On a recent morning, Nicole Felicci sat in a room at University of Colorado Hospital, tapping a handheld electronic tablet. At her fingertips were connections to games, apps, email, Facebook, and websites around the world.
The tablet also connected her to a world often hidden to patients: her own health care information.
Felicci stepped into that world as part of a pilot launched this summer at UCH on the Oncology Unit. The 32-year-old was admitted in late July for tests on her stomach cancer. During long periods away from her husband, stationed at Buckley Air Force Base, and her 10-year-old daughter, the hospital-supplied tablet gave her hours of reading and listening diversion. It also linked her to her medical record through the Epic MyChart Bedside application, allowing her to review and learn more about the medications she takes, check her lab results, educate herself about her disease, and read about her providers, their backgrounds, and their qualifications.
“It helps me to relax when I’m nervous and tired,” Felicci said, “but it also makes me more aware of my health. I can research the tests they are doing. I feel I have much more of a connection with my doctors.”
Tapping the tablet
The hospital launched the pilot June 1, starting with games, apps and Internet access loaded onto 55 tablets. In July, the Bedside app went live. For many patients, having ready access to information about their care and the people who provide it is a powerful change, said Jamie Nordhagen, RN, nurse manager of the Oncology Unit.
“Many of them feel they have no control over their disease and their lives,” Nordhagen said. “This allows them to become more engaged in their plan of care. That’s very comforting.”
Patients can use either the hospital loaners or their own tablets to access the application. Nurses give them a quick introduction and tip sheets. With a PIN number, they’re in, and essentially a member of their care team.
“It’s allowed patients to go inside their own medical charts,” said Kathy Smith, RN, a clinical nurse informatics specialist who played a key role in the pilot. “It’s transformative because it makes patients a partner in their own care.”
Partners in care
That partnership can take many forms, said Mandy Johnson, RN, CCRN, OCN, quality and innovation liaison with the Oncology/BMT Unit. Johnson took a lead role in the Bedside rollout as part of her UEXCEL credentialing project. For example, a patient getting education about self-administering insulin shots might use the tablet to type notes, record audio comments, or make a video of the steps. All of that content flows into My Health Connection, Epic’s patient portal, for later reference, Johnson said.
The application helps to change a long-entrenched health care dynamic that made patients passive onlookers, waiting for information from their providers, Smith said. With access to their own charts, they can plan their daily schedules around times slated for medications, lab draws, radiology exams, walking and so on. Instead of wondering how they’re progressing with their care, patients can make a few keystrokes and view their vital signs and lab results and see how they trend over time, Smith added.
That’s as it should be, Felicci said. “I’m not in the medical field, so I don’t always know what’s going on,” she said. “We should all be aware of our own health care. If I’m confused about something, explain it to me. With the tablet, I can get every bit of information about my procedures. I feel much more knowledgeable.”
The tablets have also had nonclinical benefits. For example, Felicci said she uses it each day to read the newspaper and keep up with the world outside. She reads books online with her daughter, who also uses the tablet to do crafts with the help of YouTube videos. Johnson recalled another patient who connected with her three-year-old via Skype to tell a bedtime story.
The pilot has required some extra effort, including demonstrations and hands-on training for staff, Nordhagen said. Nurses are responsible for providing tablets to patients who request them, explaining how to use them, collecting them, and cleaning them to prevent infection.
Patients can also use the tablets to call nurses and send providers messages. That led some to worry that they’d be overwhelmed with requests, but Smith said that hasn’t happened.
“We’ve found that the things they like best are knowing who the members of their care team are, seeing their labs, getting education, knowing what their meds are, and checking their schedules,” she said. “They aren’t using it much for sending messages and requests. If they need something, they still put their call lights on.”
Next up for the pilot is adding tablet access to OpenNotes, the My Health Connection feature that allows patients to view their providers’ progress notes. That is currently slated for September. As for UCHealth as a whole, the Bedside app will go live at all hospitals in northern Colorado, replacing the GetWellNetwork, this fiscal year, Smith said, and will also be available at the soon-to-open Longs Peak Hospital in Longmont. A full rollout at either UCH or Memorial Hospital in Colorado Springs would follow in fiscal year 2018, she said.
For Nicole Felicci, the tablet has made a difficult situation a little bit easier. “This has been my most comfortable hospital stay,” she said. “My providers have been great with me, and the tablet has been awesome. It’s helped to make the time go faster.”