Virtual nurse explains discharge process

The software features a computer-animated nurse, called Louise, who talks patients though the hospital discharge process and assesses their understanding of medical instructions.

’Post-discharge self-care regimens are typically complex, with the average patient going away with 10 medications and multiple follow-up appointments,’ said Bickmore. ’The discharge is even more hazardous for patients who have difficulty reading and following basic written medical instructions.’

Despite this level of complexity, he said, the average pre-discharge conversation outlining care instructions lasts fewer than eight minutes.

According to Dr Brian Jack, a physician at the Boston Medical Center, nearly 20 per cent of discharged patients are eventually readmitted to the hospital within a month as a result of low health literacy and insufficient knowledge of self-care medical instructions. Nearly 30 per cent of these readmissions are preventable with a more complete reinforcement of discharge directions, said Jack. Reducing these preventable readmissions not only means healthier patients, but also lower healthcare costs.

Louise is Bickmore’s solution to the discharge issues that contribute to the hospital readmission rate. Using a touch screen, a patient interacts with Louise through an 11-step discharge process that takes an average of 52 minutes - a pace that can be controlled by the patient. Louise asks about medication regimens and follow-up visits. She also tailors her facial expressions and responses to the patient based upon the input and quizzes patients on their comprehension of the discharge material.

In a pilot programme at Boston Medical Center, nearly 450 patients used Louise and the results were encouraging, said Bickmore. ’Patients in the trial group weren’t afraid to repeatedly ask Louise for instructions and didn’t feel rushed to move though the discharge process,’ he said.

San Francisco-based Engineered Care has been granted exclusive rights to implement the technology for patient discharge. The company’s goal is to market the product both domestically and globally within the next three years.