Norman Regional Health System

The challenge

As part of its overall focus on clinical excellence, Oklahoma's Norman Regional Health System (NRHS) is on a mission to increase the identification of pressure ulcers, more commonly known as bedsores, at the point of admission.

Its goal is to ensure proper patient care, to track each injury over the patient's length of stay and to control hospital costs by reducing the number of sores defined as hospital-acquired. This can provide huge value to a health system given that Medicare estimates that each pressure ulcer adds more than $43,000 in costs to a hospital stay.

Historically, NRHS nurses conducted a subjective assessment at the patient's bedside to identify the progression of pressure wounds. One nurse might observe the wound, consider it improved, but a second nurse might look at the same wound and decide there had been no change. NRHS had no objective way to compare pressure wound progression. To improve this situation, they needed a solution to better identify and track pressure injuries from the moment of admission.

The solution

Through their existing partnership, NRHS was introduced to Hyland's PACS Scan Mobile — a solution designed to encrypt and send images and videos to a picture archiving and communication system (PACS), vendor neutral archive (VNA) and/or electronic medical record (EMR) directly from a smartphone, tablet or other mobile device.

After evaluating PACS Scan Mobile, NRHS determined that it was an ideal solution to enhance its pressure ulcer tracking process. NRHS installed PACS Scan Mobile in March 2019 and was surprised that the implementation was completed in a single afternoon.

Now the NRHS team captures wounds on admission with a "four-eye" check:

1. Two care providers conduct a full skin check to look for wounds on the patient.
2. If a wound is found, a consult is placed and a Wound Care nurse visits the patient and captures a photo of the wound(s) using their iPad and the PACS Scan mobile application.
3. Using PACS Scan Mobile, NRHS routes this information from the iPads to their PACS.
4. The pressure wound photos are also linked to the patient's chart in NRHS’ EMR system, allowing clinicians to quickly access and view these images to determine if the pressure wounds are improving or worsening throughout the patient’s length of stay.

PACS Scan Mobile performs all of these steps securely because all photos are encrypted and no images are saved to the mobile device itself.

Simple to use, easy to train "Our inpatient team loves it, the nurses love it, the doctors love it," says Paul Jones, NRHS's clinical director. NRHS believes the implementation of PACS Scan Mobile has been crucial to improving early detection, tracking and care of the wounds. "If we can identify just two pressure ulcers at admission that would have been missed in the past, we will save the hospital more than enough to pay for the PACS Scan Mobile solution," says Jones. "Just two."

Today, NRHS is looking to expand use of PACS Scan Mobile throughout the enterprise. The initial implementation was limited to certain units but the results indicate that PACS Scan Mobile makes a difference for the health system.

The difference

• Pressure ulcer images captured on iPads at the point of admission provide a visual record of the injuries to aid with early detection, wound progression and care
• Photos are routed and stored in NRHS' PACS alongside other diagnostic medical images for consolidated management
• Pressure ulcer images are linked to NRHS' EMR for quick access and viewing by clinicians
• Images can be edited and annotated at the point of capture
• All information is encrypted and no images are stored on the mobile device, ensuring security and patient privacy
• An intuitive, web-based application allows for quick deployment and training