A before and after example of digitization in patient care: How hospitals gain efficiency while nursing staff and patients become more satisfied

Digitization in the healthcare sector is advancing worldwide. However, even in a modern country like Germany, it has by no means reached all hospitals. In this article you will learn how patients often experience reality and what a hospital stay could be like thanks to digitalization. A true story.

If you have to go to hospital, you can still take part in a time-consuming odyssey in 2020.

My colleague Patrick calls me one morning at 8:30 a.m: He had fainted during an examination by his family doctor, who referred him to the nearest hospital – just across the street.

In the emergency room he is stabilized by an infusion, at the same time he is told that he should be admitted as an inpatient for further examinations. “It cannot be ruled out that I will have to stay in the hospital for one night, the head physician wants to discuss the results with me in order to possibly adjust the medication because of my fluctuating blood pressure,” he tells me. “However, I think that I will be discharged in the morning and be back in the office around noon. The results will be forwarded to my family doctor anyway, where I will be given a new appointment.

If there is no information flow between doctors and clinics, staff and patients suffer.

Around 9:00 a.m. Patrick reports to me and confirms the inpatient admission. He was given his paper file and asked to report to “his” ward. Once there, an obviously irritated nurse received him with the remark that she had no information and that there was no free room available. 

Patrick hands over all the documents and is asked to sit down on a chair in the corridor for a moment. As soon as a free room is available, he can move into it. Sitting on his chair, Patrick repeatedly addresses the passing nursing staff: that he has a very bad headache and needs help. In vain.

The strength and patience of the nursing staff and patients are finite.

After six hours Patrick is assigned a room. Until then he gets no support at all. Now Patrick stays in his room for another four hours – without any further contact to a member of the hospital staff. Is the new shift even informed about his presence? After pressing the emergency call button several times, no other sources of contact are available, he is visited by a nurse. With reference to his severe headaches, he asks the staff to measure his blood pressure (165/90). At 22:15 he gets an infusion of paracetamol, a possible intolerance is not checked. A last blood pressure measurement at 22:35 gives 129/83, good night! At this time Patrick had no contact or visit from a doctor.

The last chapter of the non-digital hospital stay begins. 

Patrick is awakened the next morning at 6:30 by the nursing staff. His blood pressure and blood sugar are measured, further medication is refused until the responsible doctor arrives, at 8:00 Patrick gets breakfast. Asking when a doctor would stop by for further treatment, no precise time can be given, but it´s clear that without the consultation of a doctor a discharge would be impossible. 

The doctor arrives at 2 pm, takes a brief look at the documents, inquires about his well-being and then decides to have a long-term ECG. This means that Patrick should spend another night in hospital. 

The conclusion for the patient is frustrating.

Ergo: The staff is overstrained, time is wasted uselessly, the strain and time expenditure for both patient and staff are in no relation, in addition a room is blocked unnecessarily long, so that also following patients have to wait.

A digital application could positively influence the daily routine of the entire staff.

Is there a possibility nowadays to make this true story more pleasant for the benefit of all, patient, nursing staff, doctors and following patients, by means of digital support? How could something like this look like? Let’s play through a fictional scenario, with the best knowledge that all this is already possible today, provided that decision makers are willing to learn, accept and be more open to new things. 

7:45 a.m.: The family doctor receives the data of his patient via app.

Patrick sends a message to his family doctor via his integrated app and complains about massive blood pressure problems, directly with digital transmission of the real-time values. His doctor’s office immediately recognizes from the digital data that this is highly deviant data, even though Patrick has already been set up with appropriate medication. Via app he gets an emergency appointment with his family doctor at 8:15 am.

8:15 a.m.: The examination is in progress, the data is transferred to the hospital.

Patrick appears at his family doctor’s office and is immediately led to the examination room. During the first examination his circulation leaves him and he faints. His doctor decides to refer him to the emergency room of the nearby hospital for further examinations. Patrick’s data is transferred digitally to the emergency room. Even before he arrives there, the team on site is prepared for his arrival. 

8:30 am: The hospital’s in-house digital system activates the treatment.

Patrick’s data is read while he is stabilized in the emergency room, digital processes run in the background for smooth, efficient treatment. 

9:00 a.m.: Doctor and nursing staff know what is at stake and how they can act.

The doctor in charge receives a digital message, the nursing staff is informed about the inpatient admission of a new patient, a free room is equipped with a disinfected bed and bedside trolley (found via tracking app), the room is cleaned, cleaning staff were informed via digital app. 

9:30 a.m.: The patient knows he is well cared for.

Patrick has moved into his room and is logged into the digital in-house system via an app on his smartphone.

10:00 am: The medical examination is already taking place.

The doctor arrives for the first round, accompanied by a nurse. While the doctor calls up the digital patient file on his tablet to get a picture, the nursing staff again measures the blood pressure and blood sugar, all data is automatically stored in the digital file. The doctor decides that Patrick should be given a long-term ECG for 24 hours and that Patrick should spend one night in the hospital for further monitoring.

10:30 a.m.: Communication via app ensures efficient processes for the benefit of all.

Around 10:30 a.m. Patrick sends a call to the nursing staff via his patient in-house app asking for help due to severe headaches. A short time later, the nursing staff appears and administers an infusion of paracetamol while simultaneously applying the long-term ECG. A short time later Patrick orders his meals via app from the digital menu. He only sees the meals that correspond to his health profile for intolerances. 

9:30 a.m. the next day: The patient can already be discharged, the family doctor is informed about everything in a matter of seconds.

The next morning, the doctor comes to the patient’s room for a final consultation. The ECG is removed, all data is immediately stored in the digital patient file, the discharge discussion is digitally documented. Patrick’s family doctor is informed about further treatment and all relevant examination data, comments and recommendations are automatically documented and stored in Patrick’s patient file. Patrick leaves the hospital around 10:00 a.m., his room can be prepared for the next patient.

Digitalization is not magic and can be used systematically, efficiently and result-oriented in many respects. Digital support also improves time processes and much more. Even with gradual expansion, there are no disruptions in daily operations. Numerous clinics in Germany and worldwide have already made this experience.

© PatientCareNews, author: Hermann Kamp, ClinicAll International

Bild: Oles kanebckuu von Pexels

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