Ignite-Style Talks – Igniting Excellence, Efficiency & Ease of Use
Presentation by Bimal Desai, MD, MBI, FAAP, Assistant Vice President and Chief Health Informatics Officer at Children's Hospital of Philadelphia
May 20, 2020 American Medical Informatics Association (AMIA) 2020 Virtual Conference
AmbiFi®
S36: At the Tip of Your Tongue
Voice-Guided Procedural Checklists for Healthcare
Office of Entrepreneurship & Innovation
Children’s Hospital of Philadelphia
Bimal Desai, MD, MBI
Chief Health Informatics Officer
Children’s Hospital of Philadelphia
Natalie Rintoul, MD
Medical Director, Neonatal ECMO
Co-Director, Neonatal Surgical Team
Checklists Work in Ultra-Safe Industries
- Cognitive aid to reduce “slips” or lapses in attention
- Supports situational awareness
- Enhances team communication
- Reduces reliance on human memory
Total Lives Lost per Year
How Risky is Healthcare?
Encounters Per Fatality
Meet Jeff Bonasso
CEO, Founder of AmbiFi
AmbiFi®
Handsfree Support
HIPAA-compliant Reliability
? ?
Variety of Rich Devices Multimedia and Sizes
No-Code Authoring
Voice processing on-device
Does not require internet connection except to sync Navigate with touch or voice commands
Embed multi-media (video, images)
Sections & Branching Logic Toggle voice controls
Sterile Processing is an ECRI Institute Top Health Hazard for 2020
10 to 50 endoscopes processed per week Hundreds of steps per instructions for use (IFU)
8-12 observed variations from IFU per scope
Wish List: Less reliance on IFU memory • Visible Timer • Visual References
Surveys and direct observation by OEI/Project Vera team
Special Delivery Unit (SDU)
During Resuscitation: • Need shared mental model
- Establish goals of therapy • Keep track of time
- Know when to escalate
ECMO = Extra-Corporeal Membrane Oxygenation Aka “Heart / Lung Bypass Machine”
Everything Happens at Once
Initiate Blood Bank Workflow
Prepare ECMO Pack Patient and Meds
Prime Gather ECMO Equipment Cannulation Circuit
Patient Care! Pumps!
Procedures! Meds!
Devices! Bundles!
…and EHR documentation!
Challenges Faced by Nurses
Healthcare-Specific Learnings
Authoring
• Version control
• Cloud syncing
• User roles / permissions
• Metadata
• “WYSIWYG” editor – no HTML or Markdown
User Interface
• Theme and visual design
• Timers
• Parallel Workflows
• Support all modes of interaction: voice, touch, foot pedals, gestures?
Instructional Design
• Written procedures needed extensive redesign
• Takes time to design useful/usable checklists
• Takes time to create assets (images / videos) that make procedures more usable
Can Checklists Reduce Documentation Burden?
Spend Time With Patient Spend Time
With EHR
If you follow a procedure, but don’t document it, did it happen?
What if the app could write your EHR procedure note?
“[T]he volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably.
[U]nder conditions of complexity, not only are checklists a help, they are required for success.”
- Atul Gawande
Acknowledgements
• Digital Health
• Emerging Technology & Transformation
• Patrick Stewart
• Nadya Aboras
• Kanchana Hegde
• Dennis Driscoll
• Tracey Haines
• Vijay Verma
• ECMO Team
• Nursing Education
• Jacqueline Zedalis
• Michael Pizzi
• Susan Williams
• Melissa McLoone
• Elena Becker
• Sterile Processing
• Karen King
• Project Management
• Jill Manuola
• Pete Gambol
• Grayson Privette
• Entrepreneurship & Innovation
• Dean Karavite
• Tom Privette
• Harald Scheckenbacher
• AmbiFi - www.ambifi.com
• Jamie Dick