A Solution Using Existing Technology
QR codes & Pill Bottle Caps
The Inspiration to the Solution
A preface to the solution & my experience at clinicals.
Desert Springs Hospital
Example of what a patient wristband looked like. Notice the small QR code
To become CNA certified, the Nevada State Board of Nursing requires nursing assistant students to complete a required number of hours of clinical experience. At SECTA, I was granted the opportunity to complete my clinical experience at Desert Springs Hospital in Las Vegas, Nevada.
At the hospital, we shadowed CNAs and aided them with tasks that they perform on a daily basis. Although I learned a lot of what I needed to know in the classroom, the lessons that I learned during clinicals proved to be the most valuable because of the major difference in executing tasks in real life then in simulation.
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One of the tasks that the CNAs felt comfortable with us students handling were vital signs rotations. Often, that was one of the first tasks to be completed, seeing that we arrived at the hospital early in the morning. In order to record vital signs, the CNA needed a device that was an iPad in a hard casing attached to a pole. Wheels on the bottom of the pole allowed CNAs to transfer the device from room to room with ease. Not only did the machine bear an iPad, but it also bore a hand held scanner, not unlike the hand held scanners found at the supermarket. Installed on the iPad was software that allowed CNAs to directly input vital signs information on a patients digital chart.
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However, before the CNA could be granted access to updating a patient's data, the CNA must use the hand held scanner to scan the barcode on the patients' hospital wristband. The barcode on the patients wristband is an identification tag which is unique to every patient. After correctly identifying the patient, the CNAs were granted access to the software. This simple, yet effective technology of assigning a barcode to each patient was the inspiration to my capstone.
A Solution Using Existing Technology
Example of Pill Bottle
Example of QR code that is to be found underneath pill bottle cap
Smartphone camera to scan QR code
Email notification to physician if patient fails to scan
QR codes are similar to the patient identification system in place at the hospital in that they can be uniquely used for individual patients. QR codes are usually linked to websites, but in this case, Google Forms. They are easily accessed and can be created using free online QR code generators. I used the free online QR code generator, Flowcode, to create a working example of the patient John Smith's QR code pictured above.
My solution to recognize and put a stop to medication non-adherence is to assign every patient who is prescribed medication a unique QR code that is linked to a Google Form named after themselves, and it asks one simple question: Did you take your medication today?
That unique QR code is printed and attached underneath the cap of their prescription bottle. Using the camera of their smartphones, the QR code is to be scanned every time they open their prescription bottle, which then brings them to the link of their Google Form. The QR code is strategically placed underneath the pill bottle cap so that they are reminded to scan every time they take their medication.
With the knowledge that they would not have scanned had they not taken their medication, there is only one option (Yes) to the question, "Did you take your medication today?"
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Process of setting up Form Mule
If a patient fails to check-in and complete the Google Form by the time that they are due to take their medication, then an email is sent directly to their physician and/ or caretaker.
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By using Google Forms, it grants the physician's access to Google Sheets, pictured in Slide 1, where recorded responses are displayed in a row-column format.
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I installed the Google Spreadsheet Add-on Form Mule, which is an application that sends automated emails if and when a condition is present. In this case, the condition is whether or not the QR code is scanned and Google Form filled out promptly.
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Pictured to the left is a slideshow of setting up Form Mule. In my imaginary patient's case, John Smith, you can see that in Slide 2 he is scheduled to scan and take medication every 12 hours.
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In Slide 3, you can see that if Google Spreadsheet's designated box for the question, "Did you take your medication today?" is void of an answer (NULL), then the physician is sent an email alerting them of their patient's non-adherence.
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Pictured in Slide 4 is the set up for the automated email. If the condition is present, then an email is sent to the physician: "John Smith failed to take his medication."
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Pictured in the last slide is a preview of what the email will consist of and a summary of the commands it will run if the condition is present.
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