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Page 733 – Stanford Medicine X

Maximizing Technology Bridge Care Transitions: Apps, information exchange & EMRs

Michelle Litchman michelle.litchman@nurs.utah.edu
MJ Tran merijanetran@gmail.com
Joseph Nelson jnelson.do@gmail.com
Perry Gee perry1gee@gmail.com


Primary care and specialty providers are faced with significant challenges when their patients are hospitalized. The days of a clinician following patients throughout their hospital stay and back home is no longer a standard of practice. As a result, much effort is placed in improving transitions between care facilities. However, segmented care and communication between these facilities remain fragmented. This panel will highlight innovative concepts and evolving technologies being used in clinical practice to improve care transitions throughout multiple care settings.
Michelle Litchman, family nurse practitioner and Assistant Professor at the University of Utah College of Nursing, examines the intersection of chronic disease management, aging, and technology. She developed a specialty house call program for older adults utilizing multiple care services to prevent costly hospital admissions. She will serve as the moderator for this panel, framing the discussion related to the challenges of communication between health systems and how technology has the ability to improve post-acute care.
MJ Tran, a health care innovationist and transitional care leader from Granger Medical Clinic, a multi-specialty clinic with 160 providers, has designed and led a unique outpatient Transitional Care Management Program to streamline fragmented communication through multiple in-patient settings such as hospitals, skilled nursing facilities, home health and hospice to improve patient care coordination and reduce hospital readmissions. She will offer insight on how to dissect multiple electronic medical records and identify key communication factors necessary to rebuild a health care community who works collaboratively to improve patient care.
Joseph Nelson, a family medicine physician, entrepreneur and telehealth engineer, will discuss the challenges and barriers to providing efficient health care to patients on home health and hospice services. AirScripts, a HIPAA-compliant biometric technological application for Apple products, was designed to lift the hindrance of clinicians urgently waiting on signed orders and prescriptions, while allowing for medical providers to practice medicine remotely without the cumbersome facsimile machine.
Perry Gee is a registered nurse, clinical and consumer health informatics specialist, and a research scientist for Dignity Health, the largest health care provider in California. His research expertise in is in the areas of eHealth, technology and patient engagement. Perry will discuss three major research initiatives at Dignity Health involving the use of technology to empower health self-management across the continuum of care. He will also discuss how health care providers integrate these new technology tools into clinical practice and promote improved transitions of care.
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