Emergency Department Patient Access Self Serve

1. Emergency Department Patient Access Self Serve Created by Jen Link Whitney Sams

2. Objectives • Describe ED Patient Access Self Serve (PASS) • Describe hardware/software • Review the information system • Assess nursing implications • Examine related legal/ethical issues • Advantages/Disadvantages from a nursing perspective

3. What is ED PASS? • Patient self check-in kiosk to Emergency Dept. • Touch screen computer • Driver’s license is swiped to get demographics • Enters reason for visit • Type and location of pain • Any risk factors • Obtained information sent to the Emergency Department Information System (EDIS) (“Medhost Brings”, 2008) • Information is visible to clinicians (“Exit Care Business Partners”, 2008)

4. ED PASS description • Physicians are alerted of high risk patients (“Medhost’s ED PASS”,2008) • Gives the physicians real life view of waiting room • (“Medhost’s ED PASS”,2008) • Helps with triage, improving communication • Speeds up patient check in • Allows patient greater privacy • Patient complaints prioritized according to severity • (“Medhost Brings”, 2008)

5. Describe Hardware and Software

6. Hardware • LCD Touch screen kiosk (“Medhost ED PASS”, 2008) • Speakers • Slot to swipe driver’s license • Immediately obtains patient’s demographics (“Medhost Brings”, 2008) • Wireless technology

7. Hardware: LCD Touch Screen • Touch screen activate d by finger, hand, or stylus • Simple to use even for computer illiterate • Identifies high-risk patients immediately • Reduced waiting and easier registration(“Medhost ED PASS”, 2008) • More accurate demographics • (“Medhost ED PASS”, 2008)

8. Patient enters the ED and are able to enter the main reason for there visit. • Allows the physicians and other medical staff determine who needs to be seen in what order. • The ease of the touch screen allows the computer illiterate the ability to meet their needs known.

9. Software • Medhost’s Emergency Department Information System(EDIS) is created by clinicians for clinicians. (“Medhost About Us”, 2008) • EDIS integrates the EDPASS with: • Patient Tracking • Order Entry and First DataBank • Nurse Charting and Physician Documentation • Toolkits to customize settings • Reports of performance trends • Integration capability • (“Medhost Products”, 2008).

10. Software • Medhost offers software for end-user training for: • Nurses/Techs • Physicians/Mid-level providers • Secretaries • Registration • Ancillary staff • IT staff

11. Patient Tracking This link has a sample video of the software provide by MEDHOST to help train staff with the new systems. http://www.medhost.com/getdoc/1e6fc69c-7c0b-48ec-924d-9e57bf476373/Sample.aspx

12. Software: Toolkit • Allows staff to modify all aspects of the software • Individual software protected by password • Changes are put into action immediately • Software can be adjusted to increase the ease of usability • Patient privacy settings meet HIPPA regulatory compliance standards. (“Medhost Products”, 2008)

13. Software Usability • Usability dependent on the staff’s willingness to learn • Medhost offers: • Clinical Consultants • Training centered around job • 24/7 Clinical and technical support • New users learn in minutes, rather than days (“Medhost Services”,2008)

14. Review the information system Departments his will benefit….. Able to be integrated into the hospital’s existing application systems. (“Medhost Products”, 2008)

15. ED Information System • This is a closed system • Kiosk takes registration and sends it to medical staff • Allows for nurses and physicians both to document. • Information can also be used by other healthcare providers in the hospital. • Information can he inherited through the use of a password which ensures HIPPA guidelines.(“Medhost Brings”, 2008)

16. EDIS • The Emergency Department Information System was created to: • Increase patient and clinician satisfaction • Streamline ED processes • Ensure patient safety • Enhance revenue through accurate documentation (“Medhost Solutions”,2008)

17. Assess Nursing Implications

18. Continued … • No triage nurse needed which allows for more floor nurses to take care of patient needs • Able to have specific ER nurse for each specific area (cardiac, GI, urinary, ect.) since the system will already have them triaged by specific need • Less time from reception to care needed by cutting out the middle man • Allows for other hospital floors to have beds available if being kept for further review • Visualization of the waiting room and prioritizing responsibilities

19. Multiple machines allow for multiple clients to use for quicker care

20. As a nurse … • Must be competent in basic computer skills with Microsoft Word • Charting by exception with point and click • Responsibilities of informatics

21. Examine Related Legal/Ethical Issues • What if the patient uses someone else’s ID? • Some may see the triage as crucial to the initial assessment • The patient may downplay the severity of their illness • The patient may exaggerate the severity of their illness • If someone does not have an ID • Hackers • People who are blind • People who are illiterate • People who do not speak English • Privacy during check-in

22. What if unlicensed staff is looking at patients data?

23. Advantages From a Nursing Perspective • Quick and easy data entry designed for the pace of a busy ED, with on-your-feet data entry • Easy-to-understand screens means more time spent with patients and less time spent manipulating the software. • No strict rules - document as much or as little as you like at the patients bedside. No need to change your charting habits. • No more searching - all of your charts, records, labs and more at your fingertips

24. Disadvantages From a Nursing Perspective • Triage nurse will not be performing the initial assessment • Inaccurate patient reported data • Decrease in face to face time with patients • Abuse of the system • Charting becomes less personal • The possibility of hackers • Crisis patients will have more time alone without help

25. Nurses need to: • Understand the general idea touch screen • Be willing to be trained on the EDIS system • Know the different severity levels • Be able to interact via wireless • Be open to transition to newer technology

26. Informatics Nurse Responsibilities • If any technical errors occur call for support • Assist less experience nurses with clinical questions • Integrate the new system with other departments • Perform and chart thorough assessments • Log Out and never give out their password • Information should be clear, concise, and to the point.

27. Summary • The ED Patient Access Self Service (ED PASS) registration kiosk allows patients to check in and identify their complaint, ensuring: • Patient satisfaction through reduced waiting and easy check-in • Improved patient safety by identifying high-risk patients as soon as they check in. • More accurate demographics by importing information from the patient’s driver’s license . • (“Medhost Products”,2008)

28. References: • Business Wire. (2008). MEDHOST Advances HIS Integration with Discrete Patient Data Sharing Capability December 4, 2008, from http://findarticles.com/p/articles/mi_m0EIN/is_2008_May_13/ai_n25408737 • E-Medsys. (2008). Patient Access Portal. Retrieved on December 11, 2008, from http://www.practiceone.com/e-Medsys_Patient_Access_Portal.pdf • Kaiser Daily Health Policy Report . (2007). Emergency Department Kiosks Offer Short Patient Check-Ins. Retrieved on December 14, 2008, from http://www.medicalnewstoday.com/articles/82769.php • ExitCare Business Partners. (2008). Retrieved December 07, 2008 from Exitcare: http://www.exitcare.com/partners.html • Ferris, Nancy. (2007). Hacking into e-health records is too easy, group says. Retrieved on December 15, 2008, from http://www.govhealthit.com/online/news/103788-1.html

29. References Cont. • Market Wire. (2006). MEDHOST Selected As Newest Member of Electronic Health Records Vendor Association. December 8, 2008 from http://www.redorbit.com/news/technology/535221/medhost_selected_as_ newest_member_of_electronic_health_records_vendor/index.html • MEDHOST's ED PASS kiosk provides patient check-in to emergency rooms. Retrieved on December 1, 2008, from http://www.selfservice.org/article_4276_0.php • Medhost. (2008). Retrieved November 25, 2008 from Imaginuity Interactive, Medhost: http://www.medhost.com/home.aspx • MEDHOST Advances HIS Integration with Discrete Patient Data Sharing Capability. (2008). Retrieved December 04, 2008 from Business Wire: http://findarticles.com/p/articles/mi_m0ein%20/ is_2008_may_13/ai_n25408737

30. References Cont. • MEDHOST. (2008). Services; Training. Retrieved on December 19, 2008, from http://www.medhost.com/Services/Training.aspx • Rice Memorial Hospital Selects MEDHOST EDIS To Ensure Accurate Documentation And Quality Patient Care December 4, 2008, from http://findarticles.com/p/articles/mi_m0EIN/is_2008_July_29/ai_n27950 • Teagarden, Christina. (2008). MEDHOST And Ascom Integrate Systems, Giving Emergency Department Clinicians Access... Retrieved on December 2, 2008, from http://www.reuters.com/article/pressRelease/idUS1 • Wicklund, Eric. (2008). MEDHOST adds new registration kiosk to EDIS capabilities. http://www.healthcarefinancenews.com/story.cms?id=8831