The Nursing Informatics team (first from left) SSN Mary Jane Seville Poticar, (third from left) NC Zubaidah Binte Hassan and (second from right) ADN Jonathan Sim, together with (second from left) ADN Teo Lee Wah, Nursing Specialty Care Unit, and (extreme right) Senior Nurse Manager Foong Jia Yi from Ward 56 where the MyCare app is currently piloting.

“Partnering patients in their care” – with that in mind, NHCS Ward 56 piloted the MyCare application (app) since 14 October 2019. NHCS is the first specialty centre to pilot the application after SGH. 

MyCare app installed in iPads, allows patients to be actively involved in their care journey, during and beyond their hospital stay, with display of their own medical information such as test results, medications and care schedule.

Taking into consideration our patients’ needs, NHCS’ MyCare app expanded its patient’s requests module to include more options.
 
We are proud to share that our Nursing Informatics (NI) colleagues who are part of the SingHealth Nursing-OST Taskforce behind MyCare, received the You Shine Award by SingHealth.

Now with the app up and running at the ward, the work all seems a breeze – or is it not? Our NI team, Assistant Director of Nursing (ADN), Jonathan Sim, Nurse Clinician (NC) Zubaidah Binte Hassan, and Senior Staff Nurse (SSN) Mary Jane Seville Poticar, tell us more.

Surmounting the initial hurdles

“Sourcing for funds to kick-start the project was the first mountain we had to climb,” ADN Sim jokingly shared, “and the timeline to commence work on the app was quite short, and the rest was history.”

With any new initiative, there are bound to be two camps – those who are supportive and those who are skeptical. The team engaged various key staff such as the heads of departments (HODs) from the Nursing and Clinical departments to get their buy-in and views, “It was important and definitely beneficial to hear the perspectives from various stakeholders. For example, on the function to allow patients access to their investigative results, the Patient Experience Steering Committee highlighted the sensitivity of showing investigative results - something we would not have considered if we hadn’t engaged our stakeholders.”

Through several trials and refinements with the help of SingHealth Nursing Software Suite (NURSS) team, the app is now built with the flexibility to hide certain sensitive information such as HIV test results. The same function has been made available to other institutions for specific patient groups.

Tackling design issues

“When we finally got the app working, we were faced with another major issue and the biggest challenge in this project – the design of the storage holder for the device. Our bedside lockers are different from SGH so we had to design and produce it from scratch.” said ADN Sim. 

The team explored various options - from a hook-on type of holder where the tablet could be hung on either side of the locker but could potentially cause injuries should the holder, made of metal, fall on someone when being shifted; to placing the holder at the back of the locker but it would be hard for the patient to reach.

 
The device holder that is currently in use at Ward 56.

The solution? “We changed the hook-on designed holder to a screw-on mechanism and everything fell into place,” shared NC Zubaidah.

Working with the piloting ward

“When we first launched the app, we had to educate the patients on using it. We had to also ensure that our staff at the ward were around to manage any request or question sent via the app by patients. The app has inevitably changed certain workflow in the ward, hence it was essential for us to work closely with the ward on enhancing the process and app to create value for our patients and our staff,” said SSN Mary Jane.

“For instance, the ward clerk first started with a laptop to manage the incoming requests but found that it wasn’t effective as the staff had to always be at the counter to monitor via the laptop,” said ADN Sim. Subsequently, the idea of monitoring via iPhones came up and was shared with nursing leaders. “Senior management was supportive of the Ward to get two sets of iPhones to manage the app with greater convenience.”

Winning with teamwork

ADN Sim emphasised that teamwork is key in the department and that everyone in the team plays an important role.

“Though each of us lead different projects, we make it a point to communicate with one another so that everyone is aware and clear of our work. When MOH announced the vision of the Smart Nursing Ward some years back, we anticipated and have prepared to be involved in more tech-related projects; MyCare is only a part of it,” said ADN Sim. He revealed that there are other ongoing/ upcoming projects such as RFID tag for pumps and pharmacy delivery system.

With the pilot of the app underway, the team is now charging at full speed on the improved version with functions such as meal ordering and letting patients manage their own input and output charts (used to assess the amount of fluid the patient drinks, and the volume of their urine in order to see episodes of incontinence, if any). There are plans to expand the usage to other groups of staff such as Allied Health.

The SingHealth Nursing-OST Taskforce took home the You Shine Award which aims to celebrate team achievements towards better patient outcomes and experience.