CareRef app streamlines Christiana Care clinicians’ access to evidence-based guidelines

CareRef, a cloud-based application created by Christiana Care, is an innovative resource that allows clinicians providing direct care to patients to readily access the latest evidence-based guidelines and pathways of care specific to Christiana Care Health System.

The iOS and web app was developed completely in-house by the Health & Technology Innovation Center at Christiana Care and is available in Apple’s App Store.

CareRef provides effective, efficient, secure communication of clinical pathway guidelines and serves as the single source of truth for physicians, with governance over how the content is managed and updated over time. The app is the result of a two-year collaboration between the Innovation Center and clinical leaders, who examined how they reference clinical guidelines at the point of care.

“It’s a model for best practice when you develop a new technology to partner with the end user,” said Neil Jasani, M.D., MBA, FACEP, chief learning officer and vice president of Medical Affairs. “You want the end user to drive the design process because the end user is the person at the bedside with the patient.”

The mobile reference tool can be accessed anywhere via iPhone, iPad, laptop or desktop computer. Having ready access to guidelines supports the health system’s commitment to excellence through evidence-based pathways of care.

“CareRef supports Christiana Care’s efforts to ensure the right care, with the right people involved, at the right time, for every patient,” said Randall Gaboriault, chief information officer and senior vice president of Innovation and Strategic Development.

Developing the content and feel of the app was a creative, collaborative process.

“We met with clinical leaders from different areas of the health system, led by Dr. Jasani,” said Catherine Burch, Innovation Center director. “We spent a lot of time with physicians. We shadowed; we surveyed; we talked.”

During the process, the teammates learned that doctors were relying on their personal reference systems.

“Clinicians were carrying all kinds of references, including pieces of paper, or storing information in their e-mail,” said Lisa Maxwell, M.D., associate chief learning officer. “Sometimes, they weren’t the most up-to-date guidelines or the guidelines we already have at Christiana Care.”

Developing the app also required input from the IT Governance Council, the IT staff, iLEAD and service lines across the system. More than 100 clinicians participated in a proof-of-concept trial.

“It was homegrown, so we were able to develop the app successfully and at a much lower cost,” Dr. Maxwell said. Because the app was developed in-house, there were no licensing or developing fees.

“Because it is a source of truth, there is very strict governance as to what goes on it,” Dr. Jasani said. “It could be the cornerstone for how we deliver clinical information.”

The app will continue to be updated with new information, and new features and design enhancements are already being planned.

CareRef is available to any user with a Christiana Care login, said Lori Dell’Oso, project manager at iLEAD. CareRef can be accessed onsite and remotely from the app or the intranet portals.