Reframing Emergency Care

Abstract

Healthcare processes will need to transform Healthcare is an ever-changing domain in which the care process of today are already facing difficulties to meet existing demands. It can be foreseen that in 2030 our ageing population will cause healthcare costs to increase, while there will be a shortfall of medical personnel. Emergency departments will get more overcrowded with patients. Amongst others these factors will force healthcare institutions to rethink their processes and services to maintain optimal care outcomes. A visionary and human-centric approach is taken to design for meaningful experiences and interactions in a future emergency care context. Stepwise information exchange in separate databases hinder communication flow Emergency care teams are used to a stepwise workflow of handing the patient from care giver to care giver along the service chain. Thereby multiple points of interpretations and communication of the situation happen verbally. While fast assessment and decisions are indeed required to perform efficient emergency care, this information flow can lead to misunderstandings, data loss or require extra time and effort for information exchange or reporting. Pro-active patient behaviour Furthermore, we see the patients’ behaviour shifting to being more pro-active, as people develop an awareness of their health and lifestyle, have free access to (online) medical education and self-tracking devices – all of which will empower them to have conversations on eye-level with their care givers. In emergency incidents this new behaviour and mindset will cause people to have difficulties giving over control to care givers. Another aspect of this pro-activeness is that healthy people will act preventively to keep an optimal condition, while people with chronic diseases will build long-term relations to multiple interconnected care institutions. Emergency incidents will be embedded in this care continuum. Patients will also seek more social connection to their relatives during an hospital stay. Besides they will show an increasing need to understand care processes in order to accept their situation and show respect to others. Linking personal and professional healthcare in dialogs The concept of MED Dialog is proposed in this project. It suggests that care organisations acknowledge patients’ control of their own health profile and use it to bridge the gap between personal and professional healthcare. MED Dialog is an information platform that is used by emergency care givers to seamlessly cooperate and communicate around a patient to ensure a tailored care quality and trustworthy patient experience. This contributes to transforming the admission process from being an extra burden to helping get to know patients at a glance. MED Dialog is also a tool to facilitate reassuring and transparent conversations between patients and nurses. Facilitating a seamless dialog between teams of care givers and their patients MED Dialog helps patients to be prepared for any incident and contribute to the emergency care chain: They create a health profile and continuously overview their care history and plan. In emergency incidents people give over the control to professional care givers, by making their health profile accessible via a finger print identification – providing deep insights for paramedics and physicians when knowledge and minutes matter. Patients will feel like they are well understood as individuals and can receive consistent care. Enabling efficient and rich knowledge exchange between care givers around a patient MED Dialog provides each care giver with relevant background information he/she needs to know. For instance, it can reveal high priority medical facts about a patient (like a medication and allergy list) which contributes to the paramedics’ decision of which first aid to give and where to bring a patient to. MED Dialog helps paramedics in briefing the ED team by integrating a pre-announcement feature via an app and during the patient handover. This is facilitating interdisciplinary cooperation, saving time that can be spent with the patient. The ED team can benefit from pre-arrival communication – accurate vital signs trends, a more elaborate and verified handover and can involve external experts or the general practitioner more directly. Improving efficiency and lowering healthcare costs Besides enhancing the patient experience and care givers’ workflow, the implementation of MED Dialog can improve efficiency and lower costs: Because internal and external communication is simplified, the labour for admission and reporting can be reduced. For instance, less lab tests/scans will be needed if there is access to existing, relevant patient files, preventing over diagnosis. Increasing the quality of emergency care MED Dialog leads to better diagnoses and decisions, less misinterpretation or data loss and it reduces the risk of harmful interdependencies of medication. Its monitoring features can help forecasting incidents as well as smoothing the transition to home recovery. Increasing trust among care teams In the performed user research it was found that the ED personnel verifies information presented verbally by the paramedics, due to a healthy mistrust. Good communication was identified as the essential factor to high quality emergency care. MED Dialog can help eliminating unnecessary safety checks and make communication more seamless, verified and therefore more trustworthy. It was found that visual data support can better inform and calm down patient handovers, while also speeding up reporting. Integrating technologies into existing care practices User research insights also reveal the importance of embedding new products and technologies into established work routines. Therefore MED Dialog lets care givers focus on executing care by integrating its features into existing interactions like patient assessment and paramedics’ handover in the emergency department. Furthermore, MED Dialog is not directly used by patients, thereby it lets care givers take the control in dialogs. Keeping patients’ contacts in the loop During treatments patients will be supported by MED Dialog to reach out to their relatives or work contacts. This will make patients feel socially connected, reassured and eventually increase compliance to a treatment. Helping patients reflect and recover After a visit to the emergency department, all treatment data will be logged in the profile and people will better understand what happened and regain control for their future plans, because MED Dialog’s monitoring features support people in their recovery process and transition to home care.