Inspired by a desire to make the lives of the nurses he works with easier while saving time on patient intake, physician David Soria, MD, hatched the idea of the ER Smart Card, a credit-card-like device that instantly unlocks a patient’s medical history with a simple swipe.
Implemented in January, and currently only in use in the Wellington (Fla.) Regional Medical Center’s ED, the card draws raves from the nurses who use it.
“What’s great about it is — and every triage nurse knows this situation — say three or four patients come in at the same time complaining of chest pains,” says ED nurse Debbie Perdomo, RN. “A patient swipes their card and at the desk we can immediately look at their medical history and medicines and see if they are on cardiac meds and see if the chest pain they are experiencing is because of a cold vs. cardiac chest pain. As a triage nurse,”
Julie Moews, RN, the charge nurse in the Wellington ED agrees. “We have certain patients with chronic medical conditions or multiple co-morbidities where we’re familiar with their names but we may not be familiar with all their medications, or they come in incapacitated. With the card they slide it through and it gives us all the information on them, even if their mental status is altered,” she says.
“It doesn’t really add any extra steps to what we do, and if anything it saves some really important minutes that we usually lose by trying to get all that medical history out of them,” she says. The card has already proved vital for Perdomo. In one recent case, a patient came in and was so focused on his arthritis pain that while Perdomo was getting his medical profile, he forgot to mention a heart stent, which prompted a crucial question about complaints of chest pains.
“It also saves manpower because we don’t have to call information management to get the old chart,” Moews says. And the card helps expedite med reconciliation on admission, which was much more labor-intensive before its implementation, she says.
Soria, who is director of the ED at Wellington, developed the card with six other physicians in his practice, Emergency Specialists of Wellington. By late March, several hundred Wellington patients were already using the cards.
Filling out the application for the free card requires a patient to go to the Wellington website and provide information, including advance directives in respect to organ donations and do-not-resuscitate orders.
The card identifiies patients by a 16-digit number on a magnetic strip that can only be read by the scanners in the Wellington ED. The information is not Web-based, so it cannot be accessed by hacking into the Wellington website, either.
The proprietary software, created by a West Palm Beach firm, runs on touch screens that have been strategically placed throughout the department, including one for patients to self-register. No in-service was needed to train the 30 RNs and 10 emergency physicians who are using it.
“If you’re talking about 10 minutes saved with each patient and we see, say, 50 patients a day, that’s 500 minutes of nursing time saved,” Soria says. “Anything we can do to get nurses away from doing redundant data entry or things that clearly take them away from patient care and skills they’re trained to do so well is significant.”
Gil Kaufman is a freelance writer.