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God bless our nursing staff for having to document in the EMR. But I live and die by waveforms. And not just a snippet. I need to see the entire waveform and what led to an event to determine an intervention or root cause. Patient Hx allows that. It should be mandated in every hospital in the country. We just shouldn’t be practicing medicine without it.
We have to document a number to justify a procedure. Now I don’t have to worry about writing something down, or remember, I just focus on what I’m doing for the patient and then after the flurry of intervention is over, I can go to PatientHx to see exactly when it happened and document more accurately.
In a single minute I have to process over 300 data points and sometimes I process it wrong. Machines aren’t going to make the decisions for me but I need them to help me interpret all of that data faster so I can make the best decision and not lose patients because of lack of data. Sickbay helps me do that.
I recently had a patient that was being transferred from the ICU to step down. During transport the patient crashed and came to the OR. The problem was all patient data had been deleted when they were discharged from the monitor. I needed to know what the order of events were. What started first? Was it cardiac, was it respiratory? Thankfully our hospital had Sickbay so I was able to go into Patient Hx and in under 2 minutes figure out the root cause.
It is important to look retrospectively at what was done to a patient and look for an inciting event to prevent it from happening in the future. For example, when examining ventilator events like desaturations or loss of EtCO2 that leads to cardiac arrest, the physician examines various signals. Although one can obtain this information from the vent, the timestamps do not align across monitors. When correlating signals from different monitors, you can not get them on the same screen. Sickbay Patient Hx allows for all signals at exactly the same time.
In the past if I was worried about a few kids, I would have to call the nurse and ask her for information or walk to the unit and see them. With Sickbay I have a new way of observing patients in real-time. This saves me time, allows me to augment the care for the patient that is happening on the floor of the unit and ultimately can provide better patient safety and outcomes. It has revolutionized the way I think about patient monitoring.
At the bedside, the order and trending of patient signals are important. For example, if oxygen drops before blood pressure, it indicates a different issue than blood pressure dropping before oxygen. Patient Hx allows for these patterns to become clearer.
I can now remotely view ventilator data for patients. This is something that I previously could only do at the bedside. Now, I can call up a patient of interest on my computer in my office, and observe their recovery or deterioration.
The current patient monitors look for simple patterns and offer limited access to the data they produce. Vendors offer some data recording or data analysis capabilities. However, none offer the scale and power of the Sickbay platform.
I recently had a single-ventricle patient that showed a jump in heart rate from 90 bpm to 160 bpm, with arrhythmia. Unrecognized, this event is life-threatening. Fortunately, while reviewing these events with Patient Hx, I was able to apply medications to the patient when I arrived that morning and monitor the intervention remotely.
Patient Hx allows me to look at actual patient trends. Everyone has rose colored glasses when documenting for the chart but the patient looks how they look and the trends and the waveform don’t lie.
Patient Hx lets me look minute my minute and ask “are there warning signs?” I was looking at a patient near death’s door. At 3 o’clock their heart rate went up, and never came down. Why didn’t it come down? At 7pm, there was an event and the patient passed away. What was going on before then? I need to know when a patient is about to die, so I can prepare. What does that look like? Patient Hx can help me find those answers.
Patient Hx validates what is happening at the bedside. Last week I walked into the room and all the monitors had been shut off.. Looking back on Patient Hx I was able to see the exact time when the monitors were pulled off and also able to see that the shape of the waveform was bad but the numbers were ok. I could tell when the pulse ox stopped picking up and what time we were in the room. The numbers and waveforms made it clear the patient had not had a sentinel event. And I had all the evidence to back this up and even send the complete history to the EMR.
Strip charting was a constant headache at our hospital. The manual printing and scanning process is of course labor intensive but the bigger issue is trying to get issues to bedside staff and providers faster from our tele techs to expedite intervention. And then there is the reimbursement issue. We had a change in our practices and staffing that was preventing the strips from even being scanned which HIM department quickly realized meant thousands in lost revenue. Automating the process for strip charting with Patient Hx is a game changer. Less manual workload, more money for the hospital, and more important than anything is reduced patient risk.”