Using vitals integration tech for readmission prevention
Linda Martin, ME blog for Constant Care
As a nurse practitioner specializing in the skilled nursing facility arena, it has become increasing clear to me and to my colleagues that we need to embed the advanced practices and technologies found in the acute world —predictive analytics, automated data transfer, preventive strategies — if we want to achieve our mutual goal of preventing unnecessary hospital readmissions and, at the same time, helping to enhance the care we provide to our darling residents and help maintain the financial viability of the building we serve.
We all know the importance of having vitals measurements automatically downloaded to an EMR system. The simple benefits: time savings, accuracy, and error elimination. But we all want more — we want to positively impact outcomes. That's precisely why we need a vitals integration solution that delivers the advantages of FDA Clearance.
Of course, vitals are vital — but the measurements are plagued with inconsistencies. Too often documentation is rampant with errors and the time lag between measurement and entry into the resident's electronic record can mean the difference between immediate or delayed intervention, which we all know can easily result in an unnecessary re-hospitalization.
There is a solution. It's vital sign integration to the facility's EMR when the measurement is taken by an automated vitals monitor (eliminating error), then sent via wifi from the bedside to the resident's record (again, eliminating documentation error) where it arrives immediately and begins to trigger alerts for potential interventions. This type of advanced technology can take on many different forms.
Some integrations run on the medical device itself, some on an attached computer or tablet, but each has its own features and advantages. For example, vital signs carts with an attached tablet offer mobile kiosks features that allow the user to access additional applications like the ones used to document ADLs or nursing assessments —further reducing that paper to data entry time-lag and mistake potential.
When your team evaluates systems, it's important to consider what lies beneath the surface--the software that makes those connections. The software determines how efficient and effective the system is, whether new devices or measurement types can be added, and most importantly, what the system can analyze and provide as meaningful feedback to the user from the collected data flowing back and forth.
We've chosen a system that has been through the rigors of FDA clearance (Constant Care Technology) since it is able to not only engage in the data transfer, but may also utilize analytics, predictive analysis and data interpretation, alerts, thresholds, and other clinically relevant feedback from the data to engage in true, comprehensive “patient monitoring.” A system with only MDDS software is narrower in scope and limited in its functionality to transferring, displaying, and converting the data into standard formats like HL:7 for simple, basic integration.
I'm sure you are asking yourself what all that means to you? If you are feeling the increased scrutiny by the Centers for Medicare & Medicaid Services and referral partners on preventable hospital readmissions, then you'll want to embrace a solution that offers FDA cleared software so that you can reap the benefits of the more advanced features like predictive analytics for early warnings on patient's conditions, alerting when patient readings are out of range or trending negatively, and allowing facilities to set measurement thresholds and trending preferences for their patients in the system.
An example of leveraging the value of information from an FDA cleared integration is Constant Care Technology's SMART*Reports which we use to identify at-risk residents and trigger proactive intervention. The algorithms embedded within CareConnection analyze and report on the subtle combinations of changes in condition and trends in the vital signs sent through the vitals integration to the EMR. My team's experience with the SMART*Report has resulted in very early identification of subtle, but important clinical downturns in condition in otherwise asymptomatic patients.
In one of our patients, this technology-based insight actually resulted in a hospitalization, but that action saved the patient's life. Sudden onset asymptomatic hypoxia was identified by the SMART*Report. While no shortness of breath or lung obstruction were noted, the patient had critical O2 saturation declines. We ordered several tests which, in concert with her clinical condition, led us to believe that there was a possibility of a pulmonary embolism. The resident was admitted to the hospital where two P.E.s and a DVT were diagnosed. We saved a life with the help of this interactive and simple technology solution!
Our team has also had incidences where the SMART*Reports alerted us to residents in early the stages of becoming septic — when no other signs or symptoms were apparent or reported. The labs confirmed it — elevated WBC counts for one and positive urinalysis for another.
Let's face it, so many of our patients are unable to complain when they feel ill, so this system allows us to utilize a consistent monitoring tool that alerts us when something is changing, even subtly, often before any of the clinicians, staff, or family can see signs of deterioration.
The moral of the story is to choose your vitals integration product carefully. Always consider the full scope of benefits you expect to obtain from the technology for your facility and perform due diligence. Reputable companies should not have an issue providing you with documents to support their regulatory compliance claims, their data analyzing capabilities, or samples of their reports.
Be sure to select a HIPAA-compliant system, and request a copy of the security audit summary to ensure the company is capable of protecting your patient data. If a company claims to be selling an FDA cleared product, you'll want to request their 510K number or their 510K clearance form. Be wary of companies or products without FDA clearance that may be promising features that do not fall into the MDDS classification.
Linda Martin, APRN, works at Provider Health Services, Camelot of Broussard.