Christchurch Hospital staff are calling for wider use of a "phenomenal" app that reduces hassle and shortens patient stays.
Cortex is an app for iPhones and iPads that digitises patient notes and makes them instantly available to all medical staff in a patient's care team.
In mid-2017, three wards ran a three-month pilot of the app, which was used by nurses, doctors and hospital pharmacy as well as allied health professionals.
"At the end of our 12 week trial we weren't willing to give it back," says Clinical Nurse Specialist Stacey Simpson.
"General Surgery was given permission to continue using it because I think they would have had a revolt if they'd tried to take it off us."
The app allows health professionals to "subscribe" to a patient they are looking after.
That gives them access to a timeline of information including clinical notes and tasks that need to be completed.
Under the old system, Stacey says, doctors on medical rounds would write observations onto stickers, which they would later stick to a patient's clinical notes.
"They'd complete them, but they were sometimes hard to read and easy to lose.
"It could sometimes be five or six hours before these stickers would be applied to the notes. So if a nurse had not been on the ward round with the doctors, it was literally the patients telling us what the doctors had said."
With Cortex, doctors add the notes to the app as they do rounds, save them, and sign them off so other staff can access them immediately. That means nurses doing their 10am board round can see new notes instead of relying on old information.
A board round is where the care team gathers round an electronic whiteboard on the ward each morning to discuss and exchange information on each patient to ensure they get the right care.
Physical notes are usually stored in one place, but they can go wandering with another health professionals who is using them, or if the patient is taken to another ward.
"For nurses particularly, and for allied health, everybody now has visibility of the electronic notes so you don't have to go and find the physical ones," Stacey says.
"The whole closed-communication loop is just phenomenal. I mean, the amount of time it saves nurses and increases patient confidence day-to-day is a huge benefit."
The app also reduces competition for shared computers in busy wards.
Charge Nurse Manager Jessica Carey says the standard method of sending a task to a house surgeon used to involve paging them. This meant waiting by the phone until the doctor could call back, often causing the doctor to leave a ward round to go to a phone.
"Now I can delegate a task to a house surgeon on Cortex. The house surgeon then accepts my task, and I can see when they have," she says.
"If they were in clinic for the next two hours they can add a comment so I know the likely time frame for a response."
A busy house surgeon could even delegate the task to someone else who was free to pick it up, Jessica says.
"I don't have to wander back and forth to a paper note every half hour to see if something has been done."
According to Canterbury District Health Board data, the average length of stay decreased by 20 percent and readmission decreased by 12.5 percent in the wards where the app was trialled.
Dr Chris Rumball, clinical lead for the app's developer Sense Medical, says the reductions were entirely down to the use of Cortex.
He says patients are happy to get out of hospital quicker, and shorter stays mean lower risk of infection.
"The sooner you're in and out of hospital, generally the better off you are."
Shorter stays also reduce demand for beds, which Dr Rumball says is a big issue coming into winter when more people are sick.
"This has enormous implications for reduced costs and better planning."
The official plan for Cortex is to deploy it throughout Canterbury DHB's new Acute Services Building so that staff are trained and practiced in its use before the new facility comes on line.
Dr Rumball says Sense Medical also has bigger plans for the app.
"There are many areas, both in the hospital and the community, where bringing a multidisciplinary team closer together will improve the quality of patient care" he says.
"There's plenty of interest from other DHBs and community health organisations, and we're starting to look at Australia."
Cortex has been co-developed by Sense Medical as part of the Canterbury Health System's focus on using technology to improve healthcare for patients and staff.
Cortex from Canterbury District Health Board on Vimeo.
Cortex Application on iPad (2.4MB, JPEG)
Cortex being used in a hospital (1.6MB, JPEG)
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