By Jon Wells / Special to Healthcare Facilities Today

Traditionally, caregivers have viewed a patient visit as everything that happened during the direct patient-caregiver interaction. And while the interaction in the exam room is a focal point, the point of care ecosystem actually encompasses everything that happens within the practice or clinic, as well as experiences that occur outside of this environment. 

As engaged healthcare organizations work to better understand the point of care ecosystem through the lens of a complex integrated system, they quickly realize just how disconnected some of these processes and components truly are. 

These disconnected processes are barriers that prevent a well-coordinated patient experience and lead to inefficiencies, breakdowns and human error. This can have a significant impact on the diagnosis and treatment of a patient. 

A fully connected point of care ecosystem is becoming more of a reality as new technologies with greater connectivity are introduced to the industry. This connected ecosystem integrates processes, equipment and caregivers at the point of care to significantly enhance the patient and caregiver experience and improve the quality of ambulatory care. It also ensures a more satisfying and seamless patient experience by providing a platform where organizations can leverage new technologies, incorporate best practices and employ greater standardization to improve care and outcomes.

While there are a number of benefits that could result from a fully connected ecosystem, one of the most promising and most immediate is better blood pressure (BP) measurement.

Current issues with BP measurement

BP measurement continues to be one of the most inconsistently performed tests in a clinical environment. Of all the vital signs, BP measurement has perhaps the strongest connection to point of care diagnosis, patient risk stratification and medication dosing. These three critical factors of care management are essential to precise decision-making. Because of its centrality in care, it is essential that the BP assessment is accurate.

In order to properly diagnosis and treat hypertension – a major risk factor for coronary heart disease, stroke and renal failure – caregivers need accurate BP measurements, both current and trending. It is also becoming increasingly important to detect small differences in BP readings in the treatment of patients with diabetes and renal diseases, making accurate trending data and standardized protocols critical. 

Unfortunately, BP measurement continues to be one of the most inconsistently performed tests in a clinical environment. According to the American Heart Association (AHA), numerous surveys have shown that physicians and other healthcare providers rarely follow established AHA guidelines for BP measurement; however, when they do, the readings correlate more closely with objective measures of blood pressure than those readings taken not following the guidelines. 

Research has shown that BP readings are often quite different among various members of a care team. Two different caregivers independently acquiring BP measurements using manual methods on the same patient can often get two different readings.

A more accurate BP measurement

A fully connected ecosystem helps eliminate human variables that increase the likelihood of errors that can contribute to inaccurate diagnoses by normalizing and automating the BP measurement process.  

One way it does this is by introducing automation that facilitates the repeatable adherence to a health system’s clinical guidelines for proper BP measurement techniques to achieve more accurate, consistent and reliable BP measurement for all patients. 

This is especially evident when a connected diagnostic device is used in conjunction with a connected exam table that automatically positions the patient in accordance with AHA and American Medical Association (AMA) guidelines for proper BP measurement. Caregivers are set-up to easily achieve a more accurate, consistent and comparable BP measurement. 

It has also been proven that manual BP readings can have inconsistent results. One research study found that automated capture tends to produce numbers significantly lower than manually taken readings by as much as 10.8/-3.1 mmHg (systolic/diastolic error). When the data collection process is automated and standardized, consistency and precision is achieved between care sites, equipment and providers. This means increased confidence in the data collected, which ultimately leads to better clinical decisions and patient care. 

A connected point of care ecosystem also protects the quality of the BP measurement data by virtually eliminating the risk of human errors occurring at the keyboard. A connected diagnostic device directly sends patient data into the EMR, eliminating transcription errors and providing greater confidence in data accuracy. Studies have shown that manual transcription of data produces a 6.5 percent rate of error on average. Assuming a practice sees 20 patients a day, that can equate to approximately eight avoidable errors each day.

The patient-caregiver interaction at the point of care is a foundational element of effective healthcare. As new technologies continue to bring us closer to a fully connected point of care ecosystem in outpatient facilities, the industry will continue to see benefits around clinical workflow and patient care. BP measurement is just the first of those benefits that promise to enhance interaction between patient and caregiver and drive better clinical outcomes. 

Jon Wells is vice president of medical marketing for Midmark.