As the medical emergency team worked on the patient recovering from back surgery, Dr. Susan Baxter sat down at a computer and tried to piece together what had led to his respiratory failure. Was this a case of opioid induced respiratory depression, pulmonary embolism, or perhaps a complication stemming from a preexisting cardiopulmonary problem? The patient’s oxygen saturations had been declining, and a review of the vital sign data showed that his respiratory rate had been slowing as well, suggesting he might indeed have been over-sedated. When was the patient last administered an opiate, what was the dose, and did the respiratory decline begin before or after being medicated?
Dr. Baxter’s challenge is emblematic of an all-too-common problem: a front-line clinician is thrown into a life-and-death situation with little or no personal knowledge of the patient’s history. How do we as clinicians approach a situation like this? How do we accumulate the contextual awareness required to accurately interpret a situation and make appropriate management decisions? In this situation, medications may or may not be contributing to a complication linked to underlying patient-specific risk factors. What if a physician like Dr. Baxter – or a nurse, for that matter – could have had patient context integrated from multiple systems in the palm of her hand, on her smartphone? What if the rapid response team notification had presented more information than just the patient’s room number?
The better we can tell the patient’s story, the more effective we can be at responding to and solving problems. Telling that story is how the Vocera Platform improves patient care and makes clinician workflow more efficient: we can present clinically relevant information, gathered from multiple independent systems, and integrate it with other data such as alarms or abnormal labs. Providing contextually important information jump-starts the medical decision-making process, enabling the physician to begin to formulate a plan of action.
At Vocera, this context is what we can deliver. We do it behind the scenes, using a unified, event-driven alarm and alert management solution that we call Engage (Figure 1).
A Solution, Not a Pass-through Conduit
When clinical systems are interoperable, it simply reflects that data is available for use by different systems. Aggregating data and making it available for presentation is nice (some data is better than no data), but the clinician has a difficult job: he or she must interpret the data, turning it into information, and then integrate that information with as much patient context as possible to formulate a plan of action.
The Vocera difference is in our platform’s ability to interface with various systems, aggregate the data from them, and then apply the advanced rules engine within Engage to begin to make sense of the situation. In this way we deliver exceptional and unique value, efficiently, at the point of decision making.
Meaningful Information You Can Trust
The Vocera Platform optimizes the meaningfulness of information. We make sure that if we send you information, it’s the information you want to have, it’s the information you need to have, it’s information that you feel is valuable.
We don’t want to waste your time, we don’t want to create interruption fatigue or anxiety; we want to shoulder that burden. Using our rules engine, our goal is to ensure that when you get information you trust it, and you know that it’s meaningful.
Provider Context, Patient Context
I’ve used the word ‘context’ a great deal in telling this story. In fact, there are two types of context that are important to the way Vocera delivers value.
The first is the context of the recipient: is the person we’re sending information to the most appropriate recipient at this time, or should we send the information to somebody else? To determine that, we need to know as much about the intended recipient as possible. Who are they? What’s their licensure? What’s their organizational role? To which patients are they assigned? Where is the recipient located? What tasks are they involved in? Are they available?
The more context we can access, the better chance we have of understanding whether that person is available for the message; and if they’re not available, determine whether this specific message is of sufficient importance that we should interrupt them, or perhaps bypass them and escalate it to somebody else. Because the Vocera Platform understands recipient context, we’re able to ensure that information we send you is appropriate for your role. We want you to practice at the top of your license, maximizing the use of your skills and experience.
The second is the context of the patient. If we’re sending an event driven communication, we’re delivering information that’s important for direct patient care; we need to present information within the context of the patient’s story. The Vocera Platform has the ability to say, “The patient has had an episode of atrial fibrillation. Here’s what’s happening with the potassium and magnesium levels, here’s the current medication list, and here’s a view of the current cardiac telemetry.”
By aggregating information from disparate sources and presenting it intelligently, Vocera brings interoperability to life.
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