'Smart card' speeds triage, boosts safety
Swipe of card provides essential patient information
ED managers are not often thought of as inventors, but David Soria, MD, chief of emergency medicine at Wellington (FL) Regional Medical Center, has created a device that has helped his department knock an average of 2-3 minutes off its triage time, which was already an impressive 10-15 minutes.
It's called a "smart card," and it works like this: Patients who sign up for the card complete an online or paper questionnaire, which asks for information such as date of birth, current medications and dosages, allergies, medical and immunization history, family history, the name of the patient's primary physician, advance directives, and organ donation preferences.
When these patients present to the ED, they go to a kiosk, touch the screen once, and swipe the card, at which point the information is pulled from a database inside the hospital. That information is sent via computer to the triage nurse. A moment later, a triage nurse calls their names, confirms their identities and their medical histories, and starts taking vitals.
Many patients at Wellington are senior citizens and are on 10 or more medications, notes Soria. "Imagine the time it would take to enter that information, even if that person typed well." Soria estimates it could take 7-10 minutes to type in that information.
JoAnn Franklin, RN, director of emergency services, says the card is also an important patient safety tool. "When an elderly patient comes in who is unresponsive, if they have a smart card in their wallet, we will slide it through and all their information comes through," she explains. "This way, we know what types of meds they are on, if they have a pacemaker, and so on."
If the card is lost or stolen, there are no privacy concerns because all it contains is a 12-digit number; the actual medical information is stored in the hospital database, Soria adds.
The nurses "love it," says Franklin. "It saves so much time when you have a lot of patients coming in and they all want to see the docs right away," she says.
When patients arrive at the ED with an extensive list of meds, the nurses create a card for them and explain exactly what it is and how to use it in the future.
The nursing staff also had to be educated about the new card, says Franklin. All nurses were given their own smart cards. They put their information on it and learned how to log on, Franklin explains. "Then, they would pretend to be the patient and put in any requested information," she says. An added benefit is that the nurses now have cards in the event they become patients, Franklin says.
ED tool accomplishes many goals
When Soria came up with the idea for a patient "smart card" about two years ago, he saw the opportunity to meet a number of needs.
"I wanted to create something that would not only eliminate inaccuracies and the inconvenience of going over meds each and every time you go to the ED, but eliminate the inefficiencies caused by patients not remembering all the information," he explains. "In addition, I wanted to create a loyalty card, so if patients needed emergency services, they would repeatedly come back to the same facility because we have the technology that allows them to provide information without them having to go into it verbally."
The ED already had computer technology for bed tracking and for triage, and it is in development with an electronic medical record and computerized physician order entry, all designed by MedX Healthcare of West Palm Beach, FL. There already were kiosks with touch screens in the ED for self-registration, so the only hardware that had to be added was the card and a magnetic reader. MedX used items such as touch screens from Planar Systems, Inc., of Beaverton, OR; PCs from Dell Computers, of Round Rock, TX; and the readers from Magtek, or Carson, CA.
"I had retained MedX Healthcare to work on my software, so I then had them develop the 'mag' readers, the magnetic swipe card and the database that holds the information," Soria recalls. MedX completed the assignment in a few months, a one-month beta test was conducted, and the system was implemented in November 2007.
The cost of the software development — $75,000 — was borne by Soria's group, says Soria, adding that MedX has a pricing sheet for implementation in other EDs.
Soria says that to his knowledge, there is no competition for the smart card. "There are cards out there that have chips that can plug into a system and allow the patient to carry all their medical information with them, but this is the only one that comes in a 'mag' strip reader," says Soria, noting that since there is no actual medical information on the card itself, there are no privacy concerns should it be lost or stolen.
Sources and Resource
For more information on ED patient smart cards, contact:
- JoAnn Franklin, RN, Director of Emergency Services, or David Soria, MD, Chief of Emergency Medicine, Wellington (FL) Regional Medical Center. Phone: (561) 798-8535.
For more information on how to obtain smart cards for your ED, contact: Shaun Thompson, MedX Healthcare, West Palm Beach, FL. E-mail: [email protected].
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