Mobile communication is an integral and growing part of every aspect of modern life, including healthcare. Fast and secure communication between care team members can measurably improve clinical efficiency as well as patient outcomes — this is a given.
In addition, federal and state requirements for electronic health recordkeeping are pushing many medical professionals to aggressively begin updating and integrating their electronic health records and communications.
However, many physicians and healthcare organizations still rely on multiple technologies and information systems for their communications. The time it takes to monitor multiple communication portals can take away from time spent with patients and allow important messages to slip through.
The problem
Several products are currently on the market to address the need for HIPAA-compliant mobile messaging among medical professionals. However, many of these solutions have serious flaws: some are social networks that make their money by selling access to their physician user base, while others are siloed solutions that only help those who work inside a given hospital system.
The case for a social networking application for physicians may make sense in Silicon Valley, where success is measured not in terms of patient outcomes but the monetization of physician contacts and the amount of time they spend on the app. While that approach may have some currency with physicians seeking the occasional job, a vast majority of medical professionals in the trenches are far more concerned with discovering ways to help treat their patients, ensuring continuity of care and reducing annoying bottlenecks in their daily workflow.
Some apps may see value in ad space and harvesting and selling physician contact data to third parties like recruiters, and paid second opinion services, but few physicians really understand that the end-goal of those kinds of apps is to simply monetize access to their personal contact information once they sign up. In other words, once a physician's data is on the sales block there, is no telling where it will end up, which is how today's social networking model operates.
The other approach to providing physicians with HIPAA-secure mobile communication capabilities, while it may positively impact physician workflows, tends to fall short in execution. Here is how: Apps that take a closed-loop, siloed approach effectively seal off a physician's access to the rest of a community's healthcare resources. The problem with that approach is that patients do not tend to access medical care within a single healthcare organization like a hospital system or physician group. They frequently have to navigate a highly fragmented healthcare system comprised of competing hospital systems, not to mention third-party services like radiology, labs and answering services. If the needs of patients do not begin and end at the door of a hospital, then why should a mobile healthcare communication solution?
At the end of the day, physicians inside small and large healthcare organizations alike are under increasing pressure to work as efficiently as possible while at the same time improving patient outcomes and addressing run-away healthcare costs that are themselves a symptom of the highly fractured nature of the healthcare system. A physician-centric communication solution that prevents the free-flow of information ultimately reinforces the same disconnected healthcare system that is under tremendous market and governmental pressure to improve among many fronts.
A mobile communication solution should, at the very least, enable physicians to operate securely and efficiently. It should break down the communication barriers that are themselves largely responsible for high-risk patients falling through the cracks before and after hospitalization. It can, and should, prevent high rates of readmissions, spiraling healthcare costs and patients whose conditions worsen rather than improve.
Physicians need more than just a mobile communication solution that is HIPAA-secure, but one that also shields their personal information, works regardless of practice type or location and maximizes their ability to work with other healthcare practitioners from the entire community — not just one organization. If we are to eventually arrive at a solution that provides seamless, coordinated care where costs and patient care are in perfect equilibrium, such as the growing accountable care organization model, then we need a mobile communication solution that connects physicians with other providers, embeds this in their workflow and serves the greater population.
The solution
The ideal messaging application for healthcare providers should include the following:
- Efficient and instantaneous physician-to-physician communication
- A secure community to share patient information and collaborate with medical colleagues, in a HIPAA-compliant manner
- Ability to quickly send medical images and documents between physicians
- Built-in local physician and pharmacy directories
- Ability to scale from small groups, to hospitals, all the way to large multi-enterprise organizations like ACOs
- Widespread adoption among medical professionals
- Availability across platforms including smartphones, tablets and the web
- Data that resides on secure servers, not users' devices
- Ability to remotely disable the app on a device that has been lost or stolen
- Long-term message archive, compliant with HITECH recommendations
- Ability to integrate with other health IT solutions
When all the information is at a physician's fingertips, faster and richer discussions on patient treatment and care can result. Also, with local physician and pharmacy directories as well as radiology services built into a secure messaging app, the time physicians spend finding colleagues, tracking down a pharmacy or waiting on an X-ray consult is cut from hours to minutes.
Bottom-line: A mobile healthcare communication solution needs to create a secure community to share patient information and collaborate with medical colleagues throughout a community to be able to encompass all the healthcare resources required by patients. It should integrate natively with third-party services like radiology, labs, answering services, even health plans. It should also exist completely on the cloud to ensure portability, security of patient and physician data, rapid scalability for large hospital systems and ACOs and continuous refinement of functionality.
Use cases
With the proper communication platform, healthcare providers of all kinds can communicate with colleagues rapidly and securely, with the confidence that their privacy and data integrity will be maintained. Here are some exemplary use cases based on actual users’ testimonials:
- A dermatologist can send the ENT surgeon an image of a complicated skin lesion to be removed. The surgeon is able to make a more efficient plan for surgery and reconstruction ahead of time.
- A family doctor in a rural area can collaborate over X-rays with an orthopedic surgeon in the nearest city. The specialist is able to determine if an urgent surgery or just a cast is necessary, saving the patient time, extra office visits and travel.
- A radiologist can communicate test results immediately to the ordering physician, who can in turn notify the patient and bring in for treatment, if needed, much more quickly.
- An emergency physician is able to rapidly receive and send messages, images and test results to consultants and referring doctors during a busy shift. They are also able to coordinate transfer of care with outpatient primary care, or inpatient hospitalists, thereby streamlining transitional patient care and closing the loop on any ER visit.
Selecting a mobile communication platform
Ultimately, when choosing a secure critical messaging tool for medical communications, physicians and healthcare organizations must carefully consider their professional needs as well as the potential to improve patient care. What features are absolute must-haves? What app characteristics would eliminate an app from consideration? Is the solution scalable? Is it cost-effective? Can it be integrated into existing health IT solutions? Answer these questions and others will help physicians to evaluate messaging apps and select the right fit for their organization.
A HIPAA-secure mobile communication solution should put physicians firmly in control of whom they connect with and who can send them messages in order to provide the best care for their patients. Any other model opens physicians up to unwanted contacts and wasted time and is unlikely to have widespread adoption.
Tracey Haas, DO, MPH, is CMO and co-founder of DocbookMD, a pioneer in mobile health communication solutions for hospitals, physicians and care-teams. DocbookMD has become the only healthcare communication solution officially endorsed by medical societies in 41 states across America and is available as a free download to nearly 300,000 active physicians