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When a three-month-old girl was about to undergo open-heart surgery, her mother was understandably worried. The woman asked her daughter's pediatric cardiac anesthesiologist at the time, Hamish Munro, if he could please send her updates during the procedure.
Munro, director of pediatric cardiac anesthesiology at The Heart Center at Arnold Palmer Hospital for Children in Orlando, Fla., said, "'Well, you know, we're not really allowed to do that.' [But] I just saw the anguish on her face as her [daughter] was about to undergo open-heart surgery. So I said, 'You know what, I'll send you a few texts from my phone.' Which I did during the procedure."
Munro said that the mother of this three-month-old girl appreciated this, and that getting updates from the operating room really improved her experience in the waiting room.
"That just sort of got me thinking," Munro said. "This is probably something we should do."
EASE applications: A secure texting app
Munro, co-founder and chief innovation officer of EASE Applications LLC in Orlando, created and founded the company, along with several other partners, which created a secure texting app to improve communications between patient families and physicians.
After Munro's experience with the three-month-old girl's mother, "over the next four or five months, myself and a partner used our own funds to send texts and pictures from the operating room directly to parents in the waiting room while their kids had open-heart surgery," Munro said. "We saw that the response to that was something we thought we should take further."
The Heart Center at Arnold Palmer Hospital for Children gave Munro permission to develop an application that would ultimately be called EASE. Now, Orlando Health has been using EASE for three to four years as well, Munro said.
Patrick de la Roza, co-founder and CEO at EASE Applications, pointed out that, "as advanced as hospitals are for technology inside of an operating room or inside of a facility, they are, in many ways, years behind when it comes to how they communicate with families."
Kara Dobson, a circulating nurse at Arnold Palmer Hospital for Children, explained that, before EASE, families would either get a phone call from one of the nurses in the operating room or a nurse practitioner would stop by the OR, get an update from the staff tending to the patient and then go find the family and update them.
However, Dobson explained that if someone from the OR tried to call the family, and for some reason the family did not pick up, there was usually no time to keep trying to call them because of the importance of the OR focusing on the task at hand. She added that, in order for a nurse practitioner to update the family in person, that meant the family had to stay in the waiting room so that the nurse could find them.
"It was more difficult, for sure," Dobson said.
De la Roza added that the traditional way of communicating with the family from the OR wasn't conducive to physicians' and nurses' workflows either. He explained that nurses would call families from a phone in the OR, and then families would call that number back or text questions.
"During a surgery, you don't have time to have full-on conversations via text or by phone with a family," he said.
How the EASE secure texting app works
With the help of Amazon Web Services and Kony, a mobile application development company, Munro and De la Roza along with Dr. William DeCampli and Kevin de la Roza, M.D., have created an app that is free for patient families and that charges healthcare organizations on a subscription basis.
Doctors and nurses simply scan a QR code that is generated once the patient is registered at the hospital, and then they also scan the barcode on the patient's wristband, Dobson explained. "And everything gets tied together."
De La Roza explained that this also helps ensure that only the appropriate people are viewing that patient's protected health information (PHI) because once a patient's bracelet is scanned, the patient's care team is looped in.
"With traditional text messaging … you could accidentally text the wrong person [PHI]," De la Roza said. "With EASE, because we've created this process where you have to scan the patient's medical bracelet, it forces certain processes to really minimize the chance of that happening."
Once this process is complete, doctors and nurses can send not only messages with updates on the patient, but also pictures and videos. Furthermore, messages disappear after 60 seconds for added security.
Benefits of using a secure texting app
Dobson explained that EASE has not only "changed my nursing career" by enhancing and improving her relationship with her patients' families, but she has also found that patients have specifically asked whether the hospital uses EASE or not.
"They come asking for it. Even patients from other hospitals," she said. "They found patients telling us, 'I was at a different hospital, they didn't have [EASE] and we're never going back there."
De la Roza explained that they surveyed patient users through the EASE app and found that 99% said that EASE updates reduced their anxiety, 99% said they would use it again and 81% said that it would influence their choice of hospital.
Munro added that EASE has helped some hospitals improve their Press Ganey patient satisfaction scores.
"In the adult hospital, I believe the Press Ganey scores increased by 6%, and then the pediatric hospital [by] about 4%," he said. "We were able to basically show that use of the app increased these Press Ganey scores quite significantly."
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