Baycrest Health Sciences has developed a mobile tablet app that allows palliative patients to report their discomfort symptoms, such as pain, nausea, drowsiness, anxiety and appetite, directly into their electronic health record that the doctor and healthcare team see.
The app is a high tech version of the gold standard Edmonton Symptom Assessment Scale (ESAS) and it was created to replace the time-consuming, traditional paper-based reporting that required the patient to rank their symptoms on paper and then a nurse to input the data into the patient’s medical chart.
The Baycrest innovation would have gone unheralded had it not been for Paul Christopher Webster, an investigative reporter and documentary film director who has written extensively on the state of e-health progress in Canada and around the world for major medical journals. He was preparing an in-depth story on Canada’s challenges with e-health for The Globe’s Report on Business magazine when he was tipped about the Baycrest project.
Webster met with IT specialists and interprofessional clinicians at the health campus and talked with palliative patient Helmut Braun who was trying out the mobile tablet app. Webster quickly realized that he not only had a story scoop but was witnessing what could be a first – a patient writing information into their own electronic health record. Webster was also witnessing the power of mobile technologies to connect the doctor’s brain to the patient’s pain much more quickly. It was Dr. John Hamalka, chief information officer of the Harvard Medical School and the Beth Israel Deaconess Medical Center, who articulated this catchphrase in a keynote address at a Vancouver eHealth conference, which Webster reported on for a 2012 CMAJ article.
“The future of e-health, it appears, will be driven by consumer-friendly innovations such as the tablet…used at Baycrest,” wrote Webster in his ROB story.
In a blog posted last fall on the Ontario Ministry of Economic Development and Innovation’s website, Terrie Tucker, Baycrest’s executive director of eHealth and chief information officer, described the mobile app project as no less than “radical innovation that occurs when clinicians and informatics experts come together to solve a problem and focus on what’s best for the patient and the workflow of clinicians.”
The project was not mandated by a provincial or federal healthcare strategy or the recipient of special funding, she explained. “It was simply a solution to a problem that arose at the grassroots level on a hospital unit and was solved at this level. It came about from a desired outcome to reduce duplicate data entry and manual calculations and enable patients to actively participate in providing information on their own assessments of their wellbeing.”
Tucker also noted that the app development wasn’t an easy solution. It involved multiple systems (proprietary EHR, SQL database e-forms and a scripting solution); courage to let patients in the post-acute, palliative care setting record their symptoms on a tablet; and clinicians who would not just support the project, but champion it.