Bedside Ordering With a High-Tech Personal “Touch"

The nutrition aide enters the patient’s room, asks how she is feeling and what she would like for dinner, as well as breakfast and lunch the next day. He runs through the choices for each meal in turn—all of them appropriate to any special diet restrictions this particular patient may have—and logs the requests. The encounter ends with a cheerful “I’ll be back soon with your lunch” as the aide heads off to see his next patient.

This scenario would not be terribly unusual except for one detail. All of the information the aide reads, from the patient’s diet regimen to the day’s choices, as well as the actual order entry of the patient’s meal selections, is done on an Apple iPad touchscreen tablet computer.

At the thousand-bed Ohio State University Medical Center in Columbus, 15 nutrition aides make such rounds each morning with iPads in hand. The easy-to-use devices incorporate a software program called Concero for which OSUMC is serving as an early adopter. The project went active last fall.

“We actually started looking at it as we went to an on-demand system and wanted a way to provide bedside support,” says Nutrition Services Director Julie Jones. “Because of the size of the patient population, we were looking at technology solutions. We also needed something that would work on multiple platforms: touchscreens, computers, even TVs since we’re looking at that for direct patient ordering in the future.”

Jones adds that the program is also able to incorporate pictures, which will be a key component of an interactive patient menu OSUMC is planning, and easy to use. “It’s very user-friendly and familiar because so many people are used to being online,” Jones adds. That will be a key consideration in the future when the program is put in the hands of patients so they can enter their own orders.

The ease of use made training simple. “It didn’t take very long,” says Laura Meadows, a system analyst for OSUMC Nutrition Services. “The staff was very excited to begin using iPads. The program is very simple to use. The interface was built by our web team and adapts to where it is being used. You just select from a menu of current inpatients for a particular tower or location, select the meal and enter the responses.”

The nutrition aides who take the orders go around each morning to collect meal requests for that evening’s dinner and the following day’s breakfast and lunch. Currently, the aide reads off the selections but eventually there will be physical menus in each patient room, Meadows notes. The selections for each patient are only those that meet individual dietary restrictions, if any. Each aide works with a specific population, usually ranging from 30 to 50 patients. They not only take the orders but also deliver the food in order to establish a personal connection and get to know preferences.

The orders are stored in the iPad until the time comes to print tray tickets, when the trayline is ready to begin. The selections usually include a chef’s special plus customized sandwiches and salads. There is also an all-day breakfast option.

OSUMC will have even greater need for such high-tech solutions as it proceeds with ambitious plans to expand its capacity by some 400 beds in the next couple years. Meanwhile, the onsite dining program is also undergoing a modification in preparation for a room service based patient dining system that Concero will be part of.