IPad app used to screen drunk patients at Wellington Hospital

Screening programme developed to detect if intoxicated patients are at serious risk of injury or suicide

The iPad has been hailed as a cure to many things but now it can probably claim to have saved lives.

Wellington Hospital has begun a programme to screen drunk emergency department patients with iPads to discover if they at serious risk of injury, or suicide.

The screening programme has been developed by Wellington-based company End Game, with help from the Psychology Department of Otago University’s Medical School, and has been written specifically to be used in emergency departments where highly intoxicated people turn up on a regular basis every Friday and Saturday night.

The screening programme uses a series of questions and prompts that have had a psychological weighting applied to them. If a person answers the questions in a certain way the programme will red flag them for immediate psychological treatment. The pilot programme has so far screened more than 300 people who have turned up drunk at hospitals and has already flagged three people for treatment, which is a probable life-saving action.

End Game CEO Andrew Butel says the programme was originally developed at Otago University a few years back but is now in its third iteration.

“Part of the smarts built into it is EDS the Electronic Decision Support. They don’t screen people who they think are at risk, they screen everybody who has an alcohol-related reason for being submitted.

“These questions are all well researched from the likes of [Psychologist Ronald C.] Kessler and have been tested throughout the world. What we’ve done is stitch them all together so that we start off with a light set of questions: Have you ever driven in a car with someone who is drunk? Do you drink regularly? And as you answer ‘yes’ to more and more, it starts to open up and eventually if you go down certain paths it will ask you to tell us about your suicide plan.”

Butel says the system then flags the patient to the supervisor who is able to refer them on to various different agencies such as Mental Health Services.

Butel says the screening programme relies on a web-based .NET system called Rataora (hosted in Christchurch) which has been used for storing and cataloguing patient notes for a year.

The programme, which is to be introduced to more hospitals around the country, was developed after nursing staff recognised that drunk or drugged people often had major problems in their lives which have been recognised internationally as “surrogate markers” of suicidal tendencies.

Friday and Saturday nights between the hours of ten and eight in the morning are the busiest times and anecdotal evidence had suggested that repeat users of emergency departments were often alone and unsupported.

The iPad’s friendly user interface and portability means a health worker can approach people in the waiting room and ask questions in a non threatening manner.

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