Outstanding Innovation in Delivery Solutions:
Nancy Albert, PhD & Kathy Ray


In 2013, Kathy Ray, a business relationship manager supporting the Pediatric Institute and Children’s Rehabilitation Hospital, cared for her mother (pictured above) when she was discharged from an inpatient hospital stay. While being discharged, Ray noticed that her mother did not fully comprehend her discharge instructions. She thought there must be a better way to relay this important information to patients, so she leveraged her IT experience to invent a card that contained recordable, on-demand discharge instructions.

The first iterations of Ray’s invention were prototyped at home with her husband, who worked at American Greetings. Once she disclosed her invention to Cleveland Clinic Innovations, the technology began to take off and became My Recorded On-Demand Audio Discharge Instructions (MyROAD®).

Ray teamed up with Nancy Albert, PhD, Associate Chief Nursing Officer, Nursing Research & Innovation, to tackle MyROAD’s first clinical implication. The card, created in collaboration with American Greetings, plays pre-recorded messages about four different heart failure-specific topics. The messages deliver important instructions that can be replayed numerous times and are easily shared with family members.

“My mom was the inspiration for MyROAD. I knew she wouldn’t understand discharge information from various sources,” said Ray. “That’s where the idea was born – a simple card that allows you to press buttons and hear messages over and over with specific instructions related to a disease. [My mom] even contributed to the design. It was her idea to add a magnet on the back so she could stick it on her refrigerator and never lose it!”

The goal of MyROAD is to ensure that patients have consistent information to care for themselves upon returning home from the hospital. Between 2016 and 2020, Dr. Albert and a group from Cleveland Clinic conducted a research study to gauge the effectiveness of the card among patients with heart failure in Northeast Ohio. They found, and later presented at an American Heart Association Scientific Session, that the card improved early clinical outcomes following heart failure hospitalization. Patients who received the card were less likely to return to the Emergency Department (ED) 30 and 45 days post-discharge, were less likely to need a heart-assist device, receive a transplant or die from any cause at 90 days post-discharge, and were less likely to have a composite outcome of ED visit, all-cause hospitalization or death at 30 or 45 days post-discharge.

“The re-playable nature of the cards helps to remember important messages and overcomes adherence to self-care issues due to low health literacy,” said Dr. Albert. “[The cards] ensure patients, family members and other caregivers all have the same information.”

Dr. Albert and her team are currently developing a manuscript on the findings of the above study. They plan to translate the research by using the MyROAD card clinically among patients with heart failure who are hospitalized at any Cleveland Clinic location. MyROAD is specialized for heart failure at this time, but the ultimate goal is customized cards for an array of diagnoses. In an attempt to observe an effect on hospital readmission penalties for heart failure, the team is manufacturing the MyROAD card via American Greetings and will be rolling out the innovation to the entire health system in the fall.

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