Clinical Mobility: On the Move to Improving Healthcare Delivery

From accessing health records on tablets at the point-of-care to enabling remote monitoring of patients, mobile devices are at the heart of today’s enhanced patient care

By Deepa Narwani, Editor

Say goodbye to paper for good in healthcare as digital transformation is currently revolutionising outdated patient care. Today, both providers and patients require access to their data and devices at all times and clinical mobility and cloud solutions are making this possible. Not only that, it is also driving efficiencies across all areas right from improved care to streamlined clinical workflows.

Clinical mobility has started to create a profound impact not just on IT executives but also on nurses, doctors, and patients. For example, the use of handheld computers and mobile printers by doctors and nurses at the bedside or providing a tablet to patients to allow them access to their reports and care programmes, along with social media apps, is not a scene from Netflix’s sci-fi show Black Mirror anymore. It has become today’s reality and leads to an overall better patient experience.

Around the world, clinical mobility is transforming care at healthcare facilities by digitally capturing data and transmitting it in real time to clinical staff, thereby eliminating manual error-prone procedures and delivering critical time-savings. As an early adopter of innovation across the board, Dubai is also witnessing this trend in healthcare. For instance, the newly opened Mediclinic Parkview Hospital in Umm Suqeim, Al Barsha South 3, recently entered into a partnership with Zebra Technologies in order to digitise its processes and enhance patient safety and care.

Digital Hospital Model

A greenfield construction, the Mediclinic Parkview Hospital, Mediclinic Middle East’s seventh general hospital in the UAE, opened in September 2018. As part of the tie-up with Zebra, the hospital is utilising the tech company’s healthcare solutions that will be used for patient identification, increased visibility of medication administration and clinical mobility with mobile access to medical data. The facility’s ‘digital hospital model’ sees it using Zebra’s printers, barcode scanners, wristbands and tablets that are integrated with the Mediclinic Group’s new Health Information System (HIS).

Barry Bedford, Hospital Director, Mediclinic Parkview Hospital, told Arab Health Magazine: “Healthcare is a combination of service providers, doctors, and pharmaceutical companies. It is an amalgamation of a lot of people and just in this hospital, we have more than 35 different specialities and highly qualified people from 40 different nationalities. Everyone comes from different backgrounds and we want to make sure that technology is somehow aligning them. Safety is important to us that is why we have adopted systems such as Electronic Health Records (EHR) and have top-class doctors.

“Mediclinic Parkview is a flagship hospital in the southern part of Dubai. There are 800,000 people around this hospital. After just one month of opening, we see almost 260 patients almost every day. This includes around 10 in-patients, which for us is critical and we can achieve that only thanks to the technology we employ. We don’t want technology only in the hospital, we want it in our ambulances and in pre- and post-operative care.”

Zebra’s healthcare solutions for Mediclinic identify and track patients from admission to the bedside, medical laboratory, and pharmacy, ensuring visibility of key data at the point-of-care, to help enhance the quality of patient care and safety, and overall hospital efficiency. Furthermore, these mobility solutions support clinicians across the hospital including doctors on their daily rounds to assess patients with access to medical records such as patient medical history, treatment, and test results. These solutions include tablets, barcode scanners, especially when it comes to patient identification and access to medical records and ensure that the right treatment or medication is available to the right patients. It also includes specialised type of printers and scanners that can be sanitised.

Bedford highlighted that one of the first international patient safety goals is the proper identification of the patient. Also, one of the biggest errors in the world is medication errors or near miss of medication errors.“Can you imagine receiving someone else’s blood results! This is where technology plays a crucial role in filtering these aspects for the doctor. But in the old days, it used to be what’s your name, etc.? But now you scan, and as soon as that’s done it meets five criteria’s immediately. For me it’s so refreshing as between the different languages and cultures around us, there can be a gap. And thanks to technology, with one scan we are able to bridge the gap and minimise and even eliminate all these human factors that could cause errors. From a patient safety point of view, it makes it 10 times easier for us to manage,” he explained.

Raziel Peña, ICT Operations Manager, Mediclinic, added: “This integration allows for standardisation of products across the board. One of the key things we have received from Zebra is healthcare grade equipment, which means the hospital staff can safely clean the whole thing and make sure everything is up to standard when it comes to infection control, without degrading the quality of the equipment. Furthermore, it makes it easier for the staff to access information. That translates to patient safety and they can comfortably concentrate on actual patient care.”

While Thamer Nouri, Business Development Manager, Zebra Technologies explained that the company’s goal is to not to talk only about products and hardware, but put emphasis on discussing patient safety, medication administration, mobility, patient quality of care, and how technology can be used to improve patient care. He highlighted that staff from different levels of Mediclinic, such as the end-users, IT and chief nursing officers were involved in evaluating the technology that would be the right fit for the organisation.He said: “Our technology acts as the “digital voice” for a patient and links them to the HIS to ensure that it enhances clinical mobility and intelligence.”

Integrated Care

According to Bedford, an integrated hospital is a safe hospital. He expressed that EHR integration is not only clinical, it also is about the financials and the revenue. When you compare a paper-based system to an integrated one, he stressed, the integrated system also includes people, audits, recordings, and lessons learned, and everything becomes easier to extract. However, a reliance on paper could lead to errors, which might not be easy to pick up.

He said: “You often have a lot of standalone systems, but technology is able to interface and integrate it all from the end-user’s perspective. This includes everything right from barcode systems, tablets, and could even include integration between ventilators. Plus, it’s easy to use these systems. For example, a nurse takes a scanner, does the scan and puts it down, it’s as simple as that. It’s faster, more user-friendly and accurate, and gives more credibility from a patient’s point of view.

“When someone comes into the hospital, what is the safest way to treat them? You don’t want to bring a patient to the hospital and keep them around equipment that is not vetted by international standards. We follow all the required regulations to ensure that technology is helping us to be able to provide that service. Tomorrow if you want to start a cancer database, by integrating this technology with our lab results you will be able to easily identify when cancer has been diagnosed. Cancer often gets diagnosed not in the hospital but in primary care facilities. That’s where you need to get the integration right.”

Zebra’s Future of Healthcare: 2022 Hospital Vision Study identified the rising adoption of clinical mobility – the use of mobile devices such as handheld mobile computers, tablets, cordless barcode scanners, and mobile printers – in hospitals around the world. Seventy-two percent of surveyed decision-makers say that mobile devices are improving the quality of patient care, giving clinicians actionable intelligence at the bedside with the effect of increasing time with patients and reducing errors.

The numerous benefits of clinical mobility are fuelling an increase in adoption of mobile technologies at every level of care. According to survey respondents, nearly all hospitals estimate that mobile devices will be used at the bedside by nurses (97 per cent) and physicians (98 per cent) by 2022, but also increasingly by other members of the care team such as pharmacists, lab technicians, radiologists, and patient transport professionals. The study also highlighted how patients perceive the rise of clinical mobility with nearly eight-in-ten survey respondents feeling positive about mobile tools being used to improve their care.

Focus on Quality

Peña shared that involving the doctors and nurses and finding out what they think about the product, was an important step, as it helped them understand how the staff could do their jobs easily.

“For example, in the pharmacy and the lab, we have heavy-duty printers, as they have a lot of stuff to label. In terms of printing, everything is networked in the hospital. That includes printing solutions in terms of labelling and wristbands and ensuring that everything goes seamlessly via the EHR solution network and also allows to share the resource. Before we could have only one printer per workstation but now that allows us to save a little bit in terms of space and cost and now, for instance, the nurses are sharing these printers, as they are customisable. A happy staff equals to happier and healthier patients,” he described.

According to Nouri, most hospitals don’t have a high level of mobility, or probably no mobility, but he expressed that he can see a change in this trend in both the UAE’s public and private sector.

“What we are seeing among our clients in terms of applications is that when it comes to mobility or mobile computing, they look at medicine administration, or bedside sample collection and identification using a mobile printer or a mobile Personal Digital Assistant (PDA), to identify these samples and reduce risk of misidentification,” he explained. “However, there is much more that can be done around mobility. For example, we can have connected biomedical devices, where you receive patient alerts about blood pressure, it could be connected to a ventilator, could be a heart monitor, so the vital signs, are connected to the HIS and at the end of the day the nurse in charge would receive the notification about the patient. Also, these devices will be able to connect with voice, so there will be a voice solution for communication, different types of alerts, secure messaging, and that in a way encapsulates a connected hospital.”

But according to Peña, the intelligence of these machines comes down to how much data you put in and how it can be used for different purposes. Having everything connected, right from tablets to scanners to biomedical devices, is making it easier to have the information centrally and easily accessible. These systems offer analytics that can be used for different purposes such as management decisions, or to get highlights of the records that will help doctors identify some cases later and gain knowledge. In the future, that is probably the kind of intelligence the government will be looking at, for example, to find out what the population is complaining about or getting sick of and later launch prevention programmes.

He concluded: “Innovation is very important, and we are investing in the necessary technology to make sure that the patient care is improved. I am sure that soon enough there will be a mandate from the government in terms of collaboration with other healthcare providers and the government itself, and I like to think we are ready.”

Digital Transformation

Zebra is working with the Dubai Health Authority (DHA), to provide new specialised healthcare technology solutions to enable the digital transformation of the emirate’s healthcare sector. As part of the DHA’s Salama unified electronic medical record (EMR) system, the collaboration with Zebra provides enhanced patient identification and mobile access to medical data, from patient admission to bedside to discharge.

The Salama system was launched in April 2017 to provide patients and doctors with access to medical records through an electronic patient portal. In this regard, Zebra manages the deployment of a broad range of solutions including healthcare purposed mobile computers, scanner, printers as well as wristbands. These products have been specifically designed to meet the unique demands of the healthcare environment, in conjunction with DHA’s Information and Communications Technology (ICT) and clinical team requirements. The solutions have been deployed across all of DHA’s four hospitals, specialty centres and 13 primary healthcare centres across Dubai.