Trauma: Lifeline and Electronic Fetal Monitoring Virtual Games -- When the mission is patient first, you don’t try first on patients. Trauma: Lifeline and the Electronic Fetal Monitoring games are two examples of using innovative virtual simulations to improve safety and reduce risk. These games are easily accessible, available on multiple platforms, fun, and interactive for realistic clinical training.
The Electronic Fetal Monitoring serious game encompasses critical thinking and decision making in the world of Obstetrics. Here the learner is in the game interpreting the electric fetal monitoring and then making decisions about the care of a laboring mother. The learner also receives feedback based on their actions in the game. The serious game in EFM allows learners to evaluated on their interpretation and decision making in the setting of a labor and delivery unit.
Zoll Defibrillator Task Trainer -- A cardiac arrest is an example of a high risk, but low volume event in hospitals. Achieving the highest quality in performing these types of clinical interventions requires both an expert team and 100 percent accurate technology. The Zoll Defibrillator Task Trainer is a mobile digital simulation developed to improve accuracy and response times by refreshing learners on the common defibrillator tasks anytime, so they will be prepared anywhere.
Occurrence Reporting -- Hospitals have systems for reporting thousands of potential patient safety events, from near misses to serious safety events. Understanding these events is critical to improving safety across the system. Visualizations of these data reduce the burden of analysis and allow critical trends to emerge from large data sources.
Mobile Eye Tracker Device -- A unique technology that provides human factors researchers with a precise understanding of how practitioners are interacting with patients, other providers and patient tools in a given circumstance; such as a Code Blue. It also provides insights into cognitive processing to inform improvements in processes and equipment.
Rapid implementation of new medical technology can lead to adverse patient events or near-misses if there is inadequate analysis of how staff will use it and how it will be integrated into workflow. “Testing in controlled environments often does not adequately consider the ‘human factor,’ or how people interact with technology in high-pressure, real-life situations.” When Annie, a nurse at MedStar misread a glucometer, she was initially suspended for the mistake. When the National Center for Human Factors in Healthcare investigated the incident, they found that the problem was not the nurse but the device - the pop-up warning visually blocked the device's true reading indicating that the patient's blood sugar was critically low. The nurse returned to her a job and all MedStar hospitals now use an updated model of the glucometer that does not include a pop-up message. For more on this story, watch this video or read this article in Modern Healthcare.
ZocDoc -- MI2 catalyzed online appointment setting at MedStar with a vendor called ZocDoc, which makes scheduling appointments far easier and attracts a volume of new patients.
Tonic Health -- MI2 catalyzed the use of a cloud-based data collection platform called Tonic Health, to replace check-in forms on clipboards, and to facilitate online surveying and screening to drive better outcomes.
MI2 catalyzes telehealth projects that improve access while enhancing clinical quality and the patient care experience. Leveraging advanced communication and collaboration tools, Telehealth is currently being used across MedStar to deliver a range of services including telestroke, teleneurology, palliative care outreach, and ethics consultations.
Palliative Telehealth Connecting Hospital to Home (PaTCH2) -- The Palliative Telehealth Connecting Hospital to Home (PaTCH2) program extends existing palliative care services in the form of a specially configured tablet, by using connected health technology to provide supportive care to critically ill patients at home. PaTCH2 currently enrolls patients at MedStar Union Memorial Hospital and MedStar Harbor Hospital. The PaTCH2team links with home health nurses from the MedStar Visiting Nurse Association and other providers at each site to coordinate care.
Before being discharged from the hospital, the care team meets with patients and their families to enroll them in the program and train them on the use of the tablet. Once home, patients can use the tablet to send messages to and video conference with members of the care team from the comfort of their home. Patients also can access educational videos and resources specific to their condition, as well as an updated personal medication list.
Health Influence and Design Thinking
MI2 solves problems by helping people innovate and think differently by offering consults and curricula.
Health Influence and Engagement Course - This course is divided into a series of modules, each with a deeper dive into content areas related to influence as a primary function of health care. Each module has a series of videos that are easily digestible (5-10 minutes) and actionable (action items you can use immediately) chunks. The Influence Principles featured in the course include Instant Rapport, nonverbal communication and body language, and how to influence groups.
Design Thinking in Health Care - This course explains in detail what design thinking is, how to conduct design research and prototype, and how to apply these skills to challenges in health care.
Human Factors in Health Care - The National Center for Human Factors in Healthcare offers many education opportunities for clinicians, medical students and trainees interested in human factors as well as human factors experts interested in health care.
Data Science and Infonovation
Nurse Rounding -- Nurse Rounding is an enterprise-deployed, patient experience tool that was developed by MI2 through nurse-physician collaboration. Its innovative dashboard allows real-time visualization of patient experience within a unit, hospital, or the entire enterprise coupled with a communication system to fix patient issues as they occur. Read More.
GlucoMetrics -- An automatically updated, intuitive data exploration tool developed by MI2 in MicroStrategy leveraging Amalga data from every inpatient visit across seven hospitals over five years. The visualization allows filtering on patients with a diabetes diagnosis, who have multiple episodes of high blood sugar during their inpatient stay, or are prescribed insulin or oral agents. This software tool has been adopted by the MedStar Diabetes Institute Inpatient Glycemic task force to compare measures of high and low blood sugar over time within and between MedStar Hospitals. Its advanced interactive data visualization on a single screen allows clinicians to easily identify trends and conduct comparisons that are otherwise hidden, and ultimately identify hospitals with opportunities to improve glycemic control.
Glucoscope -- A real time interactive heat map visualization highlighting current inpatients having blood sugar control issues within the past 24 hours. Measures of how extreme blood sugar tests have been, and the persistence of abnormal results, drive color and cell size highlights, respectively. Clinicians can click on individual patient cells to bring up detailed laboratory result values for blood glucose and hemoglobin A1C, as well as any medications prescribed to manage blood glucose.
MedStar Inventor Services
Diaphragmatic Assist Device/InVent -- The InVent system is an implantable medical device for patients with respiratory dysfunctions that provides temporary assistance with diaphragm contraction and expansion in order to facilitate a patient’s breathing (just as the LVAD does for the heart).
Face2Face Rehabilitation App -- Face2Face Rehabilitation App is an application for an iPad used to supplement neuromuscular restoration techniques in patients with symptoms of facial weakness caused by Bell’s palsy, stroke and acoustic neuroma. The application mirrors the healthy side of the face over the damaged side to create the illusion of a “healthy” face for mirror biofeedback therapy. MedStar Inventor Services was able to take the Face2Face Rehabilitation App from concept to prototype and now the Apple Store.
Brain FORCE mTBI Screening Tool -- Alexander Dromerick, MD, Director of the Neuroscience Research Center at MedStar National Rehabilitation Network and colleagues have developed a portable test for mild cognitive impairment (concussion) and can be deployed on the battlefront, sidelines or in-theater situations. Dr. Dromerick disclosed this invention to Inventor Services who then applied for patent protection prior to making the work public. While the system was portable, it was not particularly mobile and with the help of Inventor Services, a new prototype and iOS app was developed. This prototype will be used to validate the research that Dr. Dromerick and his colleagues have previously completed. Once the proof of concept studies are complete, MedStar Inventor Services will begin securing a licensee for further commercialization.
Innovations in Healthcare Delivery
Medical House Call Program -- The award-winning Medical House Call Program is a population health model in 9 Washington, DC zip codes that delivers skilled, comprehensive, coordinated, long-term care for frail elders in their homes. A partnership of MedStar Washington Hospital Center’s Geriatrics program and MI2, the program follows elders across all settings including hospital care, and until the end of their lives. A team of 17 geriatricians, nurse practitioners, social workers and allied staff coordinate primary, speciality, urgent and acute medical care to an average of 600 people. The Medical House Call program promotes the health and dignity of frail elders so that they can continue to live in their own homes. The program has been very favorably received and has demonstrated a reduction of 17% in total Medicare costs. Check out this news article for more info.
Bridge Care -- The transition from hospital to home is often abrupt. Patients feel less safe and secure at home than they did in the hospital. The Bridge Care Program, sponsored by the MedStar Institute for Innovation and MedStar Washington Hospital Center Geriatrics, is a 30-day relationship-centered medical house call program that addresses the lack of post-discharge care that congestive heart failure (CHF) patients often experience when transitioning from hospital to home. The Bridge Care team, consisting of a geriatrician and a nurse practitioner, visits the patient in the hospital, sees the patient at home within 2 business days of discharge, and then visits or calls the patient at least weekly. After 30 days, the Bridge Care team transfers the patient back to the primary care providers, or, if the patient wishes, enrolls him or her long-term in the Medical House Call Program. During years of operation, Bridge Care significantly reduced the CHF readmission rate by 49%. The Bridge Care cohort showed high risk for readmission according to the Ottawa Hospital LACE Index Scoring Tool (94% of patients were classified as highest risk).
Rebel Treadmill Desk, Pebble and StepRx App -- MI2 wants all MedStar associates, patients and the community at large to become MedStar Healthy by harnessing the power of innovative workstations, wearable technology and mobile apps. The Rebel Treadmill Desk is a standing desk and slow-moving treadmill that was created by a 1776 startup company. The Pebble is a small wearable device that tracks daily activity including steps, calories, activity, and miles. MI2 developed an app called StepRx for displaying Pebble steps and for sharing their journey with peers.