By Matt Phillion
Collaboration in healthcare is always evolving, though not always as rapidly as we’d like. Efficient communication and sharing of data are key to patient care improvements. The healthcare integration market is enormous—expected to hit $7.5 billion by 2026—and organizations are constantly on the lookout for better ways to collaborate securely to improve patient care.
“The industry’s challenges have been amplified over the past year,” says Will O’Connor, MD, chief medical officer for TigerConnect, a communication and collaboration platform for healthcare organizations.
Two main challenges have come to the forefront as hospitals adjusted how they treat patients during a pandemic, O’Connor says. First, the electronic medical record (EMR) environment has presented communication hurdles.
“We’ve had EMR for 30 years, and they’ve been pervasive for the last decade,” says O’Connor. “I think there’s been a strong overreliance on the EMR as the solution to everything. That’s because a lot of providers spend a lot of time and money on EMR tech, so they want it to do everything, which means that we’re asking it to do something it’s not meant to do.”
Secondly, Connor notes, “the industry is still using fax and pagers to communicate. A lot of health systems are reliant upon these systems, yet they are not connected in a meaningful way that fosters communication.” In a modern world, older communication methods are prohibitive to maximizing communication between caregivers.
“Older technology like pagers and fax machines are not a good way to communicate in any industry, and certainly not in healthcare,” says O’Connor. “That’s what I see as the biggest hurdle.”
Healthcare has a tendency to resist change when it comes to communications technology, and evolving away from the customary methods of collaborating, whether that means pagers or landlines or something else, has been a hard sell for many hospitals.
“People often try to force tools that are not good for communication and in doing so, create inefficiencies,” says O’Connor.
Clinical communication and collaboration platforms
This is where clinical communication and collaboration (CC&C) platforms come into play. “These technologies are available today, designed for healthcare,” says O’Connor.
CC&C is a sort of offshoot of the EMR revolution. When EMR first rose to its current prevalence, organizations weren’t looking for all of their EMR solutions from one location—they might have been using software from several vendors to make everything work. EMR products became more defined, though, with options springing up that were designed to work better together as a single offering.
This kind of evolution is starting to happen with CC&C offerings, as well. “We’re seeing job titles like unified communications director becoming more common, and the industry is now recognizing CC&C much the same way EMR was recognized,” says O’Connor. “These leaders get it; they understand the need for this kind of technology.”
There’s still a struggle in the field with understanding the best way to communicate between providers, support staff, and patients, and how a CC&C can address that—and cut down on the signal-to-noise ratio for providers to help improve care.
“A CC&C includes all your alerts, alarms, and notifications—any form of communication in healthcare that you may get, whether it’s a message to me, or in the context of the job I’m doing, or an alert for a patient I’m taking care of,” O’Connor says. “All of those communications come through the same place.”
And information overload is a real thing in healthcare. “Everything is competing for the primacy of notification,” says O’Connor. “If I’m taking care of a patient in a room, and my old wireless handset device rings, I don’t know if that’s a patient who has pushed a call bell for water or if they’re in distress and need immediate help. Put it all in one spot and you let staff manage their work better rather than be overwhelmed by alerts.”
The ability to triage information is enormous. It can help alleviate the risks of safety issues, and it offers a better experience for both patients and providers.
Real-time location systems
Alarm management and improving provider experience is where the concept of real-time location systems (RTLS) shines.
“At the base of what RTLS systems do is that they track a person and their location,” says O’Connor. “For example, a nurse [on duty]. With RTLS, if there’s an alarm going off, their physical presence answers that alarm and turns it off. There’s a record—I was there, I addressed the alarm.”
The reporting component is essential. By tracking and reporting, the need to manually manipulate the response creates more opportunities for better care.
“It enables staff to operate at the top of their license,” says O’Connor. “That’s what we want nurses and doctors to do. We don’t want them getting water for a patient nine times a day, necessarily. The right system routes the alarm so it’s going to the right person.”
So, for example, a request for water would go to a tech, and the RTLS system would identify the tech’s presence with the patient. This frees up the nursing staff to address time-sensitive tasks requiring their level of expertise. “It’s taking the burden off of people to help them do the best work they can,” says O’Connor.
Communication in a COVID-19 world
The benefits of a technology like RTLS go beyond improving efficiency. There are particular benefits on the patient side as well.
“COVID has exposed a lot of weaknesses,” O’Connor says. For example, patients can no longer have family members with them in the hospital anymore, at least in the ways they once did. “Those family members might have acted as a buffer between the patient and the provider,” says O’Connor. They might have gone to get the patient water, for example, but now the nursing staff must absorb this work.
Because patients’ family or other external caretakers can’t be with them on-site, there’s a new level of need for external communication, and the right tools can help address it.
“These patients may not be able to communicate, and suddenly [because of COVID-19], you’ve got to call the family from the floor,” says O’Connor. It’s one thing to speak to family members in the room with the patient, but with COVID-19, updating loved ones about a patient’s status is suddenly much more complicated.
It turns out that text message is by far the most preferred method of sending status updates to family members, O’Connor says. “With a five-second text, you can reach out to say, ‘We have your spouse here, they’re doing better, and they can check out tomorrow.’ And this saves a nurse or doctor a 20-minute phone call trying to get in touch with the patient’s family.”
Converting phone calls and chasing down family members into quick, easily sent texts means freeing up providers to handle more volume. “If all my communications for the day can be done in 35 minutes instead of two hours, I have more time with my patients,” says O’Connor.
Not having the family in the hospital has exposed how traditional communication between providers and family members has actually been inadequate. Ensuring instructions get where they need to go has always been difficult in the best of times, but now it’s something that a CC&C solution can assist with.
An eye on security
Of course, with any technology, especially one involving conversations that extend outside the hospital, it’s important to consider cybersecurity.
“We can’t just simply text patients; it’s not HIPAA compliant,” says O’Connor. “What we do, and what CC&Cs generally do, is send a secure link [via text] that will open up an app-less experience. We can push all security through a browser link.”
Being app-less is important, O’Connor says, because apps can come with their own security and adoption challenges. Also, having the right methods in place—an easy-to-send secure link, for example—can help keep staff from doing the wrong thing while trying to do the right thing. It helps avoid the temptation to simply text the family unsecurely, opening up the risk of a data breach.
Barriers to adoption
So what has stood in the way of more adoption for CC&C or RTLS options? In some ways, the frustrating build-out of EMRs bears some of the blame. “EMRs took all the oxygen out of the room,” says O’Connor. “Clinicians might think: Now you want me to use something else?”
There was a massive amount of work implementing and training providers on EMR, and the workday shifted significantly with its advent and adoption, forcing providers to spend less time with the patient.
“The extra time working with new technology has to come from somewhere, so it comes from their personal time, or time with the patient,” says O’Connor. “A lot of people in medicine have been resistant because of bad experiences rolling out EMR.”
But the time saved with a CC&C system can be a game changer, if everyone gets on board. O’Connor mentions a colleague, an ED doctor who still uses pagers and loses time waiting for consults to call him back, which could take anywhere from 30 seconds to two hours.
“But what if you don’t have to look at the board and see who’s on call: the solution tells you,” says O’Connor. Start typing the specialist you need, and the right person pops up on screen.
“That’s when you get people hooked,” says O’Connor. “And the communication is just one small part of it. Data, analytics, identifying which nurses are overloaded—a CC&C helps your data tell a story, and that leads to better care.”
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at email@example.com.