August 2, 2013
by John Bennett MD


Every doctor knows the “signing-out of patients” process.  For those who do not not know, it is basically, the oral summary from a doctor on  duty, that is going off duty, to a doctor that is just coming onto duty.
Mostly, it occurs with doctors-in-training, interns, and residents, in certain hospital settings like the Emergency Room  but can occur in any medical setting,  where physicians are “inheriting” patients from another physician, who is going “off-duty”.
It is an important process, because the quality and continuity of care must be maintained, and communication between parties is very important, to insure optimum care for the patients “handed over”.

A new App has been created, called EMnote, to make this  process safer and more efficient.  It is  authored by Andrew Caravello DO, a Board-Certified Internist from Southern Jersey, to aid in the “signing-out” process.
We will let  Andrew explain how it works:

“EMnote  is based on my idea  to create an ideal sign out app that is practical with a clean UI.

 (User Interface)
I think I might have a solution for standardizing the sign out process. I’ve created an app for the iPad that fits this purpose. It is HIPAA compliant and works as follows using intern sign out as an example.
   Intern A is on call. As soon as she starts her call the ED calls for an admission. Intern A gets called for a rapid response and has a floor call at the same time.
  In comes my EMnote app. Intern A opens her app on her iPad mini, enters her password (which decrypts text and allows for entry into the app) quickly enters info for ED patient which might include patient name and MRN at this point. She responds to rapid response and stabilizes patient and enters this patient info into app including bed number and safety concerns. In the meantime she had already responded to a call for a Tylenol order and entered this information as well.
Now fast forward to end of shift. Intern A has admitted 6 patients and has had 20 floor calls (some of which for the same patient) and 2 rapid responses. Now it’s time to sign out to Intern B.
 Intern A presses the send button within EMnote app and is prompted to provide a password to create an encrypted PDF that in a sign out format to be shared with a recipient (Intern B)
Intern B now has a sign out sheet that can be used for a number of purposes.
  1) He can make a copy for his floor team to be used on rounds to ensure appropriate transition of care and address any safety concerns without involving the medical record as this is “a sign out sheet”
2) He can use it for his on call shift (since its the weekend) and patients safety concerns and responsibilities can be discussed with other interns on call
3) I’ll let you think of this one 🙂
Of course these scenario can be different. This app can be used in any scenario when a secure patient ” hand off” is necessary – Inpatient, ED attending to attending, IM attending to attending, Intern to Intern – etc.
Airdrop functionality will be added as soon as iOS 7 released. Eventually you will also be able to archive patient data as needed.



No comments

Be the first one to leave a comment.

Post a Comment