Anyone who has ever been to an emergency room is well acquainted with frustration. Methods for processing the arrivals still seem to rely on the memory and organisational capacity of overworked medical staff, often leaving patients in a Kafka-esque limbo for hours—unsure of when they will finally see a doctor. For decades this area of the hospital has remained impervious to the digital revolution. But take heart. The first signs of change are starting to emerge.
Meet Dr Bernadett Erdmann. She has been piloting a digital emergency cockpit at the Wolfsburg Clinic in Germany since October 2015. In that time the cockpit has allowed her team to make sure that every patient comes into contact with medical personnel within 10 minutes of arrival. In just eight months the system has also increased the average administrative processing time by one minute per patient. “That’s an enormous jump,” says Erdmann, when you consider that over 36,000 emergencies come rushing through their doors every year.
The big advantage to the software lies in its integration with the general hospital administrative system, which is a first in Germany. Until now, when hospital staff entered a new arrival’s information into the system this was either done in a compartmentalised program that could not cross reference with other departments, meaning that the same information needed to be entered repeatedly—wasting time. Or it was done on pen and paper, making the analysis of the patient’s medical history, personal information, case specifics etc. extremely time consuming.
According to Dr Erdmann, the Wolfsburg Clinic, in association with Agfa Health Care, has been able to create an integrated, fully digital data input system that can be accessed from anywhere in the hospital. The system even aggregates the information so that the staff is able to see at a glance how many people have been admitted over the past month or year with similar symptoms and can plan according to these macro trends.
The cockpit digitizes the triage system. Patients are assigned an urgency colour depending on their problem. Red is for patients who need to be seen immediately, ten minutes are permitted for patients designated as orange, yellow patients have a 30 minute waiting time and blue ones will be there for at least 120 minutes. If anyone has been left waiting for longer than their assigned time, red flags appear on the system, indicating that they should be prioritised..
Erdmann says the system removes unnecessary communication otherwise involved in following up on patients. “We spend less time on the phone with each other, we don’t have to constantly look for each other, so we have more time for the patients,” Erdmann says. The patient information is visible on a 2m x 1,2m screen where each patient is automatically ranked according to their priority. “All I need to do is work my way down the list,” Erdmann says.
Activity in the emergency room is monitored so that if the patient load exceeds a predetermined mark the system automatically alerts the managing doctor to the need for additional personnel. Previously this kind of decision was made subjectively, based on how overwhelmed individual doctors felt. With the digital system bottlenecks are frequently avoided, improving the morale among all the staff on call.
Each point in the patient’s treatment is also continually documented. Every nurse or doctor involved in the process appears on the log, as does the medication they receive. In this way everyone can maintain an up-to-the-minute overview of each patient’s treatment and the staff can hold each other accountable for their decisions. “Yes, mistakes happen,” Erdmann says. “But if they do happen it’s useful to be able to trace exactly when they occurred.”
Ten other hospitals in the area have already made enquiries into adopting the Wolfsburg Clinic’s digital cockpit. If enough other hospitals follow suit, perhaps your next wait in an emergency room won’t even be long enough to finish a game of Angry Birds.