Children's Hospitals Today - Spring 2017 - 15

HOME CARE / FEATURE

Autumn Parkinson
monitors newborn
Job at home,
along with Ezra,
5, and Isaac, 3.

six months. Parkinson knew from support
groups she'd found that most parents had to
take painstaking records daily in a three-ring
binder and phone them in to their doctors to
watch for complications. Even then, as many
as 25 percent of the babies would die before
their second surgery.
But the vision of a technologically minded
doctor and his team in Kansas City, Missouri,
1,900 miles away changed everything.
Parkinson has relaxed into a routine knowing
her baby's cardiologist and nurse are looking
over her shoulder every day, via the cloud.
An app conceived by Girish Shirali, M.D., a
pediatric cardiologist at Children's Mercy
Kansas City, has saved babies and made
life easier for their parents. "We focused
on HLHS because it's one condition with
bad outcomes," Shirali says. "But it quickly
became clear there are other conditions we
can use it for, too."
Shirali's Cardiac High Acuity Monitoring
Program (CHAMP), uses a Microsoft Surface
3 tablet with the Windows 10 operating
system, which connects to a database in
the Microsoft Cloud. The family enters the
baby's information in the app throughout
each day, and the cloud instantly analyzes
the figures. If there are any measurements
outside healthy cardiac parameters, such as
oxygen saturation that's too low or high, the
app automatically alerts the baby's medical
team. There's also an "I'm concerned" box
parents can click that will immediately page
a nurse. The program has been a success with
62 patients in Kansas City so far, and now 16
families in Seattle are using it.

Proactive, not reactive
Before Children's Mercy introduced the app,
parents would check various vital signs
at home that are important indicators of
cardiac health, such as heart rate, weight and
oxygen saturation. Then it was up to families
to provide the information to the hospital
each week over the phone. Otherwise, nurses
would track down the parents to find out if
they were concerned about anything.
"It was a reactive model," says Lori Erickson,

RN, CPNP, APRN, clinical coordinator for
CHAMP. "Now it's proactive. I see data within
two minutes as it goes from the tablet to the
cloud, and even if there are no alerts, we look
through the reports every day. We can catch
things before parents do, and that reduces
the burden on them."
Erickson says she was skeptical when
the hospital first began using CHAMP.
She thought the team's care was already
effective. But by the time the team was using
the program with its third patient, she was
hooked on the ability to monitor babies daily
and felt nervous without the app. No baby
with HLHS under Children's Mercy's care
has died since CHAMP was adopted in 2014.
"If we follow 30 kids a year, that's a whole
kindergarten class that was saved," Erickson
says. "We didn't know what we didn't know
before, and we didn't realize we were missing
trends because we were only getting numbers
once a week."

Reducing the cost of care
CHAMP is not only saving lives, it's reducing
costs. Babies with this disease are the most
high-cost patients in the cardiac clinic,
Erickson says, and they have the longest
length of stay. With the data she now has
access to, she can modify treatments, warding
off problems and avoiding readmissions.
The app also helps with families' schedules.
Some of Erickson's patients live five or six
hours away from Kansas City, so avoiding
unnecessary visits saves them a day trip-or
even a flight, in the case of Seattle Children's,
which serves states as far away as Alaska.
Parkinson, who uses the word "comfort"
when talking about CHAMP, lives more than
an hour's drive from Seattle Children's. With
a fragile baby and two rambunctious boys at
home-Ezra, 5, and Isaac, 3-she's grateful to
have a virtual nursing staff in her living room
to help avoid the trip when possible.

Building a smarter system
Shirali came up with the idea for CHAMP in
2012 as tablets were becoming popular. He
sketched out his concept and showed it to

CHILDREN'S HOSPITAL S TODAY Spring 2017

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Table of Contents for the Digital Edition of Children's Hospitals Today - Spring 2017

Contents
Children's Hospitals Today - Spring 2017 - Cover1
Children's Hospitals Today - Spring 2017 - Cover2
Children's Hospitals Today - Spring 2017 - Contents
Children's Hospitals Today - Spring 2017 - 2
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Children's Hospitals Today - Spring 2017 - Cover3
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