An Introduction to Unified Communications for Hospitals

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1 An Introduction to Unified Communications for Hospitals Unified Communications is being promoted as an enabler of improved productivity, better internal collaboration, more responsive customer service and reduced communication costs. This article provides readers with a short explanation of Unified Communications and the benefits it brings to health care organisations in general and hospitals in particular.. Introduction Over the last few years, considerable attention has been given to the transport of packetised voice (VoIP) in addition to the transport of traditional data over Internet Protocol networks. The use of the same networks for transporting voice, video and data is referred to as network convergence. Whilst network convergence lays the foundation for Unified Communications, it is not a prerequisite that an organisation wishing to commence the implemention of Unified Communications should be running voice over an IP network. Although network convergence brings considerable savings, it more importantly enables new applications that can improve customer service and improve productivity. What is Unified Communications? Unified Communications is the integration of communication and collaboration technologies with enterprise applications and business processes in order to improve those business processes. Examples of communication and collaboration technologies include voice, video, conferencing, instant messaging (IM), presence, messaging, calendaring and scheduling while health care enterprise applications include Hospital Information (HIS), Order Entry and Results Reporting (OERR), Electronic Medical Record (EMR) and Picture Archiving and Communications (PACS) systems. Why implement a Unified Communications Solution? The communication and collaboration technologies referred to above currently operate in silos with separate addresses across multiple devices for , voice and IM. The ability to see a contact s presence status, manage your preferred method of receiving communications and contact coworkers directly from your address book via click to call enables considerable time savings in contacting and being contacted by coworkers. Furthermore, the storage of , faxes and voice mail in one inbox (Unified Messaging) facilitates easy access to these messages from multiple locations and devices. This convenience is enhanced through text to speech and voice recognition technologies since these enable one to have one s messages read out instead of having to read them as well as to dictate a reply instead of having to write it. The above benefits provide compelling arguments to converge communications. The ability however to combine these multiple communication and collaboration technologies into one application accessible via a single interface and integrate this with enterprise applications provides substantial benefits to health care organisations and their patients.

2 These benefits include the creation of new business opportunities and sources of revenue; improved billing cycles and employee productivity; better customer service, internal collaboration and business processes as well as reduced costs. Unified Communications supports the above and enables one to be contacted via multiple methods using the same address, device and user interface. The latter is illustrated in the screen shots below of the Flash based user interface for CommuniGate Systems CommuniGate Pro Unified Communications system. Figure 1: Inbox

3 Figure 2: Calendar Figure 3: Instant Messaging

4 Figure 4: Voic and Calls Figure 5: Dialer and Conference Bridge Unified Communications in Hospitals

5 The benefits that Unified Communications brings are particularly important for health care organisations given the collaborative, communication intensive and multidisciplinary nature of health care and the mobility of health care workers such as doctors and nurses. Unified Communications systems enable health care and other workers to access better information quicker at the point of decision making, thus leading to a better experience for patients and health care workers in general and better patient care in particular. This assists institutions such as hospitals to attract good quality doctors and nursing staff. The following use cases illustrate the use of a Unified Communications system in a hospital setting: 1. Mrs Jones visits Dr Edwards, a surgeon, at his rooms at the Riverside Private Hospital. Dr Edwards needs to admit Mrs Jones for surgery. He makes a booking via Riverside s HIS and sets up an automatic reminder for the system to phone Mrs Jones the day before her admission to remind her not to eat anything the evening before surgery. At the same time Dr Edwards books Mrs Jones for an X-ray at the hospital s radiology practice as he needs the X-ray and the radiologist s report to assist him plan his surgery. Mrs Jones has her X-ray taken and the study is sent to the local radiologist by the practice s PACS for interpretation. Unfortunately the radiologist on duty had a family emergency and had to go home for an hour or so. This wasn t a problem however because the radiologist changed his presence status on the Unified Communications system to indicate his unavailability. The system thus notified a colleague of his automatically that a study was waiting for interpretation. When this radiologist had reviewed the study, she dictated her report. The system sent the report and a link to the image to Dr Edwards inbox. As Dr Edwards was in his car at the time, the message reached him via his mobile phone. Given that he could not read the report while driving, the system read the report to him and he dictated a reply which was sent automatically as an attachment. 2. Mrs Jones was admitted at the hospital using the hospital s HIS. Although beds were in short supply at the hospital, the admissions clerk had just been IM d by a member of the housekeeping staff that a bed would be released in 15 minutes. This bed was allocated to Mrs Jones. On completing the admission, the HIS automatically notified case management and catering staff of Mrs Jones arrival and called an available staff member to escort Mrs Jones to her bed. 3. Mrs Jones pre- and post-surgery assessments indicated that she was particularly vulnerable to a surgical site infection. Based on her high SSI risk index, the hospital s infection surveillance system automatically triggered a notification to an available infection control nurse to monitor Mrs Jones condition. As Mrs Jones didn t feel well later that day, she used her nurse call button to call for assistance and the Unified Communications system found and notified an available nurse to respond to her request.

6 A laboratory result the next morning indicated the presence of an infection. This automatically triggered the setting up of a teleconference between Dr Edwards and the hospital s case management, infection control and nursing staff to plan the way forward. As a result of Mrs Jones worsening condition, the Unified Communications system was set to notify Dr Edwards automatically when the outputs from the networked medical devices and equipment monitoring Mrs Jones condition exceeded certain thresholds. In the interim, the case manager telephoned Mrs Jones funder about her extended stay in order to prevent any payment problems arising. On being requested for further information, the case manager was able to IM the relevant hospital staff member for the information while she had the representative of the funder on the other end of the telephone. The case manager was also able to bring the other hospital staff member (who by now had left the hospital building and was walking to her car) into the telephone conversation by dragging and dropping her name into the conference bridge screen on her computer. It is hoped that the above scenarios, although hypothetical, illustrate how Unified Communications systems can improve hospital business processes by reducing delays in reaching the right person at the right time. Although these examples are patient and doctor oriented, Unified Communications systems can also assist hospitals by generating new sources of revenue and reducing human latency in other areas such as supply chain and treasury management. What Should You Look for in a Unified Communications Solution? The following are some points that you should consider when evaluating a Unified Communications solution. Use of open standards Ensure that your preferred solution supports open standards such as SIP (Session Initiation Protocol) for signaling, POP, SMTP and IMAP for messaging and SIMPLE and XMPP for instant messaging and presence. The use of open standards will enable you to leverage as much of your current investment in communications and collaboration technology as possible while preventing you from being locked in by vendors. Also ensure that your preferred solution provides open API s (application programming interfaces) to facilitate interfacing your solution with existing and future enterprise applications. Ease of integration An out of the box solution from a single vendor with proven reliability will reduce integration costs. Scalability Ensure that the solution you choose is scalable enough to accommodate your planned and unplanned growth. Reliability

7 When lives are on the line, you need at least 5 nines (99.999%) availability. Portability across operating environments If you don t want to be tied to your current environment, your preferred solution should be tried and tested across multiple operating environments. Security Given the importance of confidentiality and security of information in health care, your preferred solution should support external (e.g. legislated) and internal security policies. Consistent user interface Your preferred solution should provide your employees, clients and suppliers with a consistent user interface to make it easy for them to access the functionality the solution provides while minimising the time it takes them to learn how to use it. This interface should preferably be the same as or similar to existing applications with which they are familiar. Friendly pricing model The vendor/s of your preferred solution should make it easy and affordable for you to pilot your solution and then scale the implementation based on the experiences and knowledge learnt during the pilot. Future proof Your preferred solution should have been designed to accommodate future developments in areas such as mobility and fixed mobile convergence (FMC) so that it won t be obsolete within a few years. In Conclusion Unified Communications systems are bringing considerable benefits to enterprises in many sectors of the economy. Given the communications intensive and mobile nature of health care, health care organisations should benefit even more from Unified Communications implementations than these organisations. If you want to generate new revenue streams or improve your business processes or if you re considering replacing an end of life PBX or implementing/upgrading a health care enterprise application, you should consider implementing a Unified Communications System. This article has provided you with an introduction to Unified Communications and the benefits it can bring hospitals. You might as a next step want to obtain first hand experience of a Unified Communications system before considering a larger pilot implementation. An easy way to do this is to download the 5 user free community version of the CommuniGate Pro system from Alternatively, you can trial its non-voice features online at

8 About the Author Nigel Sinclair Thomson is a Health Care and Unified Communications Consultant. He is contactable on [email protected] or