Health IT

HEAL iPad platform aims to improve patient handoff, reduce nurse overtime

While some doctors and nurses are putting down their iPads, others are picking them up.

Hubbard Hill Retirement Community in Elkhart, Indiana is paying less nurse overtime and improving communication among nurses and doctors thanks to iPads and a new program developed by a nearby startup called Carex Technologies.

Carex’s first product, HEAL (Handoffs for Extended/Assisted Living), aims to improve communication in nursing homes at two critical points: among nurses during shift changes and between nurses and doctors.


The cloud-based platform is loaded onto an iPad or computer and is populated with basic information about each patient, which can be pulled from the facility’s electronic medical records (EMRs). Once in the system, patient names are assigned to a nurse, who carries the iPad and uses the program to make notes about patients throughout her shift. At the end of her shift, she uses HEAL to digitally “sign off” her patients to the incoming nurse, who is prompted to accept them when she logs in and begins her shift. When she accepts the patients, the outgoing nurse is notified with a text message. The incoming nurse now has access to all of the notes made about that patient, with the most recently edited patient records appearing at the top of the screen (See a brief demo below).

This ensures that all patients are accounted for at all times and facilitates smooth communication between nurses, said Kali Devaraj, co-founder and chief operating officer of Carex. It also closes the communication loop between nurses and patients, who don’t have to keep repeating things — like that the room is too warm or the bed isn’t working properly.

Judi Peck, unit manager at Hubbard Hill — Carex’s first customer — said the system improved communication and cut down on nurse overtime at the facility because nurses were not staying past the end of their shifts to communicate with incoming nurses.

Director of operations Martin Lebbin added that, despite worries about how nurses would adjust to the change in work flow, he observed that nurses saw the benefit in time savings and adapted quickly.

Access to HEAL can also be granted to outside doctors who visit patients at the assisted-living home. Real-time alerts sent via email and phone let him know there are new SBAR forms to be reviewed, and he can respond to them through the system rather than by fax or phone.

A 2005 Joint Commission analysis found breakdowns in communication were responsible for up to 70 percent of sentinel events at hospitals, more than half of which occurred during patient handoffs. Since then, improving patient handoff has become one of the commission’s National Patient Safety Goals and has spurred standardized methods and new technologies like the Care Thread platform, which MedCity News recently reported on.

Since assisted-living facilities have more flexibility than hospitals in determining the handoff process, it made sense to start there, Devaraj said. Improved handoffs are becoming more important to all health care provicers as reimbursement penalties tied to hospital readmissions kick in. Carex is working on two similar platforms to combat this problem in other settings —  MediConnect for Specialists, which will begin testing at Michiana Hematology & Oncology within the next few weeks, and MediConnect, which is still in the development stage for use in hospitals.

CareX recently signed on its second customer, Holy Cross Village at Notre Dame, and is looking into go-to-market strategies for HEAL.

Devaraj founded CareX in 2011 with her husband, Sarv Devaraj, a professor of management at Notre Dame. It’s headquartered at Innovation Park at Notre Dame.

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