Providing a way to engage patients in their medical care

MyChart Bedside is a tablet-based application developed by Epic and designed for patients that Ohio State Wexner Medical Center first introduced to patients in 2013. When admitted to Ohio State Wexner Medical Center, patients can opt in to accessing certain elements of their electronic medical records through this application, which is available on medical center-owned tablets or on a patient's own tablet. Patients can access schedules and test results, send messages to members of their care teams, order meals, as well as access the internet and other application-based games to utilize during their stays.

Since its introduction at Ohio State Wexner Medical Center, MyChart Bedside has supported the medical center's Strategic Plan and ongoing goals to advance innovation in healthcare delivery. In 2013, MyChart Bedside first went live in pilot units and later became available hospital-wide. In early 2015, MyChart Bedside went live throughout Ohio State's Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute. Then in 2016, the organization expanded the availability of MyChart Bedside across University Hospital, University Hospital East and the Ross Heart Hospital; Ohio State Harding Hospital went live in late 2017.

First in the field to leverage new technology


Ohio State Wexner Medical Center was the first academic medical center to implement MyChart Bedside and the second organization overall by only about four months. And in 2016, a "light" version was launched with limited functionality to test which features had the most impact on patient satisfaction.

"In 2015, we secured a four-year program project grant worth $4 million from the Agency of Healthcare Research and Quality to establish the Institute for the Design of Environments Aligned for Patient Safety (IDEA4PS)," says Susan Moffatt-Bruce MD, PhD, MBA, executive director, University Hospital; professor, Surgery; and professor, Biomedical Informatics. "This funding and the support of a brilliant research team led by Dr. McAlearney helped to study the roll-out and use of MyChart Bedside to multiple locations throughout 2016. It helped us to determine which features and functionality were most important to patients, thereby leveraging the learning laboratory."

"MyChart Bedside allows patients and families to be as engaged as they desire with the patient care team and with the activities that occur around their hospitalization," says Milisa Rizer, MD, MPH, chief clinical information officer; professor, Family Medicine; professor, Nursing; and professor of Biomedical Informatics. "It allows messaging to their providers as well as patient education activities, where they can learn at their own pace. Our partnership with Epic has allowed us to be leaders in the field of patient engagement, which we see as being critical to our patients' health."

Increasing usage at the unit level


Blaze Hirsch, BSN, CMSRN, nurse manager on the eighth floor of the Ohio State Brain and Spine Hospital's Neurotrauma/Epilepsy Monitoring Unit, and Jill List, BSN, RN, nurse manager, 9 East Doan, volunteered early on to be part of the stakeholder group for MyChart Bedside. Within the stakeholder group, leadership and front-line staff collaborate in identifying opportunities and best practices and encourage staff to adopt valuable technology at the bedside. While there are still barriers to overcome, the health system activation rate has grown from 34.7 percent in April 2017 to 43.26 percent by February 2018.

"When MyChart Bedside first came out, I remember thinking how cool it was," says Blaze Hirsch. "I made it my mission to make sure my patients had access to this tablet-based tool, and I began actively promoting it."

MyChart Bedside provides a way to engage patients in their medical care. Nursing and patient care staff can show patients trends in lab results and point out specific indicators. Patients appreciate that they can continue to access this information from home after they leave the hospital through MyChart App. It is comforting for them to know that their ongoing care is participatory and accessible through this tool. Patients also express relief when they realize they can use the tablet to update family and friends about their condition through social media or challenge themselves to a couple of levels while playing Candy Crush.

"I encourage all nurses and patient care staff to just pick up a tablet and begin using it," says Jill List, who provides care for a wide variety of patients, both in terms of age and medical conditions. "Patients use all of the features — they love to see their lab results come in, order meals for themselves, and it's a good tool for relaxation and for patients to pass the time."

For staff members who haven't learned how to use MyChart Bedside, Jill and Blaze report that it only takes about 10 minutes to learn a majority of the features that will benefit patients most. Because most patients tend to already be fairly tech-savvy, they learn to navigate MyChart Bedside quickly. And if patients are not tech-savvy, they typically decline the tablets. While it does take a few minutes to demonstrate MyChart to patients upfront, it does result in significant time savings for nursing and patient care staff over the course of a patient's hospital stay. There is also a video available for patients to watch on the tablets that will teach them about the available features.

"MyChart Bedside truly impacts patients today," says Blaze. "It gives them insight into all the care that is being provided to them, much of which they might not otherwise realize or see firsthand — from medicine, vital signs and access to patient education to ordering meals and the ability to either chat with their providers or learn a little bit about their care team. All of these benefits are combined into a single tool to enhance their overall experience with the medical center."

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