Accessibility and Blind Therapists

Support for low-vision and blind therapists

The Patient is in provides access to patient assignments and updates in 4 ways, all of which have been designed to support low-vision and blind doctors and therapists:

  • The watch app supports VoiceOver and provides a great user experience. Click here for more information about the app for Apple Watch.
  • Patient assignments from the charge nurse can be automatically announced over AirPlay compatible speakers such as Apple’s HomePod. This removes the step in which the user must first access the iPhone notification to find out about the assignment details
  • Conversations with the charge nurse using Siri on the iPhone: “Hey Siri, read my Patient messages” allows the therapist to hear her patient assignments and “Hey Siri, send a Patient message saying I’ll go to Therapy Room 2 in 10 minutes” allows the therapist to respond to assignments from either her Apple Watch or iPhone with estimated time of arrival and notice of assignment completion. Click here for more information about Siri integration with the app.
  • FaceTime support is integrated directly into all of the apps allowing the charge nurse, therapist, and other doctors to instantly connect. This includes initiating a FaceTime audio call directly from the watch app.

An important note about the important role of blind therapists in society of which many of us are unaware: they support our blind children as they start learning about the world and assist them as they transition into adulthood. Blind therapists also help our parents during the transition of age-related macular degeneration. 

An iPhone App for Doctors

The Patient is in iPhone app notifies the doctor when a patient is ready to be treated allowing her to provide an estimated time of arrival to see the patient. When the doctor has completed her assignment, she can notify the charge nurse that she has completed the assignment with a tap of a button or with Siri. The doctor may also decline the assignment if she is unable to attend.

Notifications and Alerts

The charge nurse uses the iPad app to send a patient assignment to the doctor consisting of two pieces of information:

  • The name of the room in which the patient is waiting
  • Important notes about the patient such as if he has elevated vital signs,  or perhaps that the patient is ready for discharge

and the iPhone app will alert the doctor with

  • A popup notification will be displayed on the iPhone as seen in these screen shots:
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    If the doctor is not wearing her Apple Watch, she can quickly respond to the patient assignment directly from the iPhone notification providing her estimated time of arrival

    iphone-sfb-notification-bezel
    If the charge nurse has assigned the doctor to a Skype for Business conference call, she can start the call directly from the notification

And the iPhone app provides a dashboard displaying the doctor’s assignments and because many doctors do not have easy access to tech support staff, the iPhone app displays diagnostic information to solve common configuration problems such as the iPhone’s WiFi connection to the real time peer-to-peer network; iCloud status for redundant and offsite message delivery; Apple Watch connection status if available; iOS app permissions for notifications, location, and Siri; and the status of Guided Access which allows the Doctor to lock the app into the foreground and prevents access to other apps or manually turning off the iPhone. This feature allows the app to run at peak performance to ensure that the patient assignments from the charge nurse and doctor responses are delivered near instantaneously.

Doctors may respond to assignments from the dashboard as seen in this video of joining a Skype for Business conference call directly from the app dashboard:

 

 

and more generally in the following screen shots:

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The dashboard displays patient assignments and their status
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When an item in the assignment list is tapped, the doctor can provide her estimated time of arrival to attend or decline the assignment
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When an item in the assignment list is tapped, the doctor can provide notify the charge nurse that she has completed the assignment
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If the doctor needs clarification about the assignment, she may place a FaceTime call directly from the dashboard to the charge nurse who sent the assignment. The app manages the FaceTime information providing flexibility and privacy. A business address rather than a personal FaceTime address may be used which is best for shift-based, on-call doctors.

The iPhone app provides a list of today’s doctor and allows instant FaceTime calls to be placed.

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Today’s staff is listed and their availability to receive FaceTime calls. Tap to instantly connect via FaceTime.

Siri support and a voice interface

The Patient is in apps for the iPhone and Apple Watch provide a voice interface through its integration with Siri. When used with AirPods, the doctor can have a truly wireless experience. In the following screen shot, the doctor used Siri to notify the charge nurse that she has completed her assignment in Exam Room 2:

 

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Click here to learn more about the Patient is in Siri support on both the iPhone and Apple Watch.

An Apple Watch App for Doctors

The Patient is in watch app notifies the doctor when a patient is ready to be treated with a discrete vibration felt on her wrist and allows her to provide an estimated time of arrival to see the patient. When the doctor has completed her assignment, she can notify the charge nurse that she has completed the assignment with a tap of a button or with Siri. The doctor may also decline the assignment if she is unable to attend.

Apple Watch Series 3 with Cellular: Patient assignments on the go

The Patient is in watch app supports the cellular capabilities of the Apple Watch Series 3 ensuring that the doctor can receive and respond to patient assignments:

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Notifications and Alerts

The charge nurse uses the iPad app to send a patient assignment to the doctor consisting of

  • The name of the room in which the patient is waiting
  • Important notes about the patient such as if he has elevated vital signs

and the watch app will alert the doctor with

  • A popup notification
  • A discrete vibration felt on her wrist
  • An optional, audible sound

Glanceable Information

Since the doctor may receive a new notification while she is treating another patient, the Patient is in watch app uses haptic feedback in the form of a silent vibration to alert her that a new notification was received from the charge nurse. The Patient is in watch app will display the new room name and abbreviated notes directly on the watch face affording the doctor a quick glance without disrupting her current patient’s treatment.

The following screen shots show how the app supports complications to implement glanceable information:

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Actionable Information

When the doctor is able to respond to the assignment, the Patient is in watch app allows the following:

  • Review any patient notes provided by the charge nurse by tapping on the name of the room
  • Inform the charge nurse of the estimated time of arrival
  • Decline the assignment
  • Inform the charge nurse that the assignment is complete

The following screen shots show how the doctor uses the Patient is in watch app. First, a discrete vibration is felt on her wrist, optionally with a sound. A popup alert is also displayed and allows the doctor to quickly respond directly from the notification:

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If the doctor is busy and misses the notification, she can access it by swiping down from the watch face. This will display all of her missed notifications as seen in this screen shot:

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With a tap on the notification, the Patient is in watch app is launched and visually displays the assignment allowing the doctor to quickly accept the assignment and provide an estimated time of arrival or decline the assignment. A timer displays how long has it been since the charge nurse sent the assignment. The doctor may tap the room name to review the patient notes and start an FaceTime audio call with the charge nurse if she needs clarification. Finally, when the doctor has completed the assignment, she can notify the charge nurse that she is done with a tap of a button as seen in the following screen shots:

 

 

If the doctor prefers, she can use Siri to perform theses tasks.

Siri support on Apple Watch

Using Siri, doctors can converse with the charge nurse to respond to patient assignments using the following phrases:

  • “Hey Siri, send a Patient message saying I’ll go to Exam Room 1 in 15 minutes”
  • “Hey Siri, send a Patient message saying I’ve completed my assignment in Recovery Room 2”
  • “Hey Siri, send a Patient message saying I cannot go to Operating Room 3”

And the following screen shots show the doctor using Siri to acknowledge a patient assignment and then notify the charge nurse that she has completed the assignment:

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Click her for more information about creating a voice interface with Siri in the Patient is in.

Click here for more information about integrating Siri with an AI engine to reduce patient wait times in the Patient is in.

Audio and Video Conference Calls

Enhancing the convenience of mobile conference calls with advanced presence and geolocation rules, Apple’s FaceTime is deeply integrated throughout the app allowing doctors to initiate FaceTime calls directly from the watch app. Work-only FaceTime addresses may be defined in the iOS app to protect the privacy of personal FaceTime addresses and to support on-call doctors and other shift-based staff members.

To start an audio FaceTime call with another doctor, nurse, or charge nurse who is working today, the doctor use a Force Touch gesture on list of patient assignments which pops up a menu and then taps on the “Today’s Users” button. This is seen in the following screen shots:

 

 

 

The doctor may also initiate a FaceTime audio call to the charge nurse who sent the patient assignment when clarification about the patient assignment is needed. By tapping on the patient assignment room name, the doctor has access to the patient notes and the option to begin a FaceTime audio call as seen in this screen shot:

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Support for low-vision and blind therapists

The Patient is in provides access to patient assignments and updates, all of which have been designed to support low-vision and blind therapists. For example, VoiceOver is comprehensively supported as well as Siri for voice access and FaceTime for audio conferencing with both the charge nurse as well as other available staff members as seen in following screen shots:

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Click here to learn more about the accessibility features of the Patient is in and why the app supports blind therapists.

 

A video of the Patient is in app for Apple Watch

The following video shows the Patient is in in action on Apple Watch:

 

Siri integration for a voice interface

The Patient is in apps are integrated with Siri on both the iPhone and Apple Watch to provide a voice interface for messaging.

Conversations with the charge nurse using Siri on the iPhone: “Hey Siri, read my Patient messages” allows the doctor to hear her patient assignments and “Hey Siri, send a Patient message saying I’ll go to Therapy Room 2 in 10 minutes” allows the doctor to respond to assignments from either her Apple Watch or iPhone with an estimated time of arrival. Notice of assignment completion is supported from both the Apple Watch and iPhone with “Hey Siri, send a Patient message saying I’ve completed my assignment in Recovery Room 2”.

All of these statements are processed by the Patient is in natural language processing (NLP) engine fixing homophones (“Exam Room 2″ vsexam room to” vsexam room too” vsexam room two”) and other linguistic and transcription impediments to create a structured message upon which the charge nurse’s iPad app can visually display and drive real world processes such as cleaning the room so that the next patient’s wait time is significantly reduced.

For a truly hands-free experience on the iPhone, the doctor needs only to use AirPods or another bluetooth headset and use the phrase “Read my Patient messages” after activating Siri either with a double tap on either AirPod or with the “Hey Siri” trigger phrase.

And then the doctor may respond to the assignment using the phrases: “Hey Siri, send a Patient message…” as seen in these Apple Watch screen shot:

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and on the iPhone as seen in this screen shot we see the natural language processing (NLP) engine of the Patient is in fixing homophones (“Exam Room 2″ was transcribed by Siri as exam room to” ) and other linguistic and transcription impediments to understand the doctor’s intent:

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To ensure the best experience, the internal NLP engine used in the Patient is in apps has been optimized for Siri in a medical environment.

The following are some sample phrases which the doctor may use with Siri on both the iPhone, Apple Watch, and HomePod:

  • Send a Patient message saying I’ll go to Exam Room 1 in 15 minutes
  • Send a Patient message saying I’ve completed my assignment in Recovery Room 2
  • Send a Patient message saying I cannot go to Exam Room 2

Exclusive to the iPhone and HomePod, the doctor may ask Siri the following:

  • Read my Patient messages
  • What are my messages on Patient?

Understanding the AI integration with Siri

Click below to learn more about the technology powering the integration with Siri:

Videos of using Siri with the Patient is in app

In the following HomePod video, a group of anesthesiologists use Siri to respond to patient assignments:

In the following iPhone video, the doctor uses Siri to listen to her patient assignments:

 

An iPad App for the Charge Nurse

Doctor assignments, room status, and doctor location

With the Patient Is In iPad app you can notify the doctor on her Apple Watch or iPhone that a patient is ready to be treated. Also, the Patient is in iPad app allows the charge nurse to quickly:

  • View doctor availability
  • Visualize the status of each doctor assignment
  • Visualize the status of rooms
  • Location of off-site doctors with live map
  • Location of on-site doctors using iBeacon technology
  • Start an audio or video FaceTime call with the doctor (without knowing the doctor’s FaceTime information)
  • Receive an audio or video FaceTime call from the doctor (without the doctor knowing your FaceTime information)
  • Schedule a Skype for Business conference call
  • Announce a patient assignment on any AirPlay-compatible speaker such as Apple’s HomePod  wireless speaker
  • Broadcast a general announcement to any AirPlay-compatible speaker such as Apple’s HomePod wireless speaker
  • Synchronize doctor assignments and room status with other charge nurses and administrators

 

Sending an assignment to the doctor

You send a notification to the doctor’s iPhone or Apple Watch containing

  • The name of the room in which the patient is waiting
  • Important notes about the patient such as if he has elevated vital signs

and the Patient Is In watch app will alert the doctor with

  • A discrete vibration felt on the doctor’s wrist
  • An optional, audible sound

If an AirPlay compatible speaker such as Apple’s HomePod wireless speaker is set up in a doctor’s office and authorized to be used by the charge nurse’s iPad, then the doctor can hear a wireless announcement similar to “The charge nurse says that Dr. Quinn has an assignment in Exam Room 2”. Here is a link to learn more about using multi-user Siri support and HomePod: HomePod and Multi-User Siri in Health Care: It’s how to reduce patient wait times

Additionally, this assignment is synchronized with the Patient is in iPad app managed by other charge nurses and administrators. This provides large clinics and hospitals with a global, real-time view of doctor availability, patient assignments, and room status.

In this video, we see how the charge nurse is able to quickly send a patient assignment to the doctor, visualizing doctor availability and see which doctor is onsite and connected to the real time peer-to-peer network or through iCloud, if the doctor is receiving patient assignments on her Apple Watch or iPhone, if the doctor is available for a FaceTime conference call, the status of assignments (accepted with an estimated time of arrival, decline, or completed), and the status of each room.

 

 

 

Locating an onsite doctor with iBeacon technology

In large hospitals, it is sometimes critical to locate a doctor who may be busy attending to another patient. The Patient is in app allows you to locate an onsite doctor. First tap the icon representing the doctor and then tap the magnifying glass icon as seen in the following video:

 

 

You will then be presented with a map view displaying the general location of the doctor as seen here:

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The Patient is in app implements Apple’s iBeacon technology to automatically register each time a doctor’s iPhone passes near a charge nurse’s iPad running the app. In the above screen shot, a map pin shows that at 9:21 PM, the doctor was “Near Nurse Station 6”. And likewise, a few minutes after the doctor leaves the area of the iPad named “Nurse Station 6”, the map pin will be updated to show that the doctor has “Left Nurse Station 6”.

iBeacon uses Bluetooth, so for this feature to work both the iPad and the iPhone must enable Bluetooth.

If you are a fan of TV science fiction and specifically Star Trek, you may recognize this feature as a real world example of the Enterprise computer knowing the location of a crew member by passively tracking the location of the communicator badge as seen in following snippet from the first episode of Star Trek: The Next Generation

 

 

iBeacon technology and your privacy

It is important to note that the Patient is in iPhone app is only able to report on the last time the iPhone was in the Bluetooth proximity of a charge nurse’s iPad which was at the time both running the app and had Bluetooth enabled. The Patient is in iPhone app is unable to determine its proximity to other iPhones.

 

Locating an offsite doctor

If the doctor allows, the charge nurse may see the doctor’s offsite location on a live map. This map will also display current traffic conditions and is similar to apps such as Uber, Lyft, and Glympse. This feature helps the charge nurse estimate the doctor’s time of arrival for emergency surgery and other time sensitive activities.

 

Offsite location data and your privacy

It is important to note that only the doctor can decide if her offsite location should be disclosed to the charge nurse. The doctor can at anytime enable or disable the setting “Update charge nurse” in the section “OFFSITE AND ONSITE LOCATION UPDATES” as seen in the following screen shot:

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If this setting is enabled and due to the imprecise nature of mobile location technologies, the app may update the charge nurse with the doctor’s location up to 1 mile or more from the location of the charge nurse’s iPad. Consequently, if the doctor is using her personal iPhone and not a hospital issued device, the doctor may choose to manually disable this feature when leaving work.

This setting is disabled by default.