LEXINGTON, Ky. (April 14, 2016) − Every year, tens of thousands of people are hospitalized for various ailments, and each of them require daily in-hospital visits from doctors, nurses, and other health care staff to manage their care. They often are prescribed a dizzying array of new medications for a diagnosis they’re unfamiliar with. And, once they’re well enough to go home, they’re inundated with detailed instructions for post-discharge care. Is it any wonder some of these patients and their families are overwhelmed and confused?
Countless studies have decried the low level of health literacy among U.S. adults. One of them estimates more than a third of all U.S. adults have only a rudimentary level of proficiency, and in Kentucky some regions have a dismal 82 percent health illiteracy rate. For health outcomes to improve and the rate of needless (and expensive) readmissions to decline, experts say, the system needs to move away from the traditional model where patients are passive recipients of health care.
With that in mind, the interdisciplinary patient education committee and the staff of the Don and Cathy Jacobs Health Education Center set out to find ways to engage and inform patients more effectively, making them partners in their own care. According to Judi Dunn, RN, BSN, they found their answer in a technology-based patient engagement system called the Get Well Network (GWN) that is currently being piloted in the hospital’s eighth floor cardiovascular inpatient unit.
The idea behind the GWN is three-fold: provide consistent, clear information to the patient and his/her family about their diagnosis and their care, assist staff in providing consistently high-quality instruction to their patients, and prompt patients to ask questions where they have knowledge gaps, all of which improves the care transition from hospital to home.
“Patients are overwhelmed and feel out of control on top of being sick,” said Dunn, patient education manager for UK HealthCare. “We think the GWN will empower them to learn about their illness and ask questions about their care, which has the potential to improve health outcomes for these patients. Since that also reduces costs, it’s the ultimate win-win.”
The GWN interfaces automatically with the Electronic Health Record (EHR), which improves care coordination and streamlines workflow for clinical staff.
“For example,” Dunn explains, “once a physician orders a medication for a patient, that order goes into the EHR and flows into the GWN. A patient looking at the GWN monitor in her room will see ‘This is the new medication you’ll be taking, this is what it looks like, this is what it’s intended to do, and here are some side effects to look for.’ The GWN will let the nursing staff know when that patient has reviewed her information, and a nurse can follow up with that patient to reinforce the message (called teach-back) and address any of her concerns.”
Dunn recounts one nurse who, upon checking the EHR, realized that her patient had watched the seven health videos assigned to her seven times. “It turns out that the patient watched them alone, and then made her family watch them with her,” Dunn said. “She told her nurse that the videos made it easier for her to remember what her doctor had told her.”
And that is precisely what philanthropists and longtime UK HealthCare advocates Don and Cathy Jacobs were looking for when they offered to underwrite the GWN pilot program.
“Don and Cathy just happened to stop by as we were watching a demo of the GWN and they immediately saw its potential,” explained Dunn. “They’ve made it their goal to help our Health Education Center become more ‘virtual’ to reach as many people as possible, and funding the pilot project was an important step towards achieving that.”
The Get Well Network has several other clinical features, including a extensive health video library with more than 600 titles, bios on a patient’s care team, and a virtual messaging system that allows the patient to request things like a visit from a chaplain or from Carmine, the 8th floor’s exclusive therapy dog.
Brent Krein, a UK HealthCare informatacist, says the 8th floor was a natural place to test the Get Well Network due to the unit’s culture of innovation. As the IT point person for the project, Krein worked with staff on the floor to adapt the technology’s design to UK HealthCare’s special needs and culture. He’s clearly passionate about this project and its potential to change the way patients view their care.
“Let’s face it,” he says, “the hospital is one of the worst places to be. You’re sick, you’re lonely, and the only introduction you have to your providers is the whiteboard on the wall listing the names of your medical staff.”
“Now, patients can captain their own ship, connect more fully with the world outside, and not feel embarrassed that they don’t understand something about their illness or their care.”
In addition to the GWN’s numerous clinical benefits, the technology provides access to outside entertainment and learning, including Facebook, movies, and lists of nearby hotels, restaurants, parking, and other amenities for visitors. Krein describes the joy of introducing the Get Well Network to one patient who had been hospitalized for several weeks.
“He had been very down in the dumps, but when we showed him that he could access his Facebook page and he saw all the ‘Get Well Soon’ messages posted by his friends, he looked like a kid on Christmas,” Krein said. “That may seem like a small thing, but it was no small thing for him, and it completely changed his outlook.”
Assuming long-term outcomes match initial successes, the GWN will be rolled out to other patient units, starting with the planned units on the ninth and tenth floors. Ultimately, says Krein, the team hopes to make the clinical features available to patients at home, providing seamless access to information and self-care advice.