Challenges in inpatient care 

Even in countries with well-developed healthcare, inpatient care is marked by various challenges that affect both healthcare professionals and patients. One of them is the growing administrative load due to complex treatments and, in some countries more than others, the specifics of (mostly private) health insurance and billing. This results in higher administrative costs and higher burnout rates among healthcare professionals, leading to decreased work performance and affecting the patient care. Fortunately, there are technological solutions that can eliminate or at least greatly mitigate the administration issue and significantly improve the quality of care. Many diagnostic measurements on the same device, automatic result saving into patient files and immediate sharing for a second opinion make a significant difference.  

In this blog you will learn: 

• What are the challenges in inpatient care? 
• What are the solutions to some challenges in inpatient care? 

What are the challenges of inpatient care? 

Administrative costs 

Healthcare costs in most developed countries are rising and this is projected to continue, primarily due to the rapid growth of the older population. This is the fastest-growing demographic group worldwide due to improved standards of living and advances in preventive and curative medicine [1]. The costs heavily increased during the COVID-19 pandemic, particularly those of administration [2] ​[3]​. A comparison study on eight developed countries in 2014 found that, in the United States, administrative costs accounted for 25.3% of total hospital expenditures, followed by the Netherlands (19.8%) and England (15.5%), with Scotland (11.5%) at the bottom of the list [4]​. To compare, just in 2019, total administrative spending in the United States healthcare system reached a figure of around 950 billion USD [5]. 

One of the main reasons for the high administrative costs in US healthcare is its highly complex private health insurance system, which additionally burdens physicians and other healthcare professionals with work that may not be directly connected with their education. This has had many negative consequences in all healthcare systems where extensive administrative procedures are required at the expense of the time and quality of examinations and treatment. One such consequence is the increasing burnout among healthcare professionals. 

Burnout and other issues affecting healthcare professionals 

Burnout is not a new phenomenon and is rising in prevalence [6] ​[7]. A study found nurses and paramedics at most at risk, but physicians are not far behind ​[8]​. The incidence of burnout varies widely between various medical specialities; urologists, neurologists and nephrologists are the most likely to experience burnout while their colleagues in general surgery, psychiatry and orthopedics are the least likely to be afflicted ​[9]. 

Regardless of speciality, the biggest complaint of physicians about their workload are administrative tasks, which can take a significant amount of time and are a leading factor contributing to the development of burnout. Physicians generally view administrative work as less meaningful than medical work; feeling that one’s work has little significance is an important factor in burnout. Research shows that physicians who spend a considerable amount of time on administrative tasks are more likely to report decreased career satisfaction and experience burnout ​​[10]​. They also feel that they have less time to allocate to their patients at the expense of the administration. 

Many hospitals solve this issue by delegating as many administrative tasks as possible to nurses. This is not a solution; research shows that it then increases the burnout in nurses, impacting the quality of care afforded to patients [11]. 

Decreased quality of care 

Burnout is generally associated with a decline in work performance across diverse occupations; healthcare is no exception, although it could be argued that its consequences can be far more severe. Not only does burnout affect the medical professional, but has been linked to lower quality of care and decreased patient satisfaction [12] [13] [14] [15] [16] [17]​. Studies also show a relationship between nurse burnout and how nurses rate the hospital’s safety culture and quality of care. The aggregate nurse burnout rate also correlates with publicly reported hospital quality measures ​[18] [19] [20]​. 

Research has also revealed a relationship between burnout and medical errors, low professionalism and even malpractice claims ​[21] [22] [23] [24].​ One study has even found a correlation between mortality rates of patients and the aggregate level of burnout in all members of the healthcare team that cared for them [25]. These are worrisome findings for which there might not be an easy overall solution because bureaucracy (not just in healthcare) is resistant to change. Nevertheless, technology can lend a helping hand and effectively streamline some administrative-related tasks, simplify the sharing of patient data for faster diagnosis, contribute to the reduction of medical (especially transcription) errors and, through all this, increase the overall quality of care. An example is the MESI mTABLET.  

What are the solutions to some challenges of inpatient care? 

Many diagnostic measurements on one device 

The MESI mTABLET is a versatile and intuitive diagnostic solution with seamless integration with the EHR system. It offers diverse measurements with wireless diagnostic tools and clinical support apps. All are suitable for use in inpatient care; examples are 12-lead resting ECG, advanced spirometry and pulse oximetry. You can choose any number of measurement tools and build a diagnostic system according to your needs. Digital technology helps prevent transcription errors because all the measurement results (e.g. blood pressure) are automatically stored into the patient’s file. With access to the patient’s previous measurements, an insight into the patient’s trends is provided. Whatever number of tools you use, they all fit onto a single handy trolley, with plenty of room for other accessories. 

All patient data in a single location 

Every MESI mTABLET diagnostic system comes with free MESI mRECORDS – a cloud-based storage of all measurements made with the tablet, which can be accessed from every web-enabled device. This enables fast and easy data access anywhere and anytime, fostering greater and more reliable communication between clinicians. (Please note that different working groups and different with different authorisation levels can be created.) This provides access both to the latest diagnostic results and to the patient’s measurement history – and advantage which can result in an improved quality of care. 

MESI mRECORDS is highly convenient for those users who do not use any other EHR solution. However, for those that do, the MESI mTABLET can be easily integrated with it. In this case, the measurement for an individual patient can be ordered from the EHR system; its results are automatically saved in the EHR as well as in MESI mRECORDS.  

Instant measurement sharing for a second opinion 

EHRs have numerous benefits when it comes to improving quality of care. In comparison to paper medical records, this includes faster and easier sharing of a diagnostic measurement result for a second opinion, especially if the patient’s medical state is acute [29] [30] [31]​. This has been validated by numerous studies, which found a positive correlation between the use of EHRs and improved patient outcomes and has been the experience of users of the MESI mTABLET as well. For example, a specialist of family medicine saved the life of a 71-year-old patient who presented with signs of a myocardial infarction (but with certain vital signs in normal limits) using the MESI mTABLET ECG and by sharing the results with an off-site cardiologist who confirmed the seriousness of the situation. The patient was then transported to hospital by helicopter and rushed to a catheterization laboratory, where he was successfully treated. Another user of the MESI mTABLET ECG identified an NSTEMI myocardial infarction in a 55-year-old patient, who subsequently underwent a coronary angiography (insertion of a stent into the LCX artery due to a 90% thrombosis). 

 Reduced administrative load 

The impact of EHRs on administrative burden reduction is well-recognized, and EHRs connected to digital diagnostic measurement devices are a winning combination ​[26] [27] [28]​. Not just in inpatient care, but anywhere where excess administrative work accrues unnecessary costs and hinders quality medical and other care, e.g. at primary care level.