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Medical technology transforms emergency medicine

From barcodes to drones, the possibilities seem endless

By
Elise Oberliesen

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Barcodes tie patients to testing
Tech tools save life and limb

Rapidly emerging medical technology and new equipment keeps healthcare moving forward, and it doesn’t appear that medical technology advancements will slow down anytime soon.  The industry is expected to exceed a value of
$467 billion
by the year 2020.
 

EDITOR'S NOTE:
Elise Oberliesen is a freelance writer.
Another advance in technology include barcode scanning — a relatively new addition in the ED. A patient receives a wristband with a unique code and the scanner captures the code from the patient’s wristband and ties it to any test, lab result or procedure he or she receives during an ED visit, said Pamela Assid, DNP, RN, CNS, CEN, CPEN, NEA-BC, director of emergency services for Sky Ridge Medical Center, in Lone Tree, Colo. When hospitals integrate barcode technology into their facilities, it ends up changing many of their processes — which ultimately changes the way hospitals practice emergency medicine, Assid said. She is a member of the Emergency Nurses Association, headquartered in Des Plaines, Ill, and served as a chairperson on the emergency department operations committee.  A big draw to barcode technology is that hospitals have reported increased patient satisfaction and positive health outcomes, Assid said. And there is huge potential for expanded use of the technology. According to a study from the American Medical Informatics Association, it suggests that the technology can reduce the incidence of manual errors, a common problem that requires additional time to correct mistakes. And with fewer labeling errors,
it speeds up the delivery of results
. Quick turnaround time on test results translates into quicker treatment for patients, placement with the right specialist and increased patient satisfaction, she said. In a 2017 report published in the Journal of Patient Safety, researchers from Brigham and Women's Hospital and Harvard Medical School, suggest that barcode technology, referred to as RFID, allowed the surgical team to track surgical tools and sponges since the technology reads barcodes through the skin. Outcome —
reduction in RSI (retained surgical item)
errors with accuracy rates between 98% to 100%. “All the research tells us, the sooner we can get them in the ER and connected to the right specialist the better,” Assid said. “And the sooner we can get them discharged the more satisfying experience they have in the ER department.” Each time patients provide blood or urine samples, their specimen identification code is connected to the patient ID number, because a nurse scans his or her wristband and then scans the specimen, Assid said. Barcode technology creates a tracking process that helps decrease medical errors because each time a nurse scans a patient’s wrist band, it updates the patient’s electronic medical record — which increases efficiencies and decreases incidence of error.  Scanning technology also can prevent prescription mishaps, such as giving the wrong pill, she said. After scanning the patient and his or her medication, the computer system alerts the nurse if the wrong medication is being administered, or if it’s for the wrong patient, she added.
Although healthcare experts agree medical technology creates manufacturing jobs, improves patient health outcomes and boosts the economy, some are apprehensive because of the high price tag, according to a report published by
the Hastings Group
. Regardless of your take on rising healthcare costs, as new medical technology makes its way into emergency departments, it changes the way hospitals run their EDs. ED physicians, nurses and first responders must continually learn new skills to keep pace with all the high-tech changes.
As emerging medical technologies make their way into ambulances and EDs, some stand out more than others, said Dave Bressler, director, chief paramedic for Banner Health NCMC Paramedic Services, in Northern Colorado. High-tech products designed to accelerate blood clotting — like Stop the Bleed kits — save lives every day, Bessler said. Products with blood clotting technology slow blood loss after a person begins to hemorrhage. The kit comes with a tourniquet and gauze dressings layered with anti-coagulants that control blood loss when pressured is applied to the wound, Bressler said.  First responders commonly use the kits to treat a “traumatic penetrating trauma” from stabbings, gunshots or vehicular rollover accidents, Bressler said. Hospitals have used products like these for the last 5 to 10 years, said Bressler, who has a 40-year tenure working in emergency medicine. Blood loss technology started in the military and “is becoming much more refined,” he said. “It’s a military-style dressing with a coagulation agent packed into the dressing to stop bleeding and hemorrhaging and promote clotting,” said Bressler. “Then the tourniquet is applied and the two work in concert.” Prior to the technology, he said it was ill-advised to use tourniquets. Since the military has heavily studied anti-coagulate pressure dressings paired with tourniquets during wartime, Bressler said they trust the research because of proven lifesaving benefits that include preventing the loss of limb. “It buys us the time so we can get the patient to a surgical setting. And if its full trauma, the surgeon meets you at the door,” Bressler said. Each ambulance and helicopter at Banner is equipped with five kits, one for each extremity plus one extra, Bressler said.
Telemedicine increases healthcare access
Telemedicine continues to expand ED healthcare practices said Jeremy Tucker, D.O., national director for patient safety at U.S. Acute Care Solutions, a multi-specialty practice that provides statewide emergency department management to hospitals, located in Washington D.C. Using high-tech camera equipment and sophisticated software for telemedicine gives rural hospitals access to specialists from across the state, he said. Hospitals turn to telepsychiatry and teleneurology for “consults” when these high-demand specialists are not available on site, Tucker continued. Access to more specialists that were previously inaccessible to patients means the local ED can better evaluate a patient’s health conditions, make diagnoses and develop treatment plans with assistance from remote specialists, Tucker said. He also pointed out advances in telemedicine can help patients virtually check in with ER staff before arrival. This pre-check helps patients decide whether they can delay a trip to the ED. “It can help prevent people from running to the ER who don’t need to go,” Tucker said. This kind of triage option could save money in healthcare and for insurance companies, he added. “Algorithms and artificial intelligence will help with triaging patients so they get medical care at the right time and right location,” Tucker said.
Drones reach people in hard to reach places
Not long ago Amazon made headlines when the e-commerce giant promised drone-assisted package delivery. Admittedly, it seemed far-fetched — but now the healthcare industry is exploring ways to use drones in healthcare medical emergencies and healthcare supply deliveries. Whether a local first responder attends to 911 calls, or a disaster relief emergency responder is called to task, drones perform a plethora of medical tasks, Tucker said. When someone goes into sudden cardiac arrest, Tucker said first responders can deliver an AED to just about anywhere — like parks or golf courses. Drones can even parachute blood products to people in Rwanda, he added. “Package delivery [by drone] in healthcare will involve vaccines, blood products and prescriptions,” Tucker said. When a natural disaster strikes, drones can help with search and rescue operations and drop necessary medical supplies to those in need. “Plus disaster response is huge when an area is hit by an earthquake and you need to get aid to people,” Tucker said. And when road infrastructure is destroyed from hurricanes, earthquakes and rising flood waters, people become displaced from their homes and can end up in remote places, he said. Drones equipped with GPS and mapping technology allow healthcare workers to “map out where humans are congregating” after a natural disaster, Tucker said. “You can map how to get to these people by ground and by air, whether they need medications, water, or Mylar blankets,” Tucker said. As more innovative technology makes its way into emergency departments, it will continually change the way healthcare teams practice medicine. “Innovation and technology will allow us to provide better healthcare than is currently being delivered, at a lower cost,” Tucker said. “Telemedicine, APPs, drones, and AI will allow more points of access to the healthcare system than we currently have and that will benefit everyone.”