Tablet-based app helps parents review real-time information about their child's health.
"It gives you a sense of control…I don't always want to have to ask, 'Did this happen? Did this get done?'" This is how one parent of a patient at American Family Children's Hospital (AFCH) in Madison, Wisconsin, describes a new tablet-based app that AFCH rolled out hospital-wide this year. Called MyChart Bedside, the app provides families with real-time information about their child's health, the care plan and what to expect during their hospital stay.
Every parent—or the patients themselves, if they are adolescents—receives a tablet computer loaded with the MyChart Bedside app, including families in the neonatal and pediatric ICUs. The app provides access to key portions of the child's hospital medical record, such as lists of medications and diagnoses, test results in real time, personalized education and discharge information. It also details the child's daily schedule and provides a way to communicate with the inpatient care team.
"Parents have given us a lot of positive feedback," says Michelle Kelly, M.D., pediatric hospitalist and assistant professor of pediatrics at the University of Wisconsin School of Medicine and Public Health. "They look at the lab results and often can have their questions answered without the help of the medical team. We meet every morning with the families at the bedside, so that creates an opportunity to set the stage for what's going to happen and what they're going to see on their tablet."
Based on a successful pilot
AFCH began by testing the inpatient portal with 300 patients and their families in 2014, with positive results:
- 94 percent reported it improved the quality of their child's care
- 89 percent felt that it helped reduce errors
- 8 percent said it helped them identify at least one medication error
- Others said it gave them the information they needed to make decisions about their child's care
The success of the pilot led AFCH to roll out MyChart Bedside this year to all 81 beds in the hospital.
Kelly worked with Shannon Dean, M.D., senior vice president and chief medical information officer for UW Health, and Peter Hoonakker, Ph.D., UW-Madison human factors and systems engineer, to implement the MyChart Bedside functionality. Though AFCH had successfully used a similar portal in its outpatient setting for about 10 years, there was initial concern that providing that level of transparency on the inpatient side might create some concerns.
"There was a concern that patients and families would get worried and anxious if they were getting information without a clinical translation right there, at the same time," says Kelly. So AFCH uses the app to provide real-time results for more routine tests while preserving results for more complicated or sensitive diagnoses for face-to-face conversations with the medical team.
A free toolkit to help other children's hospitals
Kelly says she and her colleagues are leveraging user feedback to continue improving the inpatient portal at AFCH to help hospital staff better serve patients. They are also using these lessons learned to assist other hospitals that may be interested in building their own inpatient portal.
The team published a free toolkit designed to help hospitals looking to implement an inpatient portal like MyChart Bedside or evaluate an existing platform. The toolkit includes:
- Materials to engage institutional stakeholders
- Timelines and planning documents
- Information on key decisions and pediatric considerations
- Data collection tools
- Lessons learned from AFCH's experience
Driving transparency and empowerment
Because MyChart Bedside provides transparency in care, parents report that it helps them feel more in control and empowered to make decisions for their child—key factors for improving engagement with parents and, ultimately, the care of their children. "Transparency is on the rise," Kelly says. "This is yet another way to engage parents as partners in care in both quality and patient safety."
UW Health plans to implement the inpatient portal with adult patients in the next year.
The team shared outcomes and lessons learned at CHA's 2018 Annual Leadership Conference in San Antonio.
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