Steve Shirley, CIO and vice president of IT at Parkview Medical Center in Pueblo, Colo., has more than 35 years of experience in the information technology field. In this role, he leads a team of 52. He holds a Master of Business Administration degree from Colorado State University Pueblo, a Bachelor of Science degree in Applied Mathematics and an Associate of Applied Science degree in Computer Science Technology, both from the University of Southern Colorado.
Q. What’s the one promise of mHealth that will drive the most adoption over the coming year?
A. mHealth’s ability to deliver contextual clinical information from the EHRs, as well as care-team communications tools and barcoded medication administration (BCMA) functionality consolidated to the bedside clinician via a single application, is really going to drive adoption in hospitals and practices. Until recently, all of our nurses and other clinicians had to carry multiple devices to perform these functions, which only contributed to their interruptions and didn’t make them any more efficient or safer. Ideally, clinicians should be able to access the clinical information they need, whenever they need it.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. I believe technology that is specifically designed for personal smartphones of clinicians working onsite will become ubiquitous in the next few years. Thousands of doctors, nurses and other clinicians rely on smartphones for voice and text communication and sharing other types of information, but using a personal device to view and exchange PHI is far too risky to hospital compliance and patient privacy. That’s why more hospitals will be adopting dedicated smartphone technology that is owned and controlled by the hospital and won’t go home with clinicians at the end of their shift. Our dedicated smartphones offer all the features and functionality clinicians have become accustomed to with their personal devices. Other than care-team voice and text communication capabilities, the appliance only includes clinically focused applications and only operates on our network, which avoids HIPAA compliance and patient privacy risks. Through this strategy, the footprint of BYOD devices has been reduced dramatically, and we have minimized efforts to protect, support or maintain all the different types and ages of personal smartphones.
Q. What’s the most cutting-edge application you’re seeing now? What other innovations might we see in the near future?
A. I would say PatientTouch by PatientSafe Solutions is certainly cutting-edge. For years, hospitals have been so focused on implementing EHR systems and CPOE; they’ve sometimes forgotten that the primary users of the EHR and the people who need data at the bedside aren’t being supported if the computer terminal is fixed on a wall or on a cart in a hallway. The PatientTouch smartphone-based platform - a format that clinicians are accustomed to anyway - is designed to deliver that EHR data in context. This means nurses have more than just the physician order, but they can also view it in context of the patient’s condition, the care they’ve received that day, the medication lists and notes from physicians. This user-centered design encourages safer rounding, more efficient communication with the care team and a better patient experience. Consolidating the EHR data, voice and text communications, as well as a barcode scanner to a single device, also helps eliminate the device overload that most clinicians face when they walk into work. Believe me, freeing up a pocket on our clinicians’ scrubs was a big deal for them.
Q. What mHealth tool or trend will likely die out or fail?
A. A BYOD policy that includes employed clinicians is a trend that organizations will realize is too risky in light of the OCR clampdown on HIPAA compliance breaches. Although it may seem efficient to just update the BYOD policy they have for physicians and apply it to nurses, hospitals do not want to face what could happen if a clinician loses his or her phone outside the hospital and it contains PHI. Hospitals also don’t want to have to maintain, support and protect numerous different types of smartphone devices, which will be inevitable if they try to add clinical apps to an employee's personal device and then allow them to use them for work. Forcing clinicians to use old VoIP, pagers and outdated technology isn’t the answer either.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. At least at our hospital, I was surprised by how enthusiastically our clinicians adopted the PatientTouch clinical communications functions. We started with PatientTouch in 2007 with just its BCMA functions, but expanded the platform several years later once the communication tools became available. Keep in mind, our clinicians had been carrying multiple mobile devices, so transitioning to one device that could help them perform all of those functions and more was a significant change. Even though it simplified workflows, change management is always a challenge for healthcare organizations. However, the majority of nurses and phlebotomists that we surveyed agreed that the PatientTouch clinical communications technology improved response time to patient requests and two-thirds of clinicians agreed that it reduced interruptions. Of the phlebotomists who were surveyed, 75 percent agreed that response time to urgent specimen collections improved.
Q. What’s your biggest fear about mHealth? Why?
A. There’s a great quote by Steve Jobs about focusing on simplicity. He said, “Simple can be harder than complex: You have to work hard to get your thinking clean to make it simple. But it’s worth it in the end because once you get there, you can move mountains.” I am concerned that in our industry’s quest to offer mobility, we will just make simple processes more complex, and in a clinical environment, that can be harmful for patients and clinicians and far more expensive.
Q. Who’s going to push mHealth “to the next level” – consumers, providers or some other party?
A. At Parkview, other than the patients, our nurses and other employed clinicians are the biggest beneficiaries of our mHealth technology. That’s why I think as clinicians at other institutions become more aware of this type of technology, they will push for a similar change at their organizations. Once clinicians see how it can help them perform rounds more safely, access and report clinical data in context, communicate with care team more efficiently and eliminate the need to carry multiple devices or Post-It notes, they will demand it at their hospital. As home-health monitoring technology improves in both capabilities and cost, I anticipate that patients will also drive mHealth demand so they can push more information from their personal mobile devices, such as watches and smartphones, directly to their EHRs and have their providers be able to view it in real time. If hospitals want to better engage patients, then they, too, should be pushing for more technologies that connect with patients’ smartphones and other technology that are currently in their possession almost constantly.
Q. What are you working on now?
A. With mHealth, it’s all about bringing people, processes and data together. Whether it's through clinicians, patients, vendors, technology, or different clinical organizations, mHealth inspires the collaboration of all these facets of healthcare. Currently, only our bedside team has access to hospital-owned smartphones. We are currently working on ways for the physician workflow to be available in the smartphones to enable more of the clinical team to have the same clinical communication devices.
On the same note of mHealth bringing people, processes and data together, this year, after only five months of development, Parkview, PatientSafe and MEDITECH collaborated to launch an interface that directly links the PatientTouch BCMA application to the MEDITECH eMAR, eliminating the need for the extra data-entry step. What’s even more encouraging is that this collaboration between IT stakeholders opened the door to more integration projects, specifically around automated quality metric data capture and nursing performance assessments, both of which right now are mostly manual endeavors for use.
