An App for Doctors

Patient Assignments, Telehealth, and Care Coordination

With the Patient Is In app for the doctor, you can perform the following:

  1. Patient assignment. Mirroring the real world, the charge nurse or other administrator assigns a doctor to treat a patient in a specific room and provides any relevant patient notes. Using the doctor app on the iPhone, Apple Watch, or via Siri; the doctor can accept the assignment and provide an estimated time of arrival or reject the assignment if unable to attend.
  2. Teams. Doctors and other medical staff ofter have a varying work schedule which require them to call in and ask the charge nurse for their updated schedule. The charge nurse app allows an administrator to group doctors and other medical staff into teams allowing the doctor to receive a real-time schedule update and be informed of her team members.
  3. Telehealth/Telemedicine Services. All of the patient apps are tightly integrated with FaceTime and provide the doctor with a directory of available colleagues and patients. Due to this tight integration, users do not have to rummage through their address book in the Contacts app but rather the app will present a “Connect with FaceTime” button when appropriate. While doctors may initiate a FaceTime audio or video call with a colleague or patient, a patient may only request a FaceTime call.
  4. Care Continuity and Remote Patient Monitoring (RPM). Traditionally, remote patient monitoring requires the patient to contract with a third party monitoring service and rent one or more health monitoring devices such a cardiac device. Periodically, the remote monitoring company will create a high-level report and sell it to you, the doctor, via their provider portal. Your office will then bill the insurance company for your time, the cost of the report, and perhaps even the cost of the remote monitoring service, and the rental devices. Due to this added cost, insurance companies will only authorize you to review a patient’s remote health data infrequently and never daily. To democratize cardiac care throughout the world, our apps empower a cardiac team to continually review a patient’s remote health data. Our apps empower the patient to securely transmit their heart data directly to their cardiac team in real-time and connect with them at any time of the day or night.
  5. Care Coordination. Using the patient app, a patient may securely send you his cardiac data before his appointment so that you have enough time to review the remote health data.

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Installation

First, make sure that nearby there is an iPad on to which the the charge nurse app is installed and properly configured. Also make sure that your iPhone is using the same WiFi network as the iPad. Enure that you are logged in and using a unique iCloud account.

The first step in the setup process is to configure the Patient is in app with the correct iOS permissions. When you launch the app, you will be presented with a request to allow the app to receive Notifications and Critical Alerts. If allowed, you will receive a notification or critical alert when the charge nurse sends you a patient assignment, changes your team participation, or an authorized patient requests a FaceTime call, ECG review, or streams his live pulse to your device:

The Critical Alerts permission authorizes the doctor app to play critical sounds that ignore the iOS “Do Not Disturb” feature and your iPhone’s mute switch. You will learn how to customize notifications and critical alerts in a later section:

You will be prompted to authorize the app to access your location. This is required during setup so that the charge nurse app can authenticate your iPhone from the iPad app. The location of your iPhone is also used to streamline checking-in with the charge nurse. Rather than updating the charge nurse in person or calling her when you go on break, you can have the doctor app automatically update her with your on-site or off-site location. And lastly, your location is used to allow or deny your colleagues to contact you via FaceTime if you are off-site. Tap authorize “Always Allow” to allow the charge nurse to be automatically updated with both on-site and off-site location. Alternatively, authorize “Only While Using the App” to update the charge nurse with your location only when the app is in use. The benefit in selecting “Always Allow” is that you will still can customize if and when the charge nurse is updated with your location. The privacy of your location is always under your control. Location updates are discussed is a later section:

You will also be prompted to authorize the app to use Siri to enable you to respond with your voice to patient assignments. You may use accept or reject assignments using Sir from your iPhone, your Apple Watch, and nearby HomePods:


Finally, you will need the charge nurse version of the Patient is in app to authorize your device. In the Settings view, add your preferred name and FaceTime contact information. After the charge nurse authorizes your iPhone, tap the “Ask to Join a Facility” button. In a few moments, your facility information will be transferred from the charge nurse app to your app and you will be authorized to receive patient assignments:

Configuring Notifications and Critical Alerts

With iOS 12, Apple introduced Critical Alerts which are high priority notifications which ignore the iOS “Do Not Disturb” setting and your iPhone’s mute switch and will play a critical sound at a higher volume than regular notifications. The app uses Critical Alerts to ensure that you hear your patient assignments, team alerts, and patient requests. Tap on “Notification Settings” to choose to use regular notifications instead, a default sound or a verbal announcement, or change the volume of a critical alert:

You may also configure the notification and critical alert settings from any notification:

Configuring Location Updates

You can configure the doctor app to inform the charge nurse of your on-site and off-site location:

On-site location update feature was requested by doctors who work at large medical campuses and want their charge nurse to know their location prior to being assigned to a patient. As we see from this screenshot from the charge nurse app, since the doctor requires 30 minutes to walk across the campus, it would make more sense to assign an alternative doctor and reduce patient wait time:

The off-site location update feature was requested by sole practitioners who might have to drive to the office for emergency surgery during the weekend and want the charge nurse to see their location on a live map.

Configuring Off-Site FaceTime Calls

On-call doctors have the option to allow their colleagues to call them with FaceTime audio or FaceTime video:

and can disable this feature when their shift has concluded.

Receiving and Responding to Patient Assignments

When your charge nurse sends you a patient assignment, you will receive a notification or critical alert on your iPhone or Apple Watch:

You can respond directly from the notification or from the app:

Using Siri to Respond to Patient Assignments

You can confirm or reject an assignment using Siri:

Team Assignments and FaceTime Calls

When your charge nurse assigns you to a team or removes you from a team, you will receive a notification or a critical alert:

You can view your team assignments on the “Today’s Staff” tab:

and you can also view the members of a team which may include both your colleagues and patients if you are part of a care continuity and remote patient monitoring team for cardiac patients:

In the example below, several patients are live streaming their pulse to their cardiac team:

Adjacent to the names of some of the team members is a FaceTime icon which means that they are available for a FaceTime call. With one-touch a FaceTime call with be placed without the need for their contact information to be stored in your address book.

Cardiac Care Continuity and Care Coordination

If your charge nurse has assigned you to a remote patient monitoring team for cardiac patients, then patients may send you a FaceTime conference call request:

an ECG analysis request:

and stream their pulse directly to your device:

When requesting an ECG report analysis, the patient app will also securely transmit both the ECG PDF report and the last 24 hours of heart rate data to provide context to the ECG. To view the ECG PDF report or the heart rate spreadsheet file, launch the built-in iOS Files app and expand the “Patient” folder:

Patients may also send their updated heart rate data prior to an appointment. In that case you will need to manually refresh the Today’s Staff view so that the latest files are made available in the Files app.


Privacy and Your Data

As stated in the Patient is in app privacy policy: the purpose of the doctor app is to securely send and receive data in support of authentication, patient assignments, team membership, care continuity, and care coordination. Furthermore, if a patient uses the patient version of the Patient is in app to transmit his heart data to you via the doctor version of the Patient is in app, a secure conduit is created between the patient’s device and your device. The cardiac data and files are automatically encrypted prior to leaving the patient’s iPhone or Apple Watch and are automatically decrypted on arriving at your iPhone or iPad. The app developer does not maintain an off-device copy of the encryption keys used to encrypt and decrypt a patient’s health data derived from HealthKit.

Please contact us if you have questions about your data privacy.