In healthcare, a lapse in communication between providers can have significant repercussions.
For one, hospital system miscommunication is costly. Journal of Healthcare Management published a study finding U.S. hospitals waste $12 billion annually on communications inefficiencies. Poor clinician communication can also negatively affect patient safety. The Joint Commission found the root cause in 21 percent of sentinel events — defined as an unanticipated adverse event in a healthcare setting resulting in death or substantial physical or psychological injury to a patient — to be communication errors.
The need to improve communication between clinicians is clear, but the process of doing so is less evident. Moreover, how can health systems facilitate seamless communication across a multihospital enterprise? The answer: employing the right technological tools.
"It has truly been a fascinating evolution to see to see how healthcare communication has changed," said Andrew Mellin, MD, CMO of Spok, a company offering a complete communication platform that includes HIPAA-compliant texting, paging, on-call scheduling, clinical alerting, and contact center solutions. "Today, we have this very sophisticated, highly interconnected world where communication systems are core to keeping our health systems running."
Healthcare communication is complex; It encompasses much more than simply relaying information over a phone call or text message. During an Aug. 24 webinar sponsored by Spok and hosted by Becker's Hospital Review, Dr. Mellin moderated a panel during which industry experts shared their organizations' progress toward improving communication as well as tools they've employed to reach this goal.
Implementing communication technology
Many hospitals and health systems do not have a change management program for implementing communication technology. In a 2017 Spok survey, 63 percent of surveyed CIOs reported their hospital does not have a formal process to quantify the success of technology projects that support communication needs of mobile staff. When Durham, N.C.-based Duke Health opted to move to Epic in 2013 and eventually adopted an integrated EHR across the enterprise, the health system learned the value of having a formalized process for how to apply and decide which technologies to implement. To ensure the health system's technological investments aligned with its strategic mission, the system made sure clinicians were involved in IT governance groups charged with making these decisions.
"Governance isn't just about the EHR. It's about the application of technology and clinical care including [tools] like communication platforms," said Brian Griffith, MD, assistant professor of medicine of Duke Health.
Leaders within Duke Health aim to meet the health system's overall mission of 'advancing healthcare together' by focusing on communication, according to Eric Poon, MD, MPH, the health system's chief health information officer. For providers across disciplines to effectively communicate, they have to have the right technology in place.
"It is part of our role [as leaders] to maximize the use of existing technology and leverage new technologies to facilitate communication, whether that is in the domain of population health, increasing patient satisfaction or simply empowering the patient," Dr. Poon said.
Technologies can also alleviate many of the time constraints physicians face that affect their ability to communicate. Salisbury, Md.-based Peninsula Regional Medical Center employed Spok's paging software to facilitate quick, effective communication between staff members.
"We found some powerful ways to leverage the communication tools that are available from Spok," said Chris Synder, CMIO of Peninsula Regional Medical Center, a regional trauma center with 3,500 employees. "We are busy guys and ladies. We need to have these types of tools within our workflow and, if you can integrate this information into the EHR, it will drive people to want to use it."
Answering that crucial question — Who do I call?
Knowing which physician to call regarding a particular issue is a core challenge staff members face across all hospital systems. A Spyglass study found 14 percent of pages are sent to physicians who are not on duty or on-call, indicating hospitals need updated lists of providers who are available and make those widely available to eliminate any potential for miscommunication.
In years past, Peninsula Medical Center often took a gamble to figure out who to call by getting in touch with the operator and hoping he/she had an accurate schedule of staff members. The trauma center has since progressed and has adopted physician-targeted paging. Peninsula Medical Center has an updated list of available providers that is integrated into the EHR so the list is "available at your fingertips," Dr. Synder noted.
"[The list] eliminates any delay in the potential miscommunication of information basically through a duck-duck-goose process," Dr. Synder said.
Duke Health, which includes three hospitals and 16,627 full-time employees, constantly has an influx of personnel, making it difficult for members to send the right message to the right person. For example, there are four nephrology teams across Duke's health system. It was challenging for clinicians to decipher which specific nephrologist should be paged for a specific patient across the four teams. However, the health system overcame this challenge by adopting a unique solution.
"Healthcare delivery has transitioned to being team-based delivery and what the team may look like across disciplines may be very different," said Brian Griffith, MD, assistant professor of medicine for Duke Health. "Being able to identify who to call first for a patient and how we connect between teams has been a problem we have had to figure out from multiple different angles."
To overcome this issue, Duke Health adopted the use of functional pager numbers that individual teams self-manage. This works by each team having a single pager number and a specific team member who is responsible for that team's patients and relaying the message to the appropriate person.
"[Figuring out who to page] is something we work on through the pagers and we've had benefits from integrating them into the EHR," Dr. Griffith said. "The combination of having the EHR and the communication platform gives us a lot of flexibility to make sure critical messages go to the right person consistently."
Blending the old with the new
Many providers prefer pages as their method of communication, and some may hesitate to adopt other emerging technologies. However, health systems and hospitals can opt to marry the two, giving providers the option of using pagers in tandem with other platforms to articulate messages throughout the organization.
"Pagers are still the gold standard. We still use group paging in a number of different areas," Dr. Synder remarked. "We have developed a culture where providers have a choice. Many haven chosen the [Spok] mobile app because they get more information. We are evolving over time."
To view the webinar's slides, click here.
To view the webinar's recording, click here.