Integrating patient headshots into the EHR decreased wrong-patient order entry by roughly 35 percent, increased patient identification, and boosted patient safety in the emergency department, according to a study published in JAMA Network Open.

On a yearly basis, clinicians at Brigham and Women’s Hospital in Boston, MA place over a million orders through the EHR system. While past studies have shown clinicians place the correct order 99.9 percent of the time, an error rate of less than one in 1,000 orders would result in roughly 600,000 wrong-patient orders.

Patient safety is an ongoing epidemic that healthcare organizations, stakeholders, and EHR vendors are trying to fix.

“There’s one specific solution to mitigating wrong-patient errors that turned out to be really effective: displaying patient’s photos in their electronic chart. As a provider, these are patients that you know personally—you’ve cared for them and you’re going to quickly recognize that face,” Hojjat Salmasian, MD, Department of Quality and Safety at the Brigham, said in a statement.

Prior to this study, Brigham and Women’s Hospital researchers integrated EHR alerts to decrease the number of wrong-patient errors. However, those alerts interrupted the user and resulted in burden, according to Salmasian. Additionally, EHR alerts still fail to detect up to 33 percent of medication errors.

In an effort to cut down on interrupted EHR navigation, Salmasian and his research team looked at past positive study results of integrating patient photos into the EHR. The research team also realized humans are good at recognizing facial features and familiar faces.

According to the study, wrong-patient order entry happens more often in the emergency department (ED), up to two per 1,000 orders, mostly due to the fast-paced ED environment and a need to multitask.

Over a two-year time period, researchers took headshots of nearly 72,000 participating patients, integrated the photo into the EHR, and analyzed over 2.5 million orders for errors.

There was a 35 percent decrease in errors. Salmasian said this significant error decrease shows the high volume of errors made per year at the Brigham and he agreed that two out of every 1,000 orders in the ED could be incorrect without a photo.

The research team noted decreased error risk in white patients. Salmasian said this could result from treatment inequities, implicit bias, and the mostly white patient population at the Brigham.

Researchers said these headshots will remain in the individual’s EHR moving forward but because of COVID-19, Brigham and other hospitals across the country may have to wait to take photos in the hospital until the current mask restrictions are lifted. However, one way around this is for individuals to take a headshot at home and upload it into their patient portal.

This study was relatively inexpensive compared to most other studies because researchers only had to train the staff on taking photographs and researchers bought six cameras totaling less than $2,000. The boost in patient safety will far exceed the minimal costs, said the research team.

“It’s important for all of us to realize that there are things that we can do as patients that directly impact the appropriateness and safety of care that we receive,” said Salmasian. “If more patients engage in the care they receive, our health care system improves in both safety and quality.”

It’s little exaggeration to say that the college experience of 2020 is unrecognizable from that of years past. With the COVID-19 pandemic refusing to dissipate, many students are earning their credits through their computers. Those who are attending classes on campus are navigating social distancing requirements and frequent testing protocols.

All of this comes with the normal stressors young adults may face during their college years: academic performance, financial strain, relationship navigation or the death of a loved one. Each of these individual issues is potentially amplified by the pandemic, leading to a greater need – and demand – for effective mental healthcare delivery within this population.

“There was a CDC report that came out that [said that more than] one out of four young adults contemplated suicide during the lockdown and the pandemic, which is astronomical,” Edouard Gaussen, cofounder and CEO of Mantra Health, a startup partnering with upper education institutions to deliver virtual mental health services, told MobiHealthNews.

“The necessity for virtual care on campus has become tremendous overnight, because the status quo of walking to the counseling center and seeing a provider on campus is unfortunately no longer the normal. They’ve had to adapt … and so as a result what we saw was a 360% increase in inbound leads from the spring semester to the fall semester implementation season.”

Mantra first launched in 2018, and last year raised an unannounced $3.2 million seed funding round led by Global Founders Capital, with support from Hof Capital, Western Technology Investment and a syndicate of angel investors.

Today, the startup went public with news of major client partnerships with Pennsylvania State University, St. John’s University and Moravian College. Each of these schools is bolstering its on-campus resources with the virtual care, patient referral and EHR offerings of Mantra’s newly unveiled Managed Care Program.

This new model is “not too dissimilar,” from the company’s initial offering, Gaussen said, but hones in on the startup’s pitch of a closed-loop telehealth platform. It consists of three major components: a telehealth app for students, a collaboration portal used by campus counselors to monitor patients and refer them to Mantra providers, and a proprietary EHR system that follows cases across the closed ecosystem.

This design allows schools to more promptly connect their students with outside mental healthcare services, explained cofounder and COO Matt Kennedy.

“Where we started out was stepping back and diagnosing all these problems that were going on with university mental health: Why is there a three-month wait-list to get into the counseling center? When you translate that to school years, that’s a semester,” he said. “That’s why you’re having folks drop out or have worse school outcomes as well as mental health outcomes.”

Once referred through the system, students can schedule live video calls with psychiatry or therapy providers that Mantra exclusively staffs through a “Friendly PC” model. These providers are able to provide care across state lines, which Kennedy noted as a major selling point for universities with students living at home through holidays or quarantines.

The app supports 24/7 asynchronous messaging, “reducing the need for these 30-minute, costly appointments” and “reducing drop off because a lot these questions don’t need to wait three weeks,” he said.

While these types of services are also available from competing virtual mental health vendors, Gaussen and Kennedy stressed the data flow and referral tools for campus care teams as the primary advantage of Mantra’s approach.

Many behavioral care providers don’t use any form of EHR in their practice, Kennedy said, so keeping the referrals and case records in network (so to speak) prevents schools from losing track of a student’s progress as soon as care moves off the campus.

“What really makes us different is … we are keeping the school in the loop, and the school is typically still seeing that patient when they’re working with us,” Kennedy said. “The school is collaborating and seeing the patient, and then you have a Mantra provider who’s also seeing the patient.”

The cofounders said that this design has so far been well received by their partners. In addition to the inbound lead increase, more than half of Mantra’s partner schools have already hit their case referral goals, and one university has been seeing “upwards of 20 messages between collaborating providers” within the first couple months of deployment, Kennedy said.

Meanwhile, Gaussen said that the startup is benefitting due to the current landscape of virtual and behavioral care. Along with a few more partner schools that Mantra isn’t yet able to disclose, he said that an upcoming funding round is picking up much more attention than it would have back in 2016 or 2017, when he was a VC seeking to invest in mental health startups.

“Telemedicine has really become the new buzzword in the wider tech world – not [just] digital health-focused investors,” he said. “We’ve really seen an increased level of interest from investors realizing we’re seeing a paradigm shift with COVID and the need for virtual care specifically. I think it’s also represented in some of the public stocks that are out there. Look at Teladoc, Livongo and some other digital health companies that have been trading at a real strong level of interest.

At the northwest corner of Jane Street and Major Mackenzie Drive in Vaughan is a mammoth medical facility years in the making, but the Cortellucci Vaughan Hospital is now just months away from opening.

At a time when hospitals across Canada are being overwhelmed by capacity issues brought on by the COVID-19 pandemic, the new hospital is expected to alleviate some of that pressure.

Altaf Stationwala, president and CEO of Mackenzie Health, told Global News they were approached by Ontario’s minister of health several months ago to assist with surgical backlogs.

Stationwala said they will not only be addressing Mackenzie Health’s own backlog, but will be providing assistance to William Osler Health System and Southlake Regional Health Centre.

“When we open, we will be providing them access to some additional ORs so they can actually deal with some of the patients that have been delayed in their care,” he explained. The project received government approval in July 2011 and the groundbreaking took place in October 2016.

At 1.2 million square feet, the new hospital sits on land formerly owned by Canada’s Wonderland. “I’ve been a resident of Vaughan for 16, 17 years and it is the largest city in the country without its own dedicated hospital,” said Stationwala.

“It’s not just growing in the traditional sense of a suburban community, but it’s actually an urban community. We see the Vaughan Metropolitan Centre, so we see a thriving growing city.” With a population of 335,000 people, Vaughan has been one of the fastest growing cities in Canada.

Cortellucci Vaughan Hospital is being billed as the first smart hospital in the country. “The technology is integrated and speaks to each other,” explained Mary-Agnes Wilson, chief operating officer and chief nurse executive.

For those contemplating the value of the technology to their quality of care, Wilson pointed to the type of access they will have to their medical information, which is updated in real time. MyCare bedside tablets will be available in all inpatient units. Whenever a care provider walks into the room, their photograph and name appear on the television screen as well as the tablet.

They can also access information about medications they have been prescribed, order meals, adjust the temperature in their rooms, and the beds automatically gauge a patient’s weight, which is updated in their electronic medical record.

“We’re not closing down a hospital and opening a new hospital. We’re actually opening a new hospital,” said Wilson. “The capacity we’re creating by doing that is certainly going to have an effect in western York Region and in York Region altogether, and for our partner hospitals who are feeling burdened with their capacity issues.”

The Ontario government invested $1.3 billion in the project, which represents the lion’s share of the funding. However, a considerable portion of construction costs and medical equipment was funded by donations.

The Ultimate Suits You campaign, chaired by Vaughan Mayor Maurizio Bevilacqua, has a goal of $250 million. To date, more than $178 million has been raised. Bevilacqua credited perseverance and tenacity with getting them to this point.

HonorHealth contracted with Twistle, an automated digital communication platform that supports patients undergoing surgical procedures, managing acute and chronic conditions, and navigating other healthcare journeys, to efficiently activate patients in their care and overcome patient adoption and engagement challenges with portal and app based tools.

HonorHealth initially deployed Twistle’s remote COVID-19 patient monitoring to support patients during this unprecedented time. Once enrolled in the COVID-19 monitoring pathway, patients received daily text messages that check-in on how they’re feeling, gather assessment data and provide access to educational materials. Care coordinators monitor progress digitally and follow-up with those exhibiting symptoms to discuss additional care measures. HonorHealth is expanding its engagement to deploy Twistle’s technology to engage patients for vaccination programs, surgical procedures and obstetrical deliveries.

“The safety of our patients remains our top priority,” said Craig Kartchner, AVP, marketing and customer experience at HonorHealth. “We were able to go live with Twistle’s technology within a week of project kick-off, and we have seen great engagement with our COVID-19 monitoring pathways.”

“Twistle’s patient engagement rates are consistently much higher than patient portals because we remove barriers and deliver meaningful support. We meet patients where they live their digital lives as opposed to forcing them into our digital world,” noted Kulmeet Singh, CEO of Twistle, “HonorHealth is leveraging our technology to keep patients on track with their care plan and ensure employee and patient safety during the pandemic. We’re proud to work with the team as they expand their digital patient engagement program using our rich library of clinical content to support procedures, surgeries, chronic conditions and population health.”

One of the most common respiratory conditions a person develops is bronchitis. This happens when the lining of the lungs’ bronchial tubes has become swollen or inflamed. There are two types of bronchitis: acute or chronic. In most cases acute bronchitis eventually clears up without requiring treatment. As for chronic bronchitis, this is more severe and harder to manage.

Some symptoms of bronchitis can be annoying during the day, such as coughing, wheezing, a sore throat, chest tenderness while coughing, and fatigue. These can also prevent you from getting a good night’s sleep.

If you’re suffering from bronchitis, let’s take a look at the ways you can get a good night’s sleep despite your condition:

Stick To A Nutritious Diet

One way to help you get enough sleep is by maintaining a nutritious diet. The ideal diet should include vegetables, fruits, whole grains, poultry, lean meats, beans, fish, nuts, and eggs. Don’t forget to include low-fat dairy and fat-free products while limiting food items that contain saturated and trans-fat, salt, cholesterol, and added sugars.

The role of a healthy diet is to boost your immune system, which can aid the body in having a better chance to overcome bronchitis in no time.

Elevate Your Head

The coughing caused by bronchitis can disrupt your sleep at night. Sleeping flat on your side or back causes mucus to build up in your throat, which triggers a cough. The ideal way to prevent this is to raise the level of your head by using more pillows. Another option is to utilize a wedge that will raise both your head and neck. Just remember to avoid elevating excessively since this could result in neck pains.

Use A BiPAP Machine

Similar to other lung diseases, bronchitis causes breathing difficulties, particularly wheezing. A device that can ease breathing issues is a bi-level positive airway pressure (BiPAP) machine. It helps a person with bronchitis breathe with the delivery of pressurized air via a face mask. This device works by supplying varying air pressure levels during inhalation and exhalation, helping soothe the lungs and muscles of the chest wall.

A BiPAP machine is typically recommended for nighttime use since breathing is significantly impaired during this time, and it will allow the person to sleep peacefully. You can use the machine at home or in a hospital setting.

When using a BiPAP machine, position the mask over your nose or mouth. Make sure that the edges of the mask fit your face securely. The machine will deliver one pressure level while you inhale, and a lower pressure as you exhale.

Use Steam

Before heading to bed, go for a warm shower or bath. You can even consider steaming your face over a bowl or basin that contains warm water for 10 to 15 minutes. The steam produced by the warm water can help loosen up the mucus in your sinuses and chest. This can help clear your airways, lessening the symptoms of bronchitis as you sleep. With the help of steam, you have a higher chance of experiencing a good night’s rest.

Increase Your Intake Of Fluids

Since bronchitis is a lower respiratory tract infection, a person with this condition must drink more fluids, as this can help with the following:

• Loosening up and reducing the thickness of mucus
• Moistening the throat
• Lowering the risk for dehydration

Aside from water, you should consume soup, juice, and herbal tea. A cup of hot tea will also work wonders, providing the same effect as steam. Go for an herbal tea blend without caffeine. Variants that contain eucalyptus, chamomile, and other soothing herbs that can often be found in sleep apnea supplements are good choices that can help you sleep well at night.

Use A Humidifier

A humidifier increases the level of moisture in a room by releasing steam or water vapor. When humidity is low, it’s likely to irritate the throat and nasal passages, thus aggravating the symptoms of bronchitis.

A humidifier releases heated and humidified air to loosen and promote better mucus drainage. When using a humidifier, make sure that it’s well-maintained. Moreover, always monitor the humidity levels. Once the device is not maintained or regularly cleaned, it becomes a breeding ground for bacteria or mold as the leftover water gets contaminated and solidifies over time.

Soothe Your Sore Throat

If you can’t sleep well due to a sore throat caused by bronchitis, there are various ways you can soothe this condition. Let’s take a look at ways to soothe a sore throat so you can get a good night’s rest:

• Gargle saltwater
• Drink warm or cool fluids
• Take an over-the-counter pain medication
• Use over-the-counter lozenges and sprays

Get Rid Of Irritants

If you want to lessen the symptoms of bronchitis during nighttime, it’s vital to eliminate all potential irritants in your bedroom. In case you have pets, don’t allow them inside your bedroom since animal dander can aggravate these symptoms as well.

It’s also vital to avoid exposure to other irritants that can trigger bronchitis symptoms, such as air pollution, dust, and chemicals in household products. Additionally, avoid using any scented candles, perfumes, cleaning agents, or products that can irritate the respiratory system. Also make sure to regularly change the filters in the heating and air conditioning systems at home.

Take Pain Medications

Before using any pain medication, it’s best to first consult your doctor about your symptoms, especially if they disrupt your sleep at night. Some over-the-counter pain medications that can lessen your discomfort include ibuprofen (Motrin, Advil), aspirin, or naproxen (Aleve). Talk to your doctor about which pain medication is suited to you and your condition.

Quit Smoking

Similar to chronic obstructive pulmonary disease or COPD, one of the main causes of chronic bronchitis is smoking. If you want to sleep peacefully at night, your best course of action would be to stop smoking and avoid exposure to secondhand smoke. This move can make a big difference in the overall quality of your life.

Smoking impairs the bronchial tubes and lowers the body’s defense system against potential infection. Exposure to smoke can stimulate coughing episodes if a person has bronchitis.

Quitting cold turkey or limiting the habit reduces potential damage to the bronchial tubes and promotes faster healing. A person who quits smoking early is less likely to end up with acute bronchitis in the future.

sleep pictures by Depositphotos

Final Thoughts

If you’ve been diagnosed with bronchitis, getting enough sleep at night is vital to promote your recovery. Since the symptoms can be quite troublesome, especially if they disrupt your sleep, you can try out the tips above to reduce the symptoms so you can get have a restful night.