This guest blog post is by Lynne Dunbrack, Research Vice President for IDC Health Insights.
“Someone will page you to let you know when your father comes out of surgery and how he is doing,” explained the waiting room staff person as she handed me a pager. At 95 years old, my father’s age and frail condition made the surgery more complicated. Unfortunately, I missed the page from the OR nurse who was reaching out to tell my brother and I that the surgery was taking longer than originally expected, but that everything was okay. We had wandered off in search of coffee, not realizing we went beyond paging range. We waited for hours, growing more concerned as the clock chimed another hour. Finally, after 7 p.m. the surgeon himself called me on my smartphone to tell me that the surgery went well, and that Dad was resting comfortably in the recovery room and we could come up and see him.
Little frustrates patients or their family caregivers more than waiting to hear back from physicians and nurses about test results, diagnoses, and procedures, or when they might be going home if they’re in the hospital. Effective clinician communication and collaboration solutions make it easier for clinicians to collaborate about their patients' care, and communicate readily with patients and family members. When clinicians communicate better, patients are more satisfied, leading to higher HCAHPS scores and reimbursement rates.
Healthcare IT organizations manage a wide range of communication solutions. These include telephony, voicemail, email, instant messaging, short message services (SMS), paging, video and web conferencing, and mobile devices. Many of these solutions are offered by different vendors, and add up to being a collection of multiple, parallel, and all too often, independent communication pathways. Because they’re point solutions, IT must expend a lot of effort to get them to interface with each other and with core clinical and operational systems such as EHRs, nurse call systems, and scheduling applications.
In contrast, platform-based solutions feature published, upward-compatible application programming interfaces (APIs) that support directional data flows and user workflow. A published API, also referred to as an open API, is published on the Internet and shared freely to encourage third-party developers to create new capabilities for the platform solution. In contrast, unpublished APIs often use proprietary protocols and require vendor tools that are difficult to learn and use. Upward compatibility (also referred to as forward compatibility) ensures that the API will continue to work when newer versions of the software are released. Published, upwards compatible APIs make it easier for the hospital’s IT organization to enhance platform-based solutions through self-development. New functionality can be readily added to keep pace with the needs of the IT organization and clinicians.
Security is a critical requirement when care team members are communicating patients’ personal health information. More than half of IT professionals responding to a recent IDC Health Insights survey reported that they were concerned (32.8%) or very concerned (18.9%) that clinicians were using native texting to send unencrypted messages that include protected health information. With more clinicians using personal or corporate-provided smartphones and other mobile devices to care for their patients, the risk of a breach of privacy or security is high unless the proper mobile security safeguards are in place.
Healthcare IT must strike a careful balance between securing PHI via encrypted messaging, and enabling clinicians to readily access patient information at the point of care to support clinical decision making in real time. It’s imperative that secure communication works within clinician workflows. Otherwise physicians will find workarounds that may not be secure or HIPAA compliant.
Healthcare workers are mobile, and the nature of patient care services is highly collaborative, particularly in the inpatient setting. It is vitally important that the care team can communicate in real time or near real time when caring for patients.
Fragmented communication and information handoffs can result in suboptimal workflows. More importantly, they often put patient safety at risk. The Joint Commission Sentinel Event database reveals that poor communication is the root cause in nearly 70% of reported sentinel events.
Clinicians want to be able to provide optimal care to their patients. But in a post reform environment, they spend nearly 80% of an eight-hour shift documenting care, endeavoring to meet key performance metric audits, trying to learn the new EHR system, and performing other administrative tasks.
Only 20% of clinicians’ time is devoted to caring for patients. This is not why clinicians chose to become nurses or doctors. Clinicians want to focus on providing excellent care, not struggling to master using the current technology provided to them by IT. Communication technology in particular should be transparent to clinicians, while enabling them to communicate and collaborate securely so that they can focus on their primary mission, caring for their patients.
At the end of the day, the value of a clinician communication and collaboration platform is in the insights it can provide to clinicians as they care for their patients.
The highly interdependent nature of healthcare processes frequently requires that care team members in one area respond in a timely manner to an event that has occurred in another. For example, a patient arrives in the ER with chest pain and shortness of breath. Time is of the essence when ER nurses activate the code team for a STEMI, alerting the team that a patient is being sent to the catheterization lab and needs to be prepped for surgery. CMS requires that hospitals meet a Code STEM within 60 minutes. A clinician communication and collaboration platform ensures that these alerts and information about the patient are delivered with a high degree of certainty to the appropriate clinicians who can act on it in a timely manner.
Connectivity between the clinician communication and collaboration platform and clinical systems further enhances care. For example, a bed alarm goes off, thus triggering an alert to the nurse’s mobile device that a patient has gotten out of bed. Results for stat tests sent from the lab system to the EHR are also sent to the physician’s smartphone.
When care team members can communicate better at hand-off points, it can help to:
Most of all, clinicians can have more meaningful interactions with patients and their families, enabling a positive experience for all involved.