Not long ago, Abbott Northwestern Hospital in Minneapolis was training interns on bedside portable ultrasound machine usage with a tracking system that consisted of index cards and an Excel spreadsheet. They moved to an iPhone app last year and the change has been dramatic.
Dr. David Tierney, director of the Internal Medicine Bedside Ultrasound Program at the hospital, says the importance of these bedside ultrasound machines is enormous and proper training is absolutely essential.
"It is more specific and sensitive than our hands and ears can ever be. As a result, patient care improves because we make the correct diagnosis faster and with less cost and radiation than we can without portable ultrasound. It allows us to make real-time decisions at the bedside rather than reacting to data that isn’t available for hours to days," he said.
That's why it was so essential for the hospital to find a more efficient way to track intern training than the previous system.
"Previously, each physician carried a collection of 5x7 cards in their pocket with a grid including all of the exam areas they needed to learn. When they performed an exam, they would write the date/time/exam info on the card. These were then manually entered into an Excel spreadsheet and tracked."
They knew there had to be a better way to do this, so they explored a number of options including a web-based entry tool, an Access solution, and FileMaker.
The solution Abbott Northwestern chose consisted of FileMaker Pro, FileMaker Server, and FileMaker Go (for iOS).
With the the old system, Tierney said there were delays of up to 10 hours between the time the physician saw the patient and entered the information into Excel, and it was a system that was ripe for errors and mistaken recollections of what happened. Today, it's done in real time as soon as the physician leaves the room.
It also simplifies training tracking for the physicians, who can now see how many instances of a certain type of test they need to complete to reach the certification requirements. Another bonus is the phones themselves can be loaded images and video clips of normal and abnormal findings as well as the program's digital textbook.
The hospital has a BYOD policy, so an iPhone isn't explicitly required, but more than 95 percent of physicians are using them. (The others are using a bedside iPad or entering the information on Macs located throughout the ward.)
"When new physicians come, they get a stipend for a phone of their choice and then get reimbursed for their monthly cellular bill. This allows our physicians to stay on family plans, [use] specific carriers that get better reception at their cabin, or just allow them to keep the phone and carrier that many people see as religion these days," he explained.
Tierney said the transition to the new system has gone remarkably well -- with one exception.
"The one "gotcha" was that the port needed to connect to the FileMaker server hosted on an external web host was not open, due to security reasons, from the hospital-wide wireless network that all of our physician phones are connected to. Therefore, unless the physicians changed from WiFi network to their 3G data connection, they were unable to connect to it."
Abbott found a work-around by moving the FileMaker server to a MacPro in his office so it was on the in-house network. The downside to this approach was that physicians couldn't access the server off-campus, but that didn't prove to be a problem since they only use it while at work.
Tierney says the physicians love the new system and the convenience of having they system on their phones, which they carry all the time anyway -- it certainly beats carrying around note cards.