Television: The New Nurses Little Helper

More hospitals are turning to televisions as a way to improve a patient's stay, and some are finding that premium television services do much more than show movies.

When patients can make requests for room servicing and health education through their televisions, they report greater satisfaction, and nurses say they have more time to devote to clinical work. Thats according hospital surveys provided by Skylight Healthcare Systems, a company offering such services.

A growing number of hospitals are expanding their television offerings. In October, Health First in Florida, will begin offering such Skylights ACCESS service for 700 beds, including just over 100 in a dedicated heart hospital.

The non-profit health system has been named one of the nations "100 Most Wired" hospitals for the last two years. Health First currently runs three hospitals, plus outpatient clinics. The new heart hospital opens later in 2006.

Health First CIO Rich Rogers said that he began looking for television services similar to those offered by the hotel industry. He and his team researched vendors at the annual meeting of Healthcare Information and Management Systems Society, a large trade group, and eventually requested proposals from seven vendors.

During the approximately six-month process, representatives from nursing, patient relations, facilities, clinical engineering and marketing evaluated the systems, assigning points according to desired attributes.

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According to Rogers, the vendors fell into two main camps: TV rental companies with many entertainment offerings, but little health care experience and health IT companies that offered to install additional monitors that patients would use for entertainment and nurses would use to access clinical information.

Rogers said the first options were too narrow and that the latter were both too expensive and likely to interrupt workflow.

Skylight was a happy medium, he said. It specialized in health care, but its system could be implemented without new and potentially disruptive equipment.

Particularly valuable is a health education module that allows patients to order educational video, said Rogers.

Previously, nurses or other hospital personnel would assign patients a time to watch necessary video, wheeling the necessary equipment on a cart. Now, patients will be able to watch the videos whenever they want, and can easily view or review materials with family members.

The system also administers a test to make sure patients understand the video and allows them to submit requests for additional information. It also keeps a record of which videos have been watched and understood. Such documentation is required for hospitals to maintain their accreditation.

Rogers decided to have the system go one step further, feeding information about what video a patient had watched straight into patients EMR (electronic medical records).

He said that getting Skylights ACCESS system to interface with the hospitals Eclipsys EMR system took about 40 hours and that neither Skylight nor Eclipsys engineers charged for this work because they felt it would allow them to offer enhanced service to other clients.

The results, said Rogers, is that patients will have better access to information and nurses will have less of a record-keeping burden.

"Its all automatic, and the nurses dont have to do that manually like they did before."

Getting the system set up did require that the hospital throw out some dusty VHS tapes and purchase digitized videos that could be sent across the system, but Rogers said it was a good opportunity for the hospital to revise and expand its offerings.

Patients will also use their televisions to request room service, like cleaning spills in the bathroom or new sheets. Otherwise, said Rogers, patients might wait unhappily for a nurse to come by before requesting service. Now, patients should be served faster and nurses wont be interrupted, he said.

Patients will also make meal choices through their television screens. Though SkyLight offers a non-personalized module for this service, Rogers is working with the dietary departments computer system so that patients can only see the food choices appropriate for them.

Rogers and his team are still working on creating that interface, which is trickier. He estimates it will take between 120 and 160 hours, but that once in place a whole suite of manual tasks will be automated. Plus, patients wont be disappointed by listings of tasty foods that turn out to be off limits.

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Finally, says Rogers, the hospital will use televisions for "non-traditional revenue generation." Patients can shop at the hospitals gift shops from their beds, as well as purchase medical equipment and services. In addition, patients can purchase premium movie content and high speed Internet access for $8 a day.

Asked whether patients will resent such revenue-generating attempts, Rogers admits that hes not sure, but he suspects that patients are so accustomed to this business model in hotels that they wont think twice about it.

As for staff training when the televisions go online, Rogers doubts anyone will need more than ten minutes. He plans to combine television training into the same session that covers use of the hospitals new VOIP (voice over IP) phone system.

And that underscores his advice for how other hospitals can get the most from their TVs. "View it more as a communication system than an entertainment system."

Readers: If you have had a good or bad experience installing interactive TV in your hospital and want to offer advice, please let me know. I plan to feature another type of technology next month.

M.L. Baker is health IT and biotechnology editor for Ziff Davis Internets Enterprise Edit group. She can be reached at

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