Considering its team-based nature, the healthcare industry continues to struggle with communication challenges — between providers and between patients and providers. After Ben Moore, CEO of healthcare communications platform TelmedIQ, experienced these communication gaps firsthand, he decided to found a company in 2012 to fix them.
"When my daughter was born, it was a complicated pregnancy, and my wife and daughter ended up spending eight weeks in the hospital," Mr. Moore says. "I noticed a lot of issues in communication between clinicians, specifically when patients were handed off between shifts, between nurses and doctors."
This content is sponsored by TelmedIQ
Clinical communication, by and large, has not kept up with the digitization of most other aspects of healthcare. By some estimates, 85 percent of healthcare organizations today still rely on pagers for communication. That number is on the decline as providers swap pagers for other mobile devices, such as smartphones. However, many communication platforms for smartphones and tablets still don't address a key communication challenge healthcare providers face: integrating communication between providers and integrating communication between hospitals.
The current state of clinical communication
As is, communication in the healthcare setting is not very comprehensive across an organization or across the care continuum, and many communication platforms don't address this gap, Mr. Moore says. Implementing solutions just for communication between nurses or solely for physicians doesn't allow for optimized team-based care.
"A lot of the point solutions are built around connecting physicians or nurses, but there [are] very few platforms that span the bridge between all the clinicians," he says. "What you see is adoption initially on some of these secure texting platforms, but since they've only been deployed to physicians, they only get marginal use. You need to involve all clinicians."
That barrier between communication lines extends to providers who work outside of the hospital yet are still in the patient's care network. This presents a double whammy in today's healthcare environment, where care coordination and patient outcomes directly affect a hospital's reimbursement.
"The fact that a certain hospital has one communication platform but [another] healthcare system has a different one and they don't talk to each other [shows] a complete lack of integration," Mr. Moore says.
Part of these disconnected communication patterns are due to the rudimentary technology providers still largely use: pagers.
"The 'state-of-the-art' in healthcare communication has been the pager," Mr. Moore says, but that's changing. "In transcending hardware pagers into a software domain, there's a huge opportunity for integration, but that's largely an open challenge that hasn't been addressed by most companies."
Where clinical communication platforms fall short
There has been a proliferation of platforms seeking to address communication challenges in the clinical setting, but Mr. Moore suggests they miss the central mark of communication integration.
He describes the current offering of clinical communication platforms in two generations. The first generation focuses on secure texting. These vendors “took text messaging and secured that channel," Mr. Moore says. "[But] there's not really any efficiency provided by those solutions, and no clinical workflow. They don't really solve any of the fundamental communication problems we observe."
The second generation of vendors starts to move toward integration with other clinical systems and include features such as call centers and links to physician schedules.
But Mr. Moore says vendors need to take it one step further with a third generation to truly offer value to providers. Secure messaging services alone do not achieve this, he says, because they do not change how providers work nor create efficiencies. "If it's just purely secure messaging, that's not really adding value," he says. "You need to address clinical workflows."
Additionally, many vendors focus their offerings on text messaging without considering how often clinicians still communicate verbally. Mr. Moore estimates between 30 and 50 percent of communication between clinicians is via voice. Few vendors today provide voice capability, like speaking on the phone and leaving voicemail, on top of the texting capability.
"We think the industry has to go to a more strategic communication platform that integrates tightly with the medical record to integrate workflow and care coordination," Mr. Moore says.
A comprehensive solution
Mr. Moore describes TelmedIQ as a "healthcare communications hub" that integrates communication between providers and integrates communication between hospitals. TelmedIQ offers HIPAA-compliant secure text messaging, mobile paging and automated workflow solutions that integrate with hospitals' clinical systems.
Any given hospital is likely to employ between seven and 10 different communications platforms for different purposes, including in-house pagers, nurse house phones, secure texting and email. "We came along and said, 'Well, adding another solution doesn't really fundamentally help a hospital. It just creates more management overhead and more clutter for communications,'" Mr. Moore says. Instead, he and his team worked to simplify the number of platforms. "We've become the router for communication within the hospital. By bringing all the systems into a single hub, we've unified all the efforts and provided visibility that has never before been achieved."
The TelmedIQ platform is compatible with smartphones on which providers can send text messages, images, files, and audio and video messages to one another. The platform also functions as a digital pager. Users still have pager numbers, but all text and voice messages sent via pager are routed through the smartphone. This allows users to use their personal devices while keeping that number private. TelmedIQ also features an automated medical answering service that integrates with clinician call schedules and forwards calls and messages to the appropriate provider.
These features address the internal integration hospitals seek, offering a streamlined communication channel between different types of providers within an organization. But TelmedIQ also seeks to solve that second integration challenge — the problem of cross-hospital communication — largely by integrating the platform into a hospital's EHR.
"By integrating with the EMRs [and the] care team, we can actually provide better coordination of communication," says Mr. Moore, which in turn results in improved patient care quality and outcomes.
Clinical information communicated via the TelmedIQ platform is automatically uploaded into the EMR, providing a patient's comprehensive care history. When providers switch shifts or if there is a care team transition, the TelmedIQ platform allows the departing care team to fully hand over a patient and all corresponding information to the next provider and effectively share their notes.
"By putting the patient at the center of the workflow and uploading tasks that a physician would otherwise have to manually do in the EMR, you're providing a lot of value," Mr. Moore says.
All this integration within hospitals and between hospitals relates back to patient care and safety, and Mr. Moore mentions the patient has a critical role to play in care delivery, as well. TelmedIQ is exploring ways patients can start using its tools and platform, especially in the transition between inpatient and outpatient settings. He says the platform can recognize when a patient is discharged from a hospital, and automatically notifies that patient's primary care physician when that happens.
"The majority of patient communication into a healthcare system or practice happens either one day before or one day after a visit to the hospital, so by recognizing that pattern and providing a tool for patients where inbound communication can be distributed and triaged, you can offload a lot of costly follow-up with the patient," Mr. Moore says.
Currently, when a patient calls a healthcare facility using TelmedIQ, the patient's call is routed to an on-call provider. Later this year, the company plans to add capabilities for patients to text a healthcare facility in addition to calling.
"This is not a solution for [just] doctors, [or just] nurses or patients; it's a solution for all stakeholders in the continuum of healthcare delivery," Mr. Moore says.