Station 1 – REGISTRATION: the healthcare worker scans each patient’s driver’s license using an innovative “sled” that couples with the mobile device and reads the magnetic stripe or 2-D barcode. Additional data can be entered manually if required (e.g., phone number, race, and health insurance information). Using a mobile printer, a barcoded label with the patient’s unique identifier is printed and given to the patient for presentation at the other stations.
Station 2 – INTERVIEW/CONTRAINDICATION: the patient’s barcode label is scanned, and the patient is asked health questions relevant to the intervention (e.g., is the patient allergic to eggs?). Patient responses are recorded by the healthcare worker on the device.
Station 3 – DOCUMENTATION: the patient’s barcode label is scanned and intervention specific data (e.g., manufacturer, lot number) are recorded, the dosage and site are determined if applicable, and the vaccine or drug is given. A card with vaccine or drug information is provided to the patient.
After the station-specific workflow is completed, data are saved on the device and transferred to the application server either in real-time or when a connection is established. The server bundles the data from each station and the complete patient record is securely transferred to a designated database or registry (e.g., state immunization registry).
HANDI was first tested during the Colorado State University meningococcal vaccination campaign in November, 2010. DPH partnered with the Larimer County Department of Public Health and Environment and shadowed 42 patients. The average time from when the patient signed consent to when the injection was complete was just 5 minutes. HANDI users reported that data entry was easy, straightforward, intuitive, and fast. HANDI was next deployed at the Denver Health mandatory hospital employee flu campaign conducted during Fall of 2011. HANDI was used during five flu clinics to vaccinate 242 employees. The average time from when the employee signed consent to when the injection was complete was about 4 minutes. HANDI users strongly agreed that HANDI is a good way to enter data and would use HANDI again to collect data.
Although vaccination times were comparable to times without the use of HANDI; the real time savings was with data entry. Prior to HANDI, each patient’s data had to be manually entered into a database or software application, sometimes more than once. This process was resource intensive, time consuming, error prone and often did not get done. HANDI significantly improves the process by reducing the amount of data entered and storing standardized data electronically. Using HL7 messaging, data were available for transfer to state immunization registries in near real-time instead of months afterward.
Although HANDI was first developed for mass immunization events, we have efforts underway to expand its use. HANDI is being modified to include an expanded public health data model to accommodate a wide range of public health services beyond just immunization and other preventative treatments. Health care reform will require public health to play a significantly different role. Public health teams will include outreach workers who collect information to support community-based interventions to improve health. Using mobile technology, such as HANDI, increases our ability to more accurately record activities happening in the community. These data may be linked to other data sources (e.g., electronic health records) for a more comprehensive view of the continuum of care.
So can you download HANDI from the App Store? Well, not exactly. While we tried to make the HANDI app as simple as possible, the server components (e.g., HANDIMan, database, data engine) are more complex due to data management, security and messaging. Every organization’s unique network security requirements also impact a HANDI installation. However, we are happy to share our experience and lessons learned, and stay tuned as we continue to develop HANDI into an accessible universal tool.
Can you think of a use for HANDI in your health department or practice? Have questions about the app? Leave us a comment.