- When BJC HealthCare embarked on its Campus Renewal project, they knew health IT was going to be the cornerstone. But as the health system felt the pressures to drive patient-centered care, they knew they also needed to build their health IT systems with the patient experience in mind.
After all, health IT systems do have a significant impact on patient experience, especially with regards to patient-provider relationships. While technology has the power to streamline processes, connect patients to their data, and drive patient care access, it can also serve as a barrier between patient and provider.
The team at BJC sought to overcome that issue by making health IT the tool which connects patients with their health system.
“When we embarked on the Campus Renewal project in 2012, we spent quite a bit of time defining what our vision and guiding principles for the project were,” said Donna Ware, the health system’s executive director of planning and design. “Throughout those conversations an idea of really focusing on the patient and the family experience became a priority.”
Naturally, conversations about patients and health IT became a central piece as well, she explained in an interview with PatientEngagementHIT.com. What began as questions about technologies that drive staff efficiency turned into questions about how those tools will impact patients and their families. How could BJC use technology to improve the patient experience and make things easier for them?
One consideration was how to ensure technology did not impede patient experience, Ware stated. For example, the location of computers in the room can make or break a patient interaction. Ware and her team learned that putting the computer next to the patient bedside allowed nurses and doctors to collaborate with patients while entering new data.
But the health system wanted to take more steps toward putting the patient at the center of care. Again, technology presented a prime opportunity to make the patient a partner in care.
“From our point of view, it's really about the patient experience and trying to make a patient centered experience where the patient really has some interaction,” explained Sara Jaegar, who is part of the clinical information systems group at Barnes-Jewish Hospital, a part of BJC HealthCare. “We want patients to be a part of their own care team.”
The health system turned to bedside tablets from health IT vendor Oneview to keep patients connected to their care teams, treatment protocol, and other hospital services. The integrated tool allows patients to learn more about their clinicians, browse entertainment options and games, look at their treatments, view hospital protocol, order food according to specific dietary needs, and access educational content.
This functionality opened doors for patient experience at BJC HealthCare, especially as it empowered patients and family caregivers to play a bigger role in their care and recovery.
“It gives patients entertainment, it gives them games, and it gives them the ability order food,” Jaegar said. “But it also has those education goals in there. From our prospective, as clinical folks, that’s what we wanted to get up and going.”
As it currently stands, BJC clinicians can assign different patient educational tools to be viewed on the bedside tablet. These resources act as a supplement to traditional, in-person patient education, which the system acknowledges can be more effective.
“We view patient education through this platform as one method, but conversations and teaching by nursing staff directly with the families is the critical piece,” noted Liz Kruvand, the family and patient experience coordinator at St. Louis Children’s Hospital, another member of the BJC system. “We don't verify retention purely based on the amount of tools looked at, or finishing the tool. We really do a second stage of teach back conversation.”
Of course, there is more the health system wants to do, Jaegar added. Their new EHR system isn’t yet plugged into the tablets, meaning much of the process of assigning and checking the patient education materials is manual.
“One goal is an integration with Epic,” Jaegar explained. “As soon as orders for that go into the EHR system, the idea is for Epic to kick out a message to the bedside tablet and automatically kick in the education for those particular elements and then the patients get that automatically and can read it.”
Documenting that patient education will also be crucial, Kruvand stated.
“Our next step would be to look at if you can ask questions after the patients view a video,” she said. “Can you make it an interactive technological piece?”
As noted above, this already somewhat happens, she said. The crux of BJC’s patient education strategy are interpersonal interactions during which clinicians should be assessing whether the patient understands her care plan and instructions.
But technology would streamline the documentation process, adding a note into the EHR that the patient has been properly educated.
The health system is still working through the kinks with this technology. While the patient-facing side of the tool experienced its own minor bugs that the IT team easily mitigated, the health system also had to contend with a complex, multi-faceted implementation process.
The bedside tablet comes as a part of an entire floor technology, meaning it integrates with team-based care tools and nurse call buttons. These functions come with their own individual technologies, each of which needed to be installed simultaneously.
“Our biggest problem was a compressed time frame,” Jaegar, who was part of the implementation process, explained. “We had to get a lot of people trained in a very short amount of time.”
But now that those tools are up and running, Jaegar and her team are able to focus on the Epic integration.
“There were a lot of things that weren't started right away that we would have liked to implement, but we are now on track to try and deal with those,” she said. “The next key element of it is documentation because if you don't document it, you didn't do it in the world of healthcare. We are making it so that if the patient really reads it, there is a documentation of that.”
But ultimately, this tool has eased the patient experience. It is a one-stop shop for all patient queries, the health system boasted, meaning patients do not need to jump through the hoops of finding and contacting a hospital representative when a need arises.
Smoothing out these areas has been key for improving the patient experience, Jaegar said.
“We feel that it’s important for a patient, in order to really, truly, get involved with their care plan, to have an understanding of who and what they are really seeing,” she concluded. “This tool makes that a little bit easier.”