In an interesting article printed this week in The Denver Post, obstetricians are touted as using an application for smartphones to monitor patients during labor. Physicians who deliver babies at Rose Medical Hospital now receive the monitor readings by BlackBerrys or iPhones . By logging on to an application called AirStrip OB, the doctor can view the readings showing fluctuations in fetal heartbeat, contractions, oxygen levels in the mother’s blood and nurses’ notes recording cervical dilation.
Doctors have called for emergency cesarean sections after looking at the graphs on their smartphones, asking the hospital to prepare for surgery as they drive over. Before Rose purchased the application about nine months ago, patients needing a C-section typically had to wait for their doctor to arrive to evaluate them.
Rose personnel note that in the past, nurses sometimes had to fax strips to a doctor, wasting critical minutes. But a spokesperson also points out, that the smartphone application is a tool to improve verbal communication between nurses and doctors — not replace it.
The typical scenario is that a woman arrives in labor, and nurses immediately hook up a monitor to record fetal heart rate and contractions. Data from the monitor is transmitted to the maternity ward’s electronic medical-records system.
An obstetrician who has the AirStrip OB application can log on to the server and see a list of all the patients in the maternity ward. And by clicking on a specific patient, a doctor can see that patient’s data in real time. Reportedly, about half of the obstetricians who deliver at Rose have the application on their smartphones.
The HealthOne system, which includes Rose, is expanding the program this month to its other hospitals, which include Sky Ridge Medical Center, Swedish, Presbyterian/St. Luke’s and the Medical Center of Aurora. AirStrip Technologies, which sells the application, also has apps for cardiology, critical care and lab results.
But the most interesting element of the story is the emphasis on the application as a means to improve the quality of the physician’s personal life, to give the doctor "a lot more freedom to have a life." There is no indication that the care provided to the mother or baby is improved – only that the doctors are released from time on the maternity ward. The more compelling question is how this new technology impacts the actual quality of care – will nurses be less vigilant because they assume a doctor is monitoring from afar? And the standard of care issues which will inevitably arise- will a doctor be liable if he forgets to maintain a charged phone?
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