Enhancing patient safety with hand-held technology


Smartphones are the newest way to stay connected and lately, it seems like everyone is using one. Remarkably, there are over 200,000 iPhone applications available for download today. But beyond keeping you entertained at the bus stop or in the grocery line, this portable technology offers great promise for advancing the quality of health care.

A project conducted by the Centre for Global eHealth Innovation, University Health Network and Mount Sinai Hospital is developing hand-held technology to enhance the safety of at-risk patients. The new technology will augment nurses’ capacity to monitor patient’s vital signs and detect clinical deterioration. The application of an Early Warning Scores algorithm in the software will alert the Critical Care Response Team (CCRT) when patients deteriorate. The CCRT typically consists of an ICU nurse, respiratory therapist (RT) and physician. The team responds around the clock to staff requests to stabilize patients who are deteriorating or at risk of deteriorating.

“Our hope is that this will provide support for nurses,” says Dr. John Granton, Critical Care Physician at Toronto General Hospital and President, Canadian Critical Care Society. “This new technology is meant to complement what nurses are doing by facilitating the entry of vital signs and validating concerns about a deteriorating patient.”

The application developed by the team at the Centre for Global eHealth Innovation, provides a user-friendly interface on the touchscreen of the iPhone, iPod Touch, or iPad that allows for the manual entry of vital signs. This supports the timely entry of information right at the bedside. Nurses will still be transcribing vital signs as they currently do, but with this technology transcription will now be immediate and at the point of care. The team is also working on a means to transfer the vital signs directly from the bedside monitors, so no transcription is necessary.

“Simply by making the data entry electronic doesn’t necessarily enhance patient safety,” says Dr. Joseph Cafazzo, Lead of the Centre for Global eHealth Innovation, UHN. “If it takes longer for nurses to use the new technology than to transcribe vital signs with paper and pencil, or if nothing is done with the electronic data, the technology is not very helpful.”

The technology developed by Dr. Cafazzo and his team focuses on what is called “actionable data.” The use of the Early Warning Score algorithm from the captured vital sign data will automatically alert the CCRT if patient deterioration is detected. Alerting the CCRT will facilitate the early interventions that are crucial to keeping patients from deteriorating further and out of intensive care units.

The team is currently refining its software designs of the system to be piloted in a clinical setting at Toronto General Hospital in the coming months. As the technology is developed over the next few years, there is real potential to expand the impact of electronic vital sign capture. Future development could demonstrate the value and feasibility of implementing this system province-wide.