result of this challenge, four new technologies were awarded funding through Greenlight, one of which is AirStrip OB, a mobile patient monitoring solution for labor and delivery departments. Increased revenue was never a consideration. The most significant factor in designing the app was the impact to patient safety.
AirStrip OB allows obstetricians to remotely access fetal heart rate tracings, maternal contraction patterns and other critical patient data, anytime, anywhere, streamed to their smartphones or iPads. It not only provides real-time access, but the ability to backtrack and see what pattern created the present situation.
Previously, physicians would often call the labor and delivery unit to check on their patients, potentially several times per nursing shift. Each time a call came in, the unit clerk had to locate the nurse in question, who in turn had to stop what he or she was doing. Then, the nurse would spend several minutes discussing the patient’s status, making references to the central station monitoring information and perinatal information system or paper chart. The physician could then adjust orders or schedule arrival based on the conversation.
Such a cumbersome process, however, disrupts bedside caregiver workflow and may often frustrate the delivering provider. In addition, there was no real way for nurses to accurately convey what they saw on the monitor. It's similar to describing how a sunset changes—everyone is going to see, interpret, and describe it differently.
AirStrip OB, therefore, creates a virtual bedside, accessible to delivering providers wherever they may be and whenever they need the information. Physicians and midwives can easily manage their workday and monitor their patients without relying upon the bedside caregiver to provide the information. This saves time and effort, and frees up nurses to spend more time where they are needed most—with patients.
The app provides increased patient safety by improving communication between nurses and obstetricians and addresses two other risk management issues: Delays in diagnosis and treatment of fetal distress and the misinterpretation of fetal heart monitoring data.
AirStrip OB has also been designed to use strong encryption with no local data stored on the mobile device, as the health industry has stringent regulations to comply with when it comes to patient information and privacy.
The first hospital went live in July 9, 2012. The idea "went viral" so to speak as other hospitals in the network wanted to adopt the same app. The overall result is significant improvements in patient safety, nurse productivity, provider satisfaction and reduction in claims filed due to challenges experienced during delivery.
Barbara Pelletreau, RN, MPH, Sr. VP, Patient Safety & Clinical Risk Management, Dignity Health, noted that physician feedback has been overwhelmingly positive. Immediate access to patient information provides actionable insight. The doctor sees exactly what is going on, how the baby is doing, where the baby might be compromised on oxygen, and other critical indicators.
The app can also extend peace of mind to the patient. "Most mothers-to-be go in with a positive attitude that things are going to go well. But there are rare occasions when delivery doesn't go well. That’s when you want that information readily available," she said.
And notably, there has been no pushback from end users. Physicians, using their own smartphones, have embraced the technology, especially during non-business hours (7 p.m. to 7 a.m.) Several nursing directors are also monitoring their patients using their iPads when away from the hospital as an extra set of eyes for their staff and patients.
"Once people see how easy it is to use, how simple it is, even those who are somewhat adverse to technology in general will say, 'Wow, see what I can do with this?' It's not been a hard sell," Pelletreau said. In fact, it's a win-win, for the patients, for hospital staff, and in this case, a literal win for the business app itself.

Honorable Mentions

A New Record
In 2012, the City of Wichita Falls deployed a mobile case management solution in its municipal court. Essentially, the city rolled out Laserfiche’s mobile app with iPad 2’s to reduce backlogs in the court. The mobile app serves numerous functions—in particular, it allows Judge Larry Gillen to update status of cases right from the bench.
According to Patrick Gray, Systems Applications Analyst, the court used to generate approximately 3,000 pages of paper a month. "By eliminating the need to print records, we've regained the space that used to house 14 filing cabinets and saved 20% on paper. Even better, by decreasing the need for court clerks to find and file records, we're decreasing wait times and saving staff time." He says the court staff calls the new process "magic."
Security was a major consideration. Along with backend and network safeguards, the app plays a role in protecting records from unauthorized users. For example, court clerks who need to administer documents have different permissions than those who only need access to them.
Looking to the future, the court plans to adopt a paperless ticketing system that will enable police officers to upload data directly to the document and records management system from the field using mobile devices—eliminating the need to scan tickets into the system and saving even more time for the court clerks. Eventually, the City would like to go completely paperless.
Ship to Shore in an App
"The Shore Excursion App has empowered our shipboard employees to book shore excursions anywhere/anytime on the ship, which has increased sales and improved customer service," said Therron Hofsetz, Director IT Applications Holland America Line.
He said their focus and approach throughout the deployment has always been on the guests and staff. "We worked extremely hard with a development team from Slalom Consulting and our internal team to design, develop and refine the Shore Excursion App so that it delivered an intuitive, easy to use and compelling solution,."
Traditionally, guests would add the excursions to their reservations prior to departure.  However, the app provides the ability to easily make changes. The  advanced search capabilities make it easy for guests to find an excursion that matches their interests, physical capabilities, schedule and price.
This was the first app built by the organization and the first time customer-facing employees have interacted with the guests using a tablet. Success can be measured, in part, by a high adoption rate. In the first 6 months, the app was used to book over 2,200 shore excursions on 48 voyages. It has also triggered a flood of new ideas for how mobile technology can benefit other parts of the business. Hofsetz says, "Our company mission is to 'Deliver Once in a Lifetime Experiences, Every Time,' and everyone on the project made this a reality in the Shore Excursion App."


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