Research Roundup: Remote Monitoring, EHRs and Bar-Code Technology

| June 11, 2012

Three new research studies shed light on the benefits of remote monitoring and share effective strategies for reducing EHR-related medical errors and technology workarounds for bar code technologies.

New research from Italy shows that remote monitoring can be an effective way to reduce emergency department (ED) visits for heart failure patients with implantable defibrillators. 

During a 16-month study of 200 patients, researchers found that monitored patients had 35% fewer ED visits than those who received standard care. In addition, the monitored group had an improved quality of life, according to FierceHealthIT.

The findings are good news for those who were discouraged in April 2012 when researchers at the Mayo Clinic and Purdue University concluded that telemonitoring doesn’t keep older patients out of the hospital. 

The study found that a monitored group of 205 older adults at high risk for rehospitalization had the same hospitalization rate, and a higher mortality rate, than a group receiving standard care.

According to FierceHealthIT, the Mayo Clinic/Purdue University study contradicted several older studies. March 2012 research by Geisinger Health Plan found that telemonitoring using interactive voice response resulted in a 44% reduction in readmissions of patients with congestive heart failure. 

A British study published in 2011 determined that remote monitoring cut emergency admissions by 20% and reduced mortality rates by 45%.

EHR Photographs Could Reduce Medical Errors

Putting a patient's photo in his or her electronic health record (EHR) could help reduce certain EHR-related medical errors, according to a study published in the journal Pediatrics.

The number of incidents in which a patient received care intended for another patient fell from 12 cases to 3 cases after the Children’s Hospital Colorado modified its EHR system. 

The modified system now shows an order verification screen each time a test or treatment is ordered. 

The verification screen displays a photo of the patient taken at the time of admission.

Knowledge of Staff Perceptions Can Prevent Technology Workarounds

Nurses who administer medications don’t seem as enamored with bar-code technology as their managers are, according to a new study in the Journal of the American Medical Informatics Association

As a result, some try to override or work around the technology, thus reducing its ability to improve safety and reduce errors.

In a small study, 83 registered nurses at a 236-bed Midwestern hospital gave the follow opinions about bar-coded medication administration (BCMA):

  • Most nurses rated BCMA as moderately easy to use.

  • More than half said BCMA didn’t make patient care any easier. 

  • More than a quarter said they would not use the technology if they had the choice. These nurses also thought their colleagues would use workarounds when available.

Researchers concluded that administrators should talk to nurses before they implement BCMA in order to gauge their perceptions of the technology’s ease of use.

CAST Executive Director Majd Alwan agrees with researchers that addressing staff concerns ahead of time could help limit workaround attempts. 

He suggests that providers might have the most success if they:

  • Educate staff about the technology and how it would affect safety and patient outcomes.

  • Engage frontline staff in the customization and implementation of the technology in order to ensure that procedures make sense, are easy to follow, are not redundant and do not warrant workarounds.

  • Train staff sufficiently on the use of the technology.