For patients on a busy hospital ward - and which hospital wards aren’t busy? - the call button next to their beds is a vital piece of kit, enabling them to alert nursing staff to their immediate needs: a glass of water, a bedpan, an extra pillow, a more urgent medical issue. For others, that call button may be totally out of reach, particularly if they have mobility issues
DeloitteAssist is the management consultancy firm’s answer to reimagining the bedside call button for the digital age, as Nick White, its co-creator and a principal at Deloitte in Sydney, Australia explained to diginomica at the ServiceNow event this week in Las Vegas.
The idea came to White when he heard how a colleague’s father had passed away unexpectedly in hospital following routine surgery. Needing to go to the bathroom, the patient had rung the call bell and, when none of the team had been able to get to him immediately, he had got out of bed, taken a fall and broken his hip, leading to an ultimately fatal decline in his condition. Says White:
It struck me that care teams in hospitals work incredibly hard to deliver care to patients, but the systems around them are often very antiquated. With nurse call, in particular, we’ve seen systems that are 30 to 50 years old. So that got us thinking: was there something we could do in this space that would support care teams in their work?
Nick and his colleague began talking to nurses about the challenges they face. First, they said, they don’t typically get any context about what the patient is asking for when they ring that bell. Second, they have no way to let the patient know that they are on their way. Third, there was no way to route calls to the right person to provide the care they needed. Fourth, there was no way to prioritize calls. Fifth, there was no way to escalate call requests when required. Finally, they had no data regarding calls - the numbers of calls, the nature of requests, the time taken to respond, for example - even though that information could help to better staff and manage hospital units.
Speak your request
DeloitteAssist is developed on a smart speaker based on Amazon Alexa, allowing a patient to speak their request, rather than physically press a button. That vocal request is then passed through ServiceNow and presented to nurses on an iPad sitting on the nurses’ station, an iPhone in their pocket, or in some cases, an Apple Watch.
So far, it has been deployed on the spinal ward at the Prince of Wales Hospital in Sydney in April 2018, and more recently, at the Canterbury District Health Board in New Zealand and at an elderly care facility, also in Sydney.
In terms of how it was built, work started with the creation of an Alexa ‘skill’ - a chunk of function written by a developer to allow Amazon’s Alexa-powered speakers to support specific use cases. That uses Alexa’s AI capabilities to translate and understand what the patient has requested, and then an ‘intent’ is passed into ServiceNow.
Once it’s in ServiceNow, this intent triggers a catalogue item to which business rules are applied. These rules can be configured by the individual hospital to determine how a request is routed and prioritized. A simple request for a blanket, for example, might be most easily and quickly fulfilled by a nursing assistant. A request for a glass of water, however, might need to be assessed by a nurse, who knows whether or not that patient is on the ‘nil by mouth’ list.
DeloitteAssist also has a role to play in combating patient isolation, said White, since the Alexa speaker also gives them access to Internet-based consumer experiences: playing music, information on the weather and so on.
Patients are really using these features of the solution a lot. They get the balance of peace of mind when it comes to access to care, but also some control over their environment, some semblance of normality and the opportunity to reconnect with their world.”
We had one patient with a spinal injury who - and it gives me shivers when I tell the story - was able to listen to his first football game in three months and text with his mates during the match. And he said to us that it totally changed his world.
At The Prince of Wales Hospital in Sydney, meanwhile, four out of five nurses said that DeloitteAssist had helped them to improve their patient care. The team behind DeloitteAssist is now starting to think about the offering’s use in home-based care and is in discussions about deployments in the US and Europe.