Pulsara Blog

Sometimes, PE is the forgotten Time Sensitive Emergency - until you are faced with "that patient" an hour before the end of your shift.

EDITOR'S NOTE: The following blog post was written by guest author Mic Gunderson, President of the Center for Systems Improvement. Mic has been involved in emergency healthcare for over 40 years in leadership, managerial, and clinical positions including prior service as National Director for Clinical Systems for the American Heart Association. 

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High performing systems of care for high-risk time-sensitive conditions like cardiac arrest, major trauma, STEMI, stroke, and sepsis are critical to achieving excellent patient outcomes. To make significant improvements in these systems of care, we need to understand how systems work in general so that we can look beyond the individual hospitals and EMS agencies that make up the ‘parts’ in these systems of care.

SILOS are one of the biggest problems facing healthcare.

The patient's journey crosses multiple healthcare entities and/or departments in a hospital.  This has massive implications on real time team communication.  However, equally important is how many hospitals and regions approach addressing communication problems from a budgetary or evaluation standpoint.

Does this look familiar?

Medical error is the third leading cause of death and contributes to 10,000 serious medical complications every day.  80% of these errors occur secondary to miscommunication during transitions of care.

In healthcare especially, it can seem impossible to stand out from the pack. Everyone has a million things on their plates. Every move you make has an impact on people's well being. Everyone else is also working long hours, on their feet all day and night, and constantly feeling like there's more they need to know or new skills they are trying to acquire.

For years now, Pulsara has been building and rebuilding, making advances, and then making them better. All in efforts to put an end to the miscommunication crisis in healthcare. 

We have a platform that WORKS. A platform that provides real-time TEAM communication which crosses ALL healthcare entities -- after all, if you're only solving the problem on the prehospital side, or the in-hospital side, or the hospital-to-hospital end, you're only solving ONE PART of the problem ... which really isn't solving the problem at all. 

All of the work we've done encompassing the problem and refining the solution have paid off. Patients in 18 states and Australia now benefit from their care teams providing faster, better care due to the instantaneous, streamlined communication systems they've adopted, which includes Pulsara. Below, check out our research, case studies, posters, press releases, and videos to learn what YOUR region can do to stop the miscommunication crisis.

A recent article published on USA Today's website interviewed the CEO of Leapfrog Group, which assigns grades to hospitals based on "medical errors, infections and injuries, patient responses to surveys, [and] data provided to CMS, the American Hospital Association, and voluntarily to Leapfrog." 

Perhaps the most striking point the article made was one that we've been trying to bring to light since Pulsara was founded. In fact, it's the reason WHY Pulsara was founded: "[These] problems are 'all too common,' with more than 500 people a day dying from preventable errors in hospitals."

I've often been asked what the hardest problem is that we face in healthcare. I believe PATIENT CENTRIC healthcare as we practice it is a failed model. Clinicians focus on serving the patient only when they are touching the patient.

This does not make any sense. As an ER Physician, I can't take care of the patient by myself. It takes a team. To complicate things even more, that team is often necessarily comprised of individuals who work for different health care entities.

The Re-Engineered Discharge (RED) program is a recently-developed strategy to reduce readmissions in hospital settings. According to a paper published about the project in BMC Health Services Research, "Project RED is comprised of twelve components focused on key aspects of the discharge process, including patient education, medication reconciliation, communication with and among health professionals, and follow-up care."

This initiative has been adapted by systems across the country, though little is known about the program's sustainability and impact. The recent study aimed to identify the factors that influence adaptation and implementation of RED and the impact of those factors on the program's sustainability.

Silly pager, emergencies are for modern technology!

I've written on this topic before, but I heard a story a few days ago that made it worth revisiting. The following is an all-too-familiar scenario to anyone still trying to use outdated systems of patched-together technology to coordinate critical care. 

The nurse in the Emergency Department at a level II Trauma Center was receiving report from EMS. To be honest, I don't know if this was a telephone called report, or one given over the radio. At the end of the day, the point is that the information shared by EMS wasn't received by the ED due to a poor connection. The nurse heard wrist injury, with a list of other seemingly minor injuries. Though there was a period that the connection was abysmal, she thought she captured all the information.

When EMS arrived, they were told to go to room 10 which isn't one of the major trauma rooms. When the nurse walked into the room to take report "again," the medic vented his frustration about the Trauma Team not being present. Upon taking the bedside report, the nurse realized that during that poor connection, the MOA was high-speed roll-over with partial ejection.

What if you could get inside the mind of a Stroke Program Consultant who helps hospitals and EMS systems get ready for certification (through the Joint Commission, for example)? You'd probably want to know what things she commonly sees hospitals doing wrong. What tricks does she have for making sure your facility is ready?

Shane Elmore, Pulsara's Vice President for Clinical Innovation and Development, recently sat down for an interview with Debbie Roper, RN, MSN, President and Founder of Strokes R Us. Debbie is a consultant who travels across the country and advises hospitals that are going through the stroke certification process.  

If you missed my previous blog post about my recent hospitalization, then I encourage you to go back and give it a read. This post serves as part two of  my up-close-and-personal experience with communication failures in the hospital. Luckily, the situations described in these two posts don’t involve time-sensitive emergencies (TSEs). When communication failures occur in TSEs, the impact can be devastating. Rather, these examples provide evidence that miscommunication is part of the everyday routine in healthcare. This communication crisis is real, and it impacts real people every day.

In case you missed my previous post, let me recap: I was out of town on a business trip and ended up being hospitalized for a day. Luckily, it was just one day; every additional day a patient stays in the hospital, the odds of a full and speedy recovery decrease. But the experience that would follow was so bad, I was half surprised a lady with crazy hair didn't walk up to me on admission and say "may the odds be forever in your favor!" (That's funny if you've seen the Hunger Games. If not, you seriously need to go to the movies now and then ... but hey, no judgment).

Listen to this post on the go with Pulsara's new Podcast!

"The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency." -- Bill Gates

I love this quote from Bill Gates. But just recently, I changed my mind about what this quote means to me and what we, as tech companies, do with that information. When I first heard this quote, I took it to mean that if you have an inefficient process then technology won't help you. If you have an efficient process, then apply technology, and it will only make it better. Makes enough sense, right? 

FOR IMMEDIATE RELEASE

Listen to this post on the go with Pulsara's new Podcast!

Bozeman, MT – July 25, 2017 – Pulsara announced today that the company has been selected as a finalist in this year’s Fierce Innovation Awards: Healthcare Edition 2017, an awards program from the publisher of FierceHealthcare. Pulsara was recognized as a finalist in the category of Digital/Mobile Health Solutions.

Pulsara was selected as a finalist for its innovative, industry leading product, the Pulsara Prehospital Alerting Package. Finalists were selected by a distinguished panel of judges from renowned U.S. hospitals and healthcare systems.  The panel included Terry Booker, VP Corporate and Business Development, Independence Blue Cross (IBC); Roy DeLaMar, Internal Business Communications Manager, Cigna; Neal Ganguly, VP and CIO, JFK Health System; Deborah Gordon, VP Marketing Sales and Product Strategy, Tufts Health Plan; Jessica Grosset, VC of IT, Infrastructure and Operation, Mayo Clinic; Kurt Cwak, CIO, Proliance Surgeons; Roger Neal, CIO and VP, Information Technology, Duncan Regional Hospital; Todd Richardson, Senior VP/CIO, Aspirus; Edward Ricks, VP and CIO, Information Services, Beaufort Memorial Hospital; and Julie Slezak, EVP, Clinical Analytics, GNS Healthcare.

Communication and operational changes at hospitals, and within EMS systems, play key role in recent drop in the death rate from heart attacks. 

Although heart disease is still the number one killer of American adults, in recent years the nation has witnessed a dramatic decrease in the death rate from heart attacks. From 2003 to 2013, the rate at which people in the U.S. died from heart disease dropped 38%.[7]

**This post is an excerpt from our eBook, "It's About Time: Addressing the Communication Crisis in Emergency Medicine." Download the full eBook here!**

This striking improvement can be attributed to a number of factors, including more effective treatments for heart disease and risk factors like high cholesterol and high blood pressure. In addition, fewer people are smoking these days. And notably, some hospitals have made sweeping changes in how they treat people having heart attacks. Many of those changes have not involved new drug therapies or procedures, but simply operational shifts that address patient flow and provider communication.

EDITOR'S NOTE: Special thanks to Cynthia Bradford Lencioni for writing today's blog post. You can connect with her on LinkedIn. 

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In a stunning development leaked this week to the media, a senior Food and Drug Administration source told journalists that the FDA plans to begin regulating as medical devices certain mobile phones, fax machines, pagers, and some models of egg timers used by healthcare providers for communication and care coordination within the next year. 

………… Fake News!!

The truth is that over the past 5 years, there has been a deregulatory trend in the US with regard to low-risk healthcare software, and the 21st-Century Cures Act (2016) is the latest in that trend. Specifically, the Cures Act provides that software for healthcare communication and logistics does not meet the FDA’s “medical device” definition, or classification, and is therefore not subject to FDA regulation.  The FDA classifications for software as a medical device are based on the intended use of the application and the risk it presents to patient safety.  

It’s About People.

As a society, we are obsessed with things. In fact, we have so many things, we’ve created the Internet of Things (IoT) to help us manage and learn from our things.

What is the IoT?

EDITOR'S NOTE: Special thanks to Cynthia Bradford Lencioni for writing today's blog post. You can connect with her on LinkedIn. 

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Security vulnerabilities are a concern for everyone in this day and age when it seems there’s a major security incident in the news each week. And unfortunately, health care entities have been specifically targeted for their sensitive, monetizable information.

About a week and a half ago, we broke the news that Pulsara had been selected to receive the Healthcare Informatics Interoperability award for 2017, which was accepted by Pulsara CEO Dr. James Woodson last week at the HIMSS conference in Orlando. If you missed that press release, take a moment to check it out! 

Now, we wanted to bring you the interview with James. The following excerpt originally appeared on the Healthcare Informatics website, and the full version can be seen here.