“Stepping into a hospital is like stepping into a time machine – technology implementation in healthcare is that far behind.”

Dr Jeeshan Chowdhury, who has a background in health information systems from Oxford University, recently talked about the fact that healthcare  is so far behind in adopting and harnessing technology; and if applied it could make patient care more efficient. He used his new app, ListRunner, as an example of how such innovative technology can drastically improve handovers.

Paper-based patient records are still readily used in hospitals and are often a clinician’s preferred method of note taking. However, the information contained in paper is not easily transferable between departments and can lead to errors, resulting in inefficiency and increased risk in patient care.

Patient issues are also becoming more complex, such as the prevalence of HIV and TB in South Africa – meaning there’s more danger than ever in inadequate patient records and handovers. Dr Chowdhury said that up to 60% of errors are the result of poor communication, which is why he believes paper-based systems are faulty.

Dr Chowdhury’s presentation highlighted the importance of clinician-led innovation technology, or the ‘bottom up approach’. “It’s essential to include more people or potential users in the conversation in order to balance technology costs with consumer expectations.” Dr Chowdhury said he believes that South Africa is ripe for innovation and that a lot can be done, especially by ‘leapfrogging’ – where small groups can surpass the need for infrastructure and rapidly take up technology.

An example of which is a collaboration between Dr Chowdhury and the Head of the Department of Medicine at Victoria Hospital, Dr Clint Cupido, and Groote Schuur Hospital Practitioner, Dr Peter Raubenheimer, who presented their first-hand accounts of using ListRunner in a clinical setting.

Victoria Hospital has been piloting ListRunner for the past three months under Dr Cupido’s guidance.  Dr Cupido stated that “it’s evident how the app has been improving daily tasks; however the biggest challenge was getting the medical staff – who are primarily interns – to adopt this new way of working. After it was made compulsory, it was evident how powerful it is in improving communication and handovers.”

According to Dr Cupido the main benefit of ListRunner is that is enables better management by knowing how many patients each team has and the care they’ve delivered; “Interns on call previously had to go through patient notes, but now they send out red flags via the app identifying patients that need to be given special attention.” The app has also drastically improved efficiency in the department; “our handover meetings were previously an hour long but thanks to ListRunner they are now only 10 minutes.”

While feedback was mostly positive, a few issues were also brought up, such as the necessity to duplicate information both on paper and the app and the security of the data.

Dr Raubenheimer was also largely in support of ListRunner, although expressed reservations when it came to replacing paper; “the strong point of ListRunner is handover, however it hasn’t replaced paper just yet.” He explained how paper is still the first choice in Groote Schuur because although limited, “writing on paper is very quick and easy, and thus far no other system has been able to replicate the convenience of taking patient notes on paper.”

Dr Raubenheimer also discussed technical obstacles that were experienced using the app including a lack of Wi-Fi access across wards, and the popularity of Blackberry devices which don’t have a large enough screen to use the app adequately. He also pointed out that it’s important for eHealth app developers to look at the bigger picture in order to integrate their solution with government and provincial systems stating that they should work in unison and not in parallel. Dr Raubenheimer concluded by saying one of the aims for this kind of technology is to be so intuitive that users learn how to use it quickly, without any training, to be completely efficient.

The session was hosted at Groote Schuur Hospital on May 27th, and was the second seminar organised by Inclusive Healthcare Innovation Powered by Students (iHI), a community of social innovators who aim to promote healthcare innovation in South Africa. Attendees included healthcare professionals, medical students and those who had an interest in the role of technology in healthcare. This second speaker series originated from the success of a ‘Health Hackathon’ that took place in January, where participants attempted to deal with healthcare problems by combining clinical and developer innovation to develop low risk initiatives at a low cost.

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