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Open App Spotlight: Keeping patients safe when the shift changes

For me success for Open is when we, the inventors of it, are surprised by what people do.

Imagine you make steel beams. You might expect people to use them to build skyscrapers and bridges. But someday, someone will build the Eiffel Tower. And we’ll respond with amazement, “You can make that?!”

If people only do what we can imagine, then we haven’t built a successful toolkit. When innovators use what you give them to creatively assemble a brand new solution, that’s success.

That’s what the Open App Challenge was all about. Phase 1 recipients proved that with access to the right toolkit (Allscripts APIs), they can help solve some of the most vexing problems in health care. For example, keeping patients safe during shift changes.

Paving the way for smooth handoffs between care teams

Smart Sign Out is working to improve the way caregivers communicate about patients, especially the efficiency and accuracy of handoffs. From any device, this app enables caregivers to leave detailed notes and instructions about each patient for incoming teams. (Check out the Smart Sign Out video for a brief overview.)

Like many of these apps, this one was inspired by a personal experience. One that should never happen to anyone. Matt Mombrea’s mother suffered a serious accident. She has recovered, but she was paralyzed and unable to speak when first admitted to the hospital. While she awaited tests, care teams lost her information during a shift change. She was left in a remote hallway – unable to move or speak – for over an hour until a passing staff member recognized her distress.

Unfortunately, this outrageous example is all too common. About 70% of hospital handoffs are defective in some way. With 640 million handoffs per year in U.S. teaching hospitals alone, that means that more than 448 million handoffs are defective every year.  I expect that statistic is as devastating to caregivers as it is to patients.

Call for swifter, smarter transitions

Matt Mombrea, now chief technology officer at Smart Sign Out, teamed up with doctors at the University of Buffalo internal medicine program. He learned that in some healthcare facilities, the sign out process involves standalone computers and spreadsheets, only accessible to one person at a time. Or, some caregivers scribble notes on paper on their way out the door.

Unlike other apps, Smart Sign Out enables many people to use it at the same time from any device – including tablets or mobile phones. It also structures the data as it comes in, so it’s clear what is meant to be the dosage, and what is meant to be the medicine. It saves time for both the one typing and the one reading.

By integrating with Allscripts Open APIs, the data entry for Smart Sign Out users is kept to a minimum. That makes it more convenient, easier to use and more accurate. Allscripts Sunrise Clinical ManagerTM teamed with Smart Sign out to increase productivity and help to reduce the problems with handoffs.

Early results are encouraging

Four hospitals are now piloting Smart Sign Out. Since September 1, users have logged more than 170,000 actions with patients. Early outcomes show that handoff times have decreased from an average of 60-90 minutes down to 40-60 minutes. Smart Sign Out is beginning to measure clinical outcomes too, such as how it impacts readmission rates.

It’s just one example of how opening up our toolkit has sparked creativity. Solving a healthcare problem that will be a win for patients and physicians.

Editor’s Note: Open App Spotlight will feature other Allscripts Open App Challenge Phase 1 recipients over the next several weeks. The challenge reflects Allscripts commitment to fostering innovation to improve health care – it’s why Open matters. To learn more about the Open App Challenge and see a full list of recipients, you can read the news release.

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