Wireless: What the doctors ordered
"Once or twice a day before rounds, I would have to spend at least an hour and a half sitting in front of a computer terminal, looking up my patients' data and writing down information on little scraps of paper that I would take with me," says Wright.
The health group's management was aware of the problem. For years John Jenkins, vice president and CIO of the five-hospital, 6,800-employee group in Greensboro, N.C., searched for a way to ease mobile physician access to clinical data. The introduction of the Palm handheld personal data assistant (PDA) seemed to signal a solution was within sight. But after a year or so of searching for appropriate software, Jenkins was getting frustrated.
"All the vendors were solving different individual problems but they didn't have a global concept of delivering clinical data to physicians and nurses for the benefit of patients," says Jenkins.
Having met with vendors such as MDEverywhere, Allscripts Healthcare Solutions, PatientKeeper Inc., and IDX Systems Corp., Jenkins was ready to give up. Finally, last March, Moses Cone's CEO asked Jenkins to sit down with a friend of a friend who was co-founder of a Durham, N.C., startup called MercuryMD Inc. The fledgling company's goal was to give doctors handheld access to the data they needed to do their rounds.
"The main problem in healthcare IT is that the systems that do exist don't get used," says MercuryMD CEO Alan Ying. Rolling laptops--where a laptop is attached to a cart for the doctor to roll from room to room--cannot be carried easily from floor to floor, and even laptops are too cumbersome for most doctors to use while examining a patient. Worse, many doctors are notoriously technophobic.
Ying believed the Palm PDA was a way around these barriers, since a growing number of doctors were already using them for calendaring and other tasks.
But MercuryMD did not yet have any customers, or even a beta user, when Ying visited Moses Cone. Jenkins was extremely skeptical--a feeling that only increased as the co-founders boasted they could install their handheld infrared MData system in four weeks with minimal involvement and no integration work by Moses Cone's IT staff. Still, Jenkins was willing to risk a free 90-day pilot, especially given the fact that MercuryMD's founders were doctors who were in surgical residency programs at Duke University School of Medicine when they decided to form the company.
"They put this data together the way a doctor would look at it. The lab results are the way doctors are used to seeing them. It's so intuitive there is no training," says Jenkins.
Jenkins picked a group of about 20 doctors to participate in the pilot. As part of the deal, they had to have their own Palm OS device. Moses Cone did not charge them for the application.
The initial pilot group was up and running with MData in April 2001. Moses Cone's IT staff ended up putting in about 100 hours for validation and testing, but MercuryMD took care of linking the software into the hospital's primary IDX LastWord Admission, Discharge, and Transfer system. The MercuryMD team also built links to the hospital's other major data sources, including a Cerner radiology system, a SunQuest lab application, an IDX pharmacy system and a MedQuist transcription system.
In a matter of a few weeks, the users were ecstatic about the MData application, according to Jenkins. Sixty days into the pilot, a survey completed by all of the users confirmed the positive reviews.
To use the system, doctors insert their Palm into a Clarinet sync station (located in the physicians' lounge, near the elevators, and in a few other spots around the hospital), input their PIN and other security data, and wait for the download to complete, a process that takes about two or three minutes. Then they can go about their rounds, armed with nearly real-time clinical information such as lab results, notes, and medication information.
"If a patient asks what were the results of his bone scan, I can pull that data up right then," says Wright. "I can check chemistry and labs and all the vital information that is supposed to be in the patient's chart but usually isn't." If Wright has a question about a drug, he can look it up in the Epocrates drug database right on his Palm and get an immediate answer. Compared to hunching over a PC scribbling down numbers, taking the time to get to a sync station and download the latest data is nothing, says Wright. "This saves me so much time."
Jenkins rolled out the MData system to 300 doctors and pharmacists--about half of its medical staff--in November 2001. He is in the process of deciding whether to expand the project to all the group's doctors and nurses, and whether to charge them for the application. Moses Cone will invest roughly $251,500 for the implementation: $125,000 for the MData application, $30,000 for the Extended Systems XTNDConnect Server, $25,000 for an Oracle 8i database, $10,000 for server hardware, and $37,500 for the data synchronization hubs. Annual MData maintenance fees run $100 per user.
The current version of the system is read-only. Future MData versions may support limited physician data entry, such as the ability to input billing information.
Jenkins is sure Moses Cone will get a return on its investment in MData, but he's leery of trying to quantify it yet. "I'm willing to bet that this doesn't show up on anyone's bottom line--at least not right away. Right now, we have no evidence that it will do anything other than save people time." But that is enough of a contribution, he says. "In the long run, it will save us dollars. You just can't put your finger on it and count that today." Another bonus: The infrared system lets him postpone investing in a more costly wireless data network, which he says he will have to do in the next two years or so.
The MData system will help cut down on errors, raising patient and physician satisfaction, by giving doctors near-instant data that they previously had to struggle to access. Says Jenkins, "We will get back way more than we invest."
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