Palliative care is all about team, care-coordination and good communication.
I met Andrew Davies, founder of Signapps, through the ‘do-you-know-someone-that…’ grapevine while I was looking for a simple cloud based electronic medical record system (yeah right!) to use in my new venture of setting up a palliative care network in Stellenbosch.
Palliative care is all about team, care-coordination and good communication, which can be a tall ask in our siloed system. Reading about the headaches of complex EMR systems like Epic in the US, I was not sure that that was what I wished for either. Despite moaning daily about their tech habits with my children, I love a good tech solution. If it can be a local one, even better. So at our first meeting, when Andrew downloaded the app they had developed on my phone I was carefully optimistic. My enthusiasm has only grown since then. This would obviate the need for a shared medical record system, would be easy to get up and running and would not break the bank.
Quality care needs efficient means of communication between health care team members
Patients with complex care needs usually have multiple specialists involved in their care at any one time. GP’s are generally left out in the cold, not to mention the allied health professionals who play a critical role in a patient’s care. Care-coordination relies on, at best, a weekly multidisciplinary meeting, perhaps the chance meeting of a colleague in the hospital passage or receiving an email so many days or weeks later. Care-coordination is on the one hand imperative for quality care, but on the other hugely time-consuming, adding significantly to the number of non-billable hours spent on patient care.
From the patient perspective, they are having to deal with mixed messages from doctors, or being the messenger of their healthcare information from one practitioner to another. This does not necessarily harbour a feeling of safety or confidence in their medical team and often leads to frustration.
On Signapps, (‘cos Whatsapp is not legal, you know!) a virtual medical team is created around a patient case, allowing the team to communicate per text message as needed, when needed. No more hopeless phoning and returning of phone calls to colleagues. Radiology or laboratory results, images or photo’s, advance directives and all things relevant to the patient can also be pulled into the patient’s thread.
This relieves the anaesthetist from answering the surgeon’s mobile phone while he is operating and a new referral comes in. It allows the oncologist to give quick feedback about the patient’s third cycle of chemotherapy to the palliative care team assisting with symptom control. Or it allows the hospice sister to check in with the palliative care doctor, before suggesting opioid dose adjustments at the patient’s bedside. I shed a little tear of joy when all it takes is a text message to arrange home nursing for a patient in need. I simply add their care-coordinator to the group and ask. They have immediate access to the patient’s relevant information in the case file including phone numbers, medical aid details and ICD10 codes. Admin can really be the last straw in my day.
Referral forms and progress reports are easy to customize and complete in the patient thread.
One of the newer additions to Signapps is the ability to create forms on the desktop version, which can then be pushed or pulled into the patient’s thread. I use this to complete the IPOS form (the Integrated Palliative care Outcome Scale) on my mobile when I have seen the patient. It allows the team to know where the patient is at in terms of symptoms or other issues, while at the same time serving as a clinical follow up note. The forms are easy to create and customize, and could be used for follow up reporting, referrals or whatever is required.
It was fortuitous to meet the Signapps team, who also recently obtained a financial boost from Alan Gray for further developments. They are innovative and keen to create practical solutions for our local communication problems.
The app is intuitive to use (respectfully ask our 73 year old palliative care sister), and saves an enormous amount of time. Most importantly I believe this level of communication between practitioners must improve the quality of patient care, as well as the patient’s overall care experience.
For more info, visit their website https://www.getsignapps.com/
Dr Margie Venter, Palliative care clinician, Stellenbosch!