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>View discussions about this entry Country: United States
Organization: STORC OB Safety Initiative
Focus of activity - Service/process
Year the initiative began (yyyy) - 2001
Positioning in the Mosaic of solutions
Define the innovation - What is the main focus (product, services, etc) of your innovation? Who are the primary beneficiaries? How does it make health and/or health care more affordable, accessible, and simpler to achieve/use? How does it differ from what currently exists in the market? Critical moments in care -
Labor, by nature, is a surprise. A pregnant woman never knows where she will be when her water breaks, labor begins, or something unexpected occurs. When she arrives at the hospital, obstetric providers need quick access to key medical information that is crucial for maternal and infant safety. It shouldn’t be the woman’s responsibility to remember important details, such as results from a certain lab that was done during her pregnancy. Discontinuities are costly - Access isn’t enough - Context for Disruption: - Describe how your innovation is transforming traditional health or related systems in the short and long term. My Obstetric Journal- The STORC OB Safety Initiative has assembled a multidisciplinary team of pregnant consumers, obstetricians, midwives, programmers, educators, informatics experts, and moms who believe that patient care and safety would be improved if the pregnant woman held her own medical record. Since medical terminologies and language are complex and out of reach for most patients, My Obstetric Journal will support medical records with educational tools providing the context for the patient to understand her medical information and empower her to improve her health.
Delivery Model - How does your innovation reach its target populations? What mechanism(s) (e.g., communications, distribution channels, etc.) do you have in place? What is your current market penetration? How do you measure this? We have successfully developed a comprehensive, electronic obstetric record that has been used by over 850 users and supported over 6000 deliveries. Additionally, we have been successful in developing customized patient decision aids to assist women in their pregnancy decision-making.
Building from our experience, we propose to develop My Obstetric Journal, a secure portable, electronic, obstetric journal that interweaves medical information with evidence-based, patient education. Medical information in the journal can be updated on the patient’s own portable device during any healthcare visit, regardless of location. My Obstetric Journal will empower women to better care for themselves while providing immediate access to key medical information for healthcare workers caring for the patient. Key Operational Partnerships - What key partnerships have you established to make your disruptive innovation model possible? Who are your partners (business, social, government, other) and what are their roles? How central are these partnerships for your initiative. Oregon Health & Science University (OHSU), OHSU’s Evidence-Based Practice Center, Consumers, Midwives, Obstetricians, Nurses, Programmers, Statisticians, Educators, Informatics Experts, and Moms.
Financial Model - Describe the financial model for your innovation. What percentage, if any, of the total operating costs does earned income (from products, services, or other fees) represent? STORC receives its funding entirely from grants.
Effectiveness - What has been the measurable impact of your project to date? How many people have benefited from your program in total? What policies, communities, or institutions have been influenced to make fundamental changes because of your work? The need for portable medical records-
A pregnant Russian-speaking woman was traveling to see her niece perform in a school play in Iowa. She was waiting for her plane connection in Chicago when she began to experience cramping and mild bleeding. She was rushed to the nearest hospital where they began asking her questions. Unfortunately, she was unable to understand and she didn’t have any records. The triage nurse checked her cervix, believing that she was in premature labor. Immediately, the patient began to hemorrhage and the baby’s heart rate plummeted. The patient was rushed to the operating room where she had an emergency cesarean and her baby was born 3 months prematurely. The patient had a condition called placenta previa, where the placenta that nourishes the baby covered her cervix. When the nurse checked her, she inadvertently made the placenta bleed, ultimately requiring that the baby be delivered emergently premature and without time for potentially life-saving medications. The patient wasn’t able to communicate, didn’t understand the condition that she had, and didn’t have her records. If the patient had My Obstetric Journal, the providers would have known immediately not to check her cervix digitally and would have had the information they needed to care for her during her emergency. This is one of many examples of how My Obstetric Journal can improve safety for mothers and babies by providing immediate access to key obstetric information. The need for evidence-based education-
Scaling up Strategy - What is your priority for the next 3 years and please describe why. We have an extensive infrastructure for the development and testing of My Obstetric Journal. After proof of concept we would search for a business partner for national expansion.
Origin of the Initiative - Tell the personal story that will help people connect to your work. How did the initiative start? Was there a particular individual or event driving the idea? Tell the reader the story behind the innovation. STORC has received national, state, and foundational grant funding (examples include: AHRQ, Oregon Opportunity, and Kuse Foundation). STORC is designated as one of three Centers of Excellence for Human Research.
Contact Information:
Jeanne-Marie Guise
Associate Professor, Director of STORC STORC OB Safety Initiative (Academic Program) guisej@ohsu.edu 3181 SW Sam Jackson Park Rd, L466, Portland, OR 97239 United States Tel: 503-494-1314 Fax: 503-418-5074 Website: www.storc.org Discussions about this entry
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Empowering Women to Have Healthy Pregnancies and Safe Deliveries
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Hello,
Thank you for your positive feedback and inquiries.
The OB Journal is intended as a powerful combination of medical information, customized education, and memories. The OB Journal would be initially released and tested in English. However, we believe the greatest potential benefit of the journal could be its ability to provide meaning and context for people whose primary language is not English. In AHRQ’s 2006 National Disparities Report, they state that “nearly half- 47%- of individuals with limited English proficiency reported that they do not have a usual source of care.” Discontinuities in care compounded by discontinuities in patient-provider language may lead to medical errors, increased costs, and diminish patient empowerment. Providing women with a copy of their medical information so it could be immediately available to care providers when needed may substantially reduce errors and costs. Similarly, providing the woman with information in her native language empowers her to improve her health and participate in decision-making. We have in-house the ability to translate the OB journal into several leading languages. We would be eager to expand to these important groups should funding and interest provide the opportunity.
We continue to examine the ideal storage/transport mechanism and strive to harness the power, security, and portability of a synthesis of media. At present, we envision an ideal blend of secure web-based applications and secure portable storage device (e.g. thumb drive, jump drive, etc.). We envision housing a secure central repository (with rigorous security similar to what we provide with our current secure OB record system) where a woman could update/upload her information on a regular basis ensuring that if her drive is ever lost, her information is not. Security measures such as password protection, data encryption, and robust firewalls will be used to provide the highest levels of security for her personal information. We continue to track developments regarding thumb drive security (for example U3 smart drive) and intend to release in the most secure, portable, and patient-centered format possible.
Please let us know if you have further questions. Again we appreciate your time reviewing our proposal.
The STORC OB Safety Initiative Team
This is an intriguing idea and has potential for great good. However, we need more information here about what the proposed OB journal would actually look like. Is it a jump drive? A portable disk? Web-based? Does it come in multiple languages? How would it address health and educational literacy barriers? Could you provide some answers to these questions and perhaps discuss more of the technical aspects? This could be a project with disruptive, empowering potential.
Thank you,
Changemakers Team