New York-Presbyterian Hospital has big plans for PatientTouch, a platform from San Diego-based PatientSafe Solutions, to help mobilize its electronic health record, improve communication among clinicians, coordinate care and close the loop in medication ordering and administration.

It is a huge undertaking for sure, given that NYP actually includes four hospitals in Manhattan and one in suburban White Plains, NY, with a total of 2,409 inpatient beds. But clinicians have been clamoring for hand-held devices to make their jobs easier. "It's what the nursing staff was looking for," says Senior VP and CIO Aurelia Boyer, a registered nurse.

PatientSafe makes a medical-grade attachment for the iPhone or iPod Touch called PatientTouch as well as supporting apps. The software is for what the company calls "patient care orchestration," with three main services, according to CEO Joe Condurso.

The first is positive patient identification, or PPID, which essentially is barcode scanning at the point of care to assure the right person is receiving the right medication, test or service. New York-Presbyterian is migrating to PPID access across all of its facilities, according to Condurso, starting with medication administration, lab specimen collection and infant care. NYP is the first site to use PatientSafe's infant care app, for matching mother to baby and for handling milk products, he says.

PatientTouch also helps clinicians execute care plans, Condurso says. A series of workflow applications help with sharing care plans among care teams, assignment of clinicians to patients and the conversion of physician orders to specific tasks for nurses, for example. This, he says, can help reduce length of stay.

Additionally, the technology facilitates communication among clinicians, with secure clinical messaging and, when paired with a clinical decision support system, alerts and alarms. Voice-over-IP (VoIP) is available on the iPhone only.

This kind of communication goes beyond the "unified communication" that had been the goal of many in hospital environments a few years ago, according to Boyer. "Now you've got to bring in the collaboration to really make that sing and dance," she says.

The first job in the deployment at each hospital is to optimize the wireless infrastructure, which NYP has mostly completed, save for the current installation of internal antennae to expand mobile phone coverage deep inside aging buildings. There are different bandwidth and coverage requirements for data entry, radio frequency identification (RFID) and this PPID/communications piece, according to Boyer.

NYP went live with PatientTouch at the Allen Hospital at the northern tip of Manhattan in April 2012. Weill Cornell Medical Center on the East Side was next, in September, and now the NYP Westchester Division in White Plains is implementing the technology. NYP/Columbia University Medical Center and Morgan Stanley Children's Hospital will go online this year, Condurso says.

"We've done the bedside medication work," Boyer says. "We've done a lot of the integration work … and tightly coupled with the pharmacy system and the clinical system," she explains.

"We've also rolled out the mother-baby breastmilk matching piece," Boyer says. "That was a very high priority for us."

Next up is laboratory and phlebotomy. "All of our lab draws are fully automated now," Boyer reports.

"We're getting it out as fast as possible," Boyer continues, largely because nurses have told her they feel more efficient documenting specimen collection or medication administration right there rather than waiting to enter the information in a computer outside patient rooms. "Nursing feels very strongly about doing it at the bedside," she says.

As a large, academic health system, NYP has the resources to develop some of its own apps. The vision for PatientTouch includes enabling video between clinicians, presenting data summaries and linking paging to telephony backbones, helping to cut out some of the phone tag that goes on between practitioners.

Boyer said it would be handy to have vital signs appear on the screen as well.