Recently we announced a collaboration with and financial investment in AirStrip Technologies and their mobile patient monitoring software. Technologies like this, give physicians the ability to check important patient information through their mobile device allowing care decisions to be made much faster. My colleague, Bill, spoke about the concept of smartphones in healthcare a few months ago. And last month, I talked about direct communication between a physician and patient via email, text, Facebook, etc… Today, in light of this recent announcement, I want to dive deeper into the idea of remotely delivering real time healthcare information about a patient to a hospital, physician or other provider. To do this, I want to walk us through a real world scenario to show how this can play out in health care delivery.
A 68 year old male having chest pains arrives via ambulance to the Emergency Department (ED). He moves to the front of the line and is seen by the medical team right away. After examining him, they take multiple electrocardiograms (EKGs) and perform other tests. Within 10 minutes it is decided that he is having a heart attack and they contact the cardiologist on call to determine if this patient should proceed to the cardiac catheterization lab for immediate intervention or be admitted to a room and be seen later that day/the next morning while receiving medical therapy.
The cardiologist is paged and returns the call within 5 minutes – he needs to see the EKGs to determine if the entire team on call needs to come in to open up the lab and take care of this patient. He logs into the hospital network and looks at the images for about 5 minutes and decides to call in the team to open the lab. They arrive within 20 minutes and the patient is wheeled to the lab for treatment. The team will treat the patient in the next 25 minutes.
The total time from entry of ED to treatment in the lab was roughly 65 minutes. This is also known as “Door-to-Balloon” time. Pretty good, right? Obviously, in this fictitious scenario, the times are idealized. Every situation is different and there can be many factors that legitimately influence the time it takes to accomplish certain steps.
I point this out because time is so important here. Studies have shown that patients, having a certain type of heart attack, who have cardiac catheterization within 90 minutes of presentation to an ED have been shown to have a better outcome. But what happens if any of the times above are off? What if there is something as simple as a 5 minute hold time on 911? Or what if the cardiologist has trouble accessing the EKGs on line or has to receive them via fax? That could potentially add more than 15 minutes. Our times are now off and the risk to the patient has potentially increased.
Imagine now that there is a way for the ambulance to securely send the EKGs in real time from the patient’s house and/or the ambulance ride to the cardiologist’s smartphone in a way that is legible and accurate. Imagine that the cardiologist can notify his team to come to the hospital even before the patient gets to the ED. Now the patient could go directly to the catheterization lab for treatment instead of going through the ED. Using our scenario above this would save an additional 20 minutes; from 65 to 45! This is not only better for him but also reduces wait times for everyone else who came to the ED on their own. That becomes a game changer for how health care is delivered!
This concept not only exists but is being utilized today in some of our facilities. Now as we enter into a partnership with Airstrip, we are expanding this capability to more of our hospitals. I used cardiology in my scenario but we can (and do) also use this technology for real time treatment of pregnant women and soon hope to use it for monitoring remotely in our ICUs. This is the kind of thing that gets me really excited about the future of healthcare.
What do you think patients and providers? Any thoughts or concerns on your end? Do you think this is too idealistic to play out as I have described?