Why don't doctors use secure messaging to coordinate care?

From the mHealthNews archive
By Eric Wicklund
10:01 am

America's hospitals are wasting $11.2 billion and a significant amount of time every year by using inefficient communication technology.

A new report, conducted by the Ponemon Institute and Imprivata, contends that many providers are still using pagers, overhead paging systems and even paper to facilitate patient handoffs and communicate between members of the care team. What they should be using, the report's authors argue, are mobile devices that make use of secure text messaging.

"The technologies that are in place today are just not keeping up with the changes in healthcare," said Ed Gaudet, general manager for Imprivata's Cortext product group. "Studies show that 80 percent of doctors have smartphones — why aren't we using them to coordinate care?"

The study of more than 400 U.S. healthcare providers focused on three areas of clinician workflow: patient admissions, emergency response and patient transfers. While collectively they cost the American healthcare system some $11.2 billion a year, that figure filters down to a stunning cost of $1.75 million wasted per hospital.

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More than half (52 percent) of the study's participants say time is lost in communication between colleagues because pagers are not efficient. Another 39 percent say the problem is exacerbated because text messaging isn't allowed, and 37 percent blame a lack of Wi-Fi. Also making the list: inefficient e-mail (35 percent), BYOD not being allowed (25 percent) and inefficient faxing (18 percent).

What’s more, healthcare systems have been hampered by the push to adopt electronic medical records, and are only now looking beyond EMRs to other areas of the healthcare setting in need of improvement, according to Gaudet. As a result, they're just starting to examine outdated communications systems and wondering whether to replace them or upgrade. Factors playing into that decision include wireless capability, interoperability and the quick adoption of smartphones and other personal medical devices by staff.

Nick Adams, co-founder and president of CareThread, a Providence, R.I.-based developer of care coordination solutions, says clinicians spend more time coordinating than they do actually providing care. That's primarily because communications technology is disparate and siloed.

"Everybody in the hospital knows who their patients are, but nobody knows who anyone else is" on the care team, Adams pointed out. "Nurses are tired of looking for doctors,” Gaudent added, “and doctors are tired of carrying around bandoliers of devices.”

So where are the bottlenecks?

When asked about communication problems in the patient admission process, Ponemon survey participants listed six pain points:

1. Waiting for an available bed or room (74 percent);

2. Waiting for a doctor/clinician to respond and sign off on the admission order (63 percent);

3. Delays with the department or facility that the patient is being admitted to (61 percent);

4. Delays in coordinating care with other clinicians (45 percent);

5. Waiting for patient information or diagnostic tests (37 percent) and

6. Delays caused by staff change-over (26 percent).

Thomas Kloos, executive director of the New Jersey-based Atlantic Health System's management systems organization, which serves the Atlantic Accountable Care Organization and Optimus Healthcare Partners ACO, highlighted the need for health systems to shift their focus away from siloed systems to solutions that stretch across multiple platforms, devices and locations.

"It's about time that clinicians are recognized as mobile workers," adds Bruce Eckert, national practice director for Beacon Partners. “What we're seeing is a general lack of thought going into workflow integration. Organizations need to understand their processes (and develop mHealth solutions) that are integrated into the workflow."

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