Overcoming EHR Messaging Limitations: Why Your Emergency Department Needs a Real-time Communication Solution

Healthcare is a team sport.

Like any winning sports team, it requires a great many individuals working in collaboration, knowing how everyone’s movements will play out. Every action is dependent on other actions. Timing and confidence in execution make or break a play.

The stakes are much higher in healthcare, of course, where problems in collaboration can have dire consequences for patients, staff and even the institution itself. Yet, we accept a range of inefficiencies in healthcare collaboration –– that no coach would tolerate from a sports team.

Electronic Health Record (EHR) systems have centralized patient data, but embedded EHR text messaging has not solved the operational challenges of quickly and efficiently coordinating patient care. Treatment can be delayed at best and delivered in error at worst. Staff are frustrated, leading to burnout. And the hospital potentially loses revenue.

A dedicated clinical communication and collaboration system that interoperates with the EHR provides a better solution. A quick look at a typical workflow can bring the pitfalls of relying only on EHR messaging to light.

Left Without Being Seen
Inefficiencies in collaboration exacerbates challenges in emergency departments. Approximately 30% of all ED patients require a consult, however time spent tracking down the right on-call specialist results in consult delays – contributing to overcrowding issues. The ED to admissions pipeline is a major bottleneck that causes patient and staff frustration. A lengthy admissions process slows down ED throughput while patients take up an ED bed. Patients in the ED waiting room can’t be seen until that bed opens. And those patients may choose to leave the ED out of frustration before being seen by a physician. For the hospital, that is literally revenue walking out the door, a metric tracked as Left Without Being Seen (LWBS).

On paper, it seems a straightforward process to get someone admitted from the ED to an inpatient floor. Yet, clinicians know that it is never that simple. The complexities involve finding the on-call hospitalist, waiting for callbacks, navigating electronic health record (EHR) systems, and coordinating multiple communications. This can easily take close to two hours while the patient is taking up a bed in the emergency room. How many patients and how much revenue have walked out the ED door in the meantime?

Despite the promise of seamless information exchange through EHR messaging, the reality falls short, and inefficiencies persist.

This inefficiency goes on today, many years after the adoption of EHRs. The limitations of EHRs in enhancing communication are multifaceted, including complex navigation, complex login procedures, and delayed responses. EHR messaging has not helped this situation; indeed many EHR vendors warn hospitals to avoid using the messaging function in critical situations such as strokes and code blue. Improving efficiency requires a different approach.

Bridging the gap with clinical communication and collaboration platforms
Thankfully, some hospitals have solved this challenge by using a dedicated clinical communication and collaboration (CC&C) platform to improve care team collaboration and expedite workflows. Unlike EHR messaging, CC&C platforms are purpose-built for real-time communication among care teams. CC&C platforms also integrate seamlessly with EHR and other critical hospital systems, allowing care teams to access and share pertinent patient information directly at the point of care. These integrations ensure that communication occurs within the context of patient care, enhancing the relevance and timeliness of exchanged information.

Innovation meets measurable improvements
In contrast to the longstanding inefficiencies observed, hospitals leveraging CC&C platforms have witnessed measurable improvements. The above ED to admission scenario took almost two hours. We’ve seen improvements that reduce it to as little as 40 minutes. The key to this success lies in simplifying the process of contacting the right person based on their role, eliminating the need to know specific names. This not only reduces wait times but also ensures that teams can efficiently convey the right information to the right person at the right time, expediting patient admissions and freeing up ED beds to improve patient throughput.

When teams operate more efficiently, everyone benefits – from patients receiving timely care to staff experiencing reduced frustration, ultimately contributing to the overall success of the healthcare institution. By embracing and implementing such solutions, healthcare organizations can foster a culture of optimized collaboration for a winning team.

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