Reprinted from Canadian Healthcare Technology, March 2009 issue
Mobile solutions give nurses access
to more information at the point of care
Visiting nurses, equipped with mobile computers and smart phones, provide more effective care.
BY A N D Y S H A W healthcare industry. The changes are hap- mobile homecare providers with either of
pening very fast and on an international the companies’ joint weapons of choice,
ou can talk, dictate, or consult
level,” continues Waegemann, “Soon, mil- the BlackBerry cell phone or the Med-
over the new BlueAnt Z9i cell lions of patients will have some of their Share eMotion wireless tablet.
phone headset in perfect clarity. health information on their cell phones To do so, both companies can call on
Its award-winning “voice isola- and will be able to send insurance, allergy, considerable forces. Procura provides inte-
tion technology” cancels out almost all and medication information in advance to grated software for point-of-care, clinical,
background noise – whether you’re their healthcare providers. Hundreds of and back office administration to over 350
buzzing in for a roof-top landing in the systems are already available and more are client sites in North America and Australia.
Rescue chopper or dictating to the tran- under development...(and with them) At these sites, Procura software manages
scription service over the clatter of the patients can easily collect and maintain over 50,000 employees. MedShare special-
hospital cafeteria. You wear the tiny 10- their own health information and transfer izes in mobile, point-of-care technologies
gram BlueAnt headset (developed in Aus- it, securely and wirelessly, using their cell meant to streamline the workflow of home
tralia) on your ear while it connects healthcare agencies. Over the air-
wirelessly via the Bluetooth 2.0 waves and into their mobile
protocol to the cell phone in your devices, they provide homecare
smock pocket. It is yet one more workers with clinical information,
weapon at your disposal in the decision support, documentation,
growing arsenal of wireless health- and reporting tools while in the
care technology. clients home – or back at their
Indeed, some healthcare pundits own home offices.
think there’s enough weaponry out On the patient end of the battle
there to suggest an uprising is afoot. line, IgeaCare Systems Inc., of
“A healthcare revolution is on Richmond Hill, Ont., is assisting
the horizon,” says C. Peter Waege- the Health Access homecare agency
mann. “The new capabilities of in Beaconsfield, Quebec through a
modern cell phones, smart phones, so far highly successful series of
PDAs, and other mobile devices are home monitoring trials. They are
creating extraordinary new possi- conducting them also with the
bilities for healthcare.” phones. This field is about to explode on help of Bell Canada and McGill University,
And Mr. Waegemann should know. He the international healthcare scene.” and have even equipped an 85-year-old
is the executive director of an outfit called If not exploding quite yet on the Cana- patient with the BlackBerry, who wielded it
the Center for Cell Phone Applications in dian scene, there are certainly vendors, with enthusiasm during a three-month fray
Healthcare, or C-PAHC for short. He took users, and their co-conspirators across the against her high blood pressure.
the helm of C-PAHC when it was country lighting fuses. One barrier facing vendors and users of
launched in August last year by the Med- For example, Victoria -based Procura wireless devices like the BlackBerry are per-
ical Records Institute, based in Boston. and Waterloo, Ontario-based MedShare ceptions about their security. It’s a barrier
“New cell phone innovations are are collaborating with intention to even- Procura and Medshare know only too well.
poised to make a huge impact on the tually arm as many as 6,000 or more “I’ve had people walk by our booth at
trade shows, look at our BlackBerry and Procura president Warren Brown notes was so keen about it, she wanted to see her
say, ‘You know those things aren’t secure’,” that much of the home care sector is in results on her own computer in order to
reports Barry Billings, president of Med- need of computerized tools. “It was part of print them out. So we helped her set that
Share. “But then I ask them on what the founding vision of this company to up. Of course, she could also see her
grounds do you say that? Do you know, bring electronically aided healthcare to the results on the BlackBerry, too.”
for example, that the BlackBerry has been home,” says Brown. “But as things stand As results came into the central Access
cleared by the U.S. Army for use in com- now, most homecare workers in Canada Health station and were captured on
bat? And that the Taliban can’t hack the are still using paper and fax machines to IgeaCare’s remote care software, monitor-
BlackBerry.” document and report their work.” ing Health Access nurses could see colour-
Closer to the home front, a few nota- Brown cites a 2005 North American coded results for each patient. When yel-
bles have recently endorsed that impene- study of how paperwork tangles up the low indicated readings were heading out-
trable security. Newly-elected U.S. Presi- homecare process. side parameters, they called the patient or
dent Barack Obama can keep his beloved “The researchers concluded that home arranged for a home visit.
BlackBerry say his U.S. security officials, at healthcare workers spend almost a third of But how effective is all this?
least for personal calls. And Ontario Priva- their time filling in, fiddling with, filing, “Our principal investigator for all our
cy Commissioner Ann Cavoukian is about and sometimes forgetting their paper studies is Dr. Antonia Arnaert. She’s a pro-
to release a report not just condoning such notes and forms,” says Brown. fessor of nursing at McGill and does the
wireless devices in healthcare, but even That’s a huge amount of inefficiency in analysis of them, assessing their cost-effec-
urging their uptake, with a proviso. a sector already hard pressed for time. tiveness contribution to the healthcare
“The one caveat she makes for her Brown and Procura believe that giving the system,” says Byrne. “And so far the results
wireless device support is, “... if properly are very encouraging.”
implemented,” says Billings. So encouraging that on the day of the
To underline proper implementation,
Most homecare workers in interview for this story, Byrne, professor
Cavoukian wrote her report with the co- Canada are still using paper Arnaert (a registered nurse with a PhD) and
operation of RIM, the maker of the Black- and fax machines to document Health Access were kicking off yet another
Berry, and Medshare. She was evidently study project – this one to bring the Black-
impressed by the end-to-end encryption
and report their work. Berry and self-care to the homes of diabetes
achieved by the two firms. sufferers who will be winging back their
So Procura and Medshare are now rac- homecare workers the technology to han- glucose levels. Next to come will be a simi-
ing to the marketing and sales front lines. dle their workflow electronically will bring lar study of wound healing in the home.
“At this point in our integration with administration time down dramatically – Byrne says further analysis of the
the Procura platform, we are building our by at least a third. results will determine whether the remote
HL7 layer. Our technology teams are The cell phone-equipped patient can monitoring of hypertensive, diabetic, or
working together on that and it is going also do battle against the homecare ineffi- wound healing patients will be offered as a
very quickly. In fact, they are ahead of ciencies. That’s what Donna Byrne, in permanent service by Health Access. She’s
schedule. So that integration should be partnership with IgeaCare, Bell Canada optimistic at least one will.
complete and available in the second and McGill University, are out to prove. “It’s the anecdotal results that come in
quarter of this year,” says Billings. “The Byrne, a registered nurse by back- that really encourage us. From what
new (joint) platform will be highly scal- ground, is president of Health Access patients tell us, they enjoy using the tech-
able, robust, and of course secure. We’ve Santé in Beaconsfield, Quebec, a West nology to monitor themselves and partic-
built encryption into both the BlackBerry Island suburb of Montreal. Byrne oversees ipate in their own care,” says Byrne. “So
and our wireless tablet that allow only the company’s home and nursing care ser- once we write down all of our protocols,
consent-based access. vices and has been pioneering videocon- policies, and procedures that the studies
“What that means is that an agency ferencing and other remote access tech- suggest, we think it will be a viable service
may be servicing 4,000 people who are nologies ever since the company’s found- that people will want to use.”
being visited at home. But the only records ing in 1996. Her passion for innovation It remains to be seen whether the pow-
of patients that a visiting caregiver will and better homecare soon emerges as she ers-that-be in the larger healthcare envi-
ever see when their device is turned on are talks about the three-month study just ronment will also value such systems.
the 40 cases or so they’ll be visiting that concluded with her partners. “It can be frustrating, because from
day,” says Billings. “What’s more, if a next- “Hypertension is the silent killer. You what we are seeing in these studies is that
door neighbour were one of those 4,000, don’t feel its symptoms. So in our study we there is just so much benefit including
the caregiver wouldn’t even know that the handed out the BlackBerry and wireless fewer visits to the doctor or the hospital.
neighbour was being looked after by the blood pressure cuffs that communicated Our hope is that those responsible for our
agency – unless their case showed up on with their BlackBerry to 50 people with hospitals and those in our health min-
their daily list.” hypertension. They either volunteered istries will take notice of our studies and
Currently, Billings says 11 of Med- directly or were referred by visiting nurses start taking wireless technology more seri-
Share’s homecare agency clients are ready- or some by their doctor,” says Byrne. “We ously,” concludes Byrne.
ing themselves for the MedShare/Procura asked them to take their blood pressure To help those authorities hear the mes-
platform. But MedShare’s “development two to three times a day. And they did that sage more clearly, maybe the folks at
partner” agency, Therapy Partners, a ther- for a week and in some cases up to four BlueAnt down under would be good
apist homecare agency in Guelph, weeks, if their medications changed as a enough to send them each a Z9i headset.
Ontario, will be the first to have it fully result of the readings that came in from
deployed. the BlackBerry.”
“In effect it will enable Therapy Part- One sidelight of interest to Byrne was
ners to go fully electronic, both in the field the reaction of the older patients to the
and back at the office.” new technology. “One of our 85-year-olds