Colorado hospital achieves the quadruple aim with RTLS, part 1

On July 11, 2023, the 160-hospital CommonSpirit Health mountain health system opened its newest hospital, St. Francis Interquest, in Colorado Springs, Colorado.

St. Francis Interquest, a 72-bed orthopedic and spine hospital, is the culmination of several years of work to deliver on the promise of technological innovations to transform patient care. St. Francis Interquest is designed as a “hospital of the future,” focused on selecting technologies that would help CommonSpirit achieve its Quadruple Aim: improved patient experience, improved population health, cost reduction and healthcare team well-being.

Using human-centered design principles, a cross-functional design team conducted hundreds of hours of stakeholder interviews, embracing the ‘art of the possible’ throughout the design process. Real-time localization systems (RTLS) emerged early as a key innovative technology to improve quality of care, patient experience and physician well-being. But the cost of the sensors, combined with their sometimes limited deployment by providers, meant that the technology’s touted promise was not always fulfilled.

But that has changed in recent years as costs have fallen and healthcare systems have become more imaginative in how they use the tracking sensors. To gain an in-depth understanding of the different ways this hospital of the future uses RTLS, Healthcare IT news spoke to Dr. Valerie McKinnis, chief medical informatics officer at Mountain Region CommonSpirit Health, a 20-hospital health system in Colorado.

Q. A good place to start is St. Francis Interquest itself. What exactly do you mean by the hospital of the future?

A. The Hospital of the Future really points to the next generation of medical care, looking at transformative technologies to really help us understand how we can deliver on the promise of the Quadruple Aim.

The quadruple goal is really: how can we improve the patient experience? How do we improve the health of the population we serve? How can we reduce costs while increasing the well-being of our healthcare team? We understand, especially after the emergence of the pandemic, that we have become aware of new challenges in delivering care within the hospital context.

How do we look at not only the potential technology available to improve care, but also the ways we could integrate those technologies to create a next-generation experience where care feels seamless for our patients?

Admittedly, right now, care is very disjointed in most of our hospitals across the country. And if you’ve been a patient recently, you remember different parts of it. You think, could everyone just get organized and be on the same page? And really, the hospital of the future is: how do we use technology to achieve that goal? How do we all get on the same page when it comes to patient care?

Q. RTLS is not a high-profile, sexy technology. What about RTLS has made the technology so important to your hospital’s efforts of the future?

A. I continue to work as a physician, as a hospitalist in our facilities with our frontline hospital staff, meaning our nurses, our physicians and other support staff. They spend hours a day searching for people and equipment. When we started thinking about what a hospital of the future would look like, we knew we had to solve this basic problem, because it is ubiquitous in every hospital environment I’ve ever been in.

And understanding how to find our people and our stuff, it was clear early on that this was essential to improving the care of our patients, streamlining operations and improving the efficiency of the care we provide to our patients. the hospital offers.

So we saw RTLS as a key to this, to help us with different challenges beyond just finding patients and things like that, including workflow optimization, data analytics, infection control, reducing costs by understanding what we’re doing and why , even compliance and accreditation issues, but also in the field of emergency response.

We knew from the start that RTLS would serve as an integrative technology that goes beyond just locating people and things. We really saw it as an asset that could be integrated with other technologies in our environment to help us create that seamless, next-generation end-to-end experience for our patients.

Q. Let’s talk about three of your applications of RTLS. First, RTLS-enabled Epic Monitor authorization and login. Describe how the technology is applied here and what it delivers that you would otherwise not be able to achieve so easily.

A. This is one of my favorite things we did at our hospital of the future. My bias as a doctor shows up here because as a hospital doctor I spend my days searching and gathering information and trying to have enough time to spend with the patient, review all the data and be with the patient in a way that makes sense at the moment it occurs. bed.

So we looked at how we could transform the completion experience. This means those daily bedside rounds where doctors, nurses and other members of the care team visit patients in their rooms. How could we really change that experience, which was often very disjointed when multiple people were on different devices, perhaps when I logged into a computer with my back to the patient?

Or worse, I would carry around pieces of paper with things written down and try to remember which patient and what I needed to discuss. We started reimagining Epic Monitor from the ground up.

Instead of just a digital whiteboard for the patient or a way to leave messages, we redesigned Epic Monitor as a high-yield physician rounding tool that incorporates important clinical information that our physicians, nurses and other members of our care team felt they were essential to truly functioning. conducting effective bedside rounds with the patients.

In our version of Epic Monitor, from the clinician’s perspective, we have included information such as vital signs, laboratory tests, patient medication orders, and radiological studies upon administration. And we displayed all of these on a test screen at the foot of the patient’s bed with a drill-down display.

In fact, our goal from the beginning was that when our doctors walked into the room, they would have immediate access to vital patient data during rounds, without ever having to log into a computer. And of course, we knew we didn’t want this data to be displayed on the patient’s monitor at the foot of their bed all day long, due to privacy concerns. We just wanted to make it a high-yield completion activity with the patients.

Again, my dream was that as a doctor, if I walked into the room on the patient’s monitor, poof, all the information I need to care for that patient appears without me ever having to go to a machine and enter my credentials . To achieve this, we have developed RTLS-compatible authorization with an automatic login for our doctors when they enter a patient’s room.

When a doctor walks into a patient’s room, an RTLS tag embedded in the hospital badge sends a signal to the RTLS sensor in the room, which is then recognized by the active directory system, which can interface with Epic on a role-based basis . access to Epic Monitor.

What this means to me as a clinician is that when I walk into a patient’s room with my RTLS hospital badge, Epic Monitor automatically switches from the patient’s whiteboard view to this high-efficiency clinical rounding view. I can, at the foot of the patient’s bed, review all the information with them in real time.

I can look at what their lab tests were that morning, determine the trend, and dig deeper into the screen. With just my finger, I can pull up the patient’s CAT scan from earlier in the day and pull up the real images and review them at the bedside, circling the abnormalities and really involving the patient in the care.

What this integration with Epic Monitor really allows me to do is when I enter the room, I can fully focus on that patient during rounds and engage them in care, rather than turning my back on them and computers to log, try to understand other devices in their room – everything is in one place.

Editor’s note: Tune in tomorrow for part two of this editorial in which Dr. Valerie McKinnis will outline how RTLS is used to find everything from staff and patients to equipment and patients’ personal items – and how that also contributes to the quadruple aim.

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Email him: bsiwicki@himss.org
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