COMMUNICATION TOOLS TO COMPLEMENT THE EHR Brian Edds, Vice President Product Strategy at Spok, Inc. ABOUT SPOK Decades of experience managing healthcare communications 98% customer satisfaction scores Financially viable, growing company Trusted by top names in healthcare 4,743 ADULT HOSPITALS SURVEYED 17QUALIFIED for HONOR ROLL ALL USE SPOK SOLUTIONS Source: U.S. News & World Report s Best Hospitals study 2014-2015 183 CHILDREN S HOSPITALS SURVEYED 10QUALIFIED for HONOR ROLL ALL USE SPOK SOLUTIONS Source: U.S. News & World Report s Best Children s Hospitals study 2014-2015 ABOUT BRIAN Has over a decade of experience in mobile strategy, software as a service, and enterprise software systems. Helped lead the strategy and development of Spok Mobile Is currently responsible for strategic product direction for Spok, Inc. 1
OVERVIEW EHRs=complex functionality, but increasing reliance on purpose-built solutions to interoperate Example: communications among care team members SAMPLE USE CASE TEST RESULTS lab tests via CPOE Request to Phlebotomist via EHR Ordering physician likely spends time frequently checking EHR for results Phone tag between Lab and ordering physician Results published Draws blood, delivers vials to the Lab Test results entered in the Laboratory Information System (LIS) SAMPLE USE CASE AFTERHOURS ANSWERING SERVICE Patient calls after hours Answering service pages physician calls answering service for details Answering service checks multiple times to see if encounter has been closed calls patient and updates EHR 2
SAMPLE USE CASE INPATIENT MEDICATION REQUESTS Nurse pages physician for Rx request calls back for details enters had to make a call Nurse checks EHR multiple times for Rx IMPROVEMENTS WITH MOBILE TECHNOLOGY REACHING CLINICIANS SMARTPHONES ARE EVERYWHERE 96% of physicians are using smartphones to support patient care BUT THEY RE NOT ENOUGH 61% 53% of physicians express concerns about having access to colleagues of nurses cite difficulties determining which physician is available Spyglass Consulting Study Point of Care Communications for s 2014 Spyglass Consulting Study Point of Care Communications for Nursing 2014 3
REACHING CLINICIANS In a two-month study at academic medical centers in Toronto: of pages were sent to 14% an off-duty provider 32% of those pages were urgent JAMA 2009 Frequency and Clinical Importance of Pages Sent to the Wrong EMPOWERING MOBILE PROVIDERS: STREAMLINING COMMUNICATIONS Give staff web access to the full directory Integration with on-call schedules Facilitate easy, secure messaging to individuals or groups Reach the right person on the right device IMPROVING WORKFLOWS WITH COMMUNICATION SOLUTIONS STAFF MEMBERS SMARTPHONES TABLETS CLINICAL SYSTEMS INTERFACES NURSE CALL TELEMETRY Contact and Scheduling Information MODES OF INTEGRATION SMTP HL7 API URL WIRELESS TELEPHONY REMOTE MONITORING DEVICES PAGERS STAFF MEMBERS VENTILATOR DIGITAL SIGNAGE WHITEBOARDS 4
CONNECTION KEY: THE DIRECTORY CONTACT AND SCHEDULING INFORMATION Include all key stakeholders not just hospital employees Make on-call schedules and scheduling exceptions accessible Seamless integration, not point-to-point delivery Future: Patient and Family External (i.e., referring physicians) Contractors Employees WHY THE DIRECTORY INTEGRATION IS KEY Save time For physicians more time with patients For call center staff focus on code calls and customer service For patient response better patient outcomes Improve satisfaction For physicians, nurses, and patients Cut code initiation time in half Quieter hospital happier patients Door-to-balloon time in 62 minutes SAMPLE USE CASE TEST RESULTS lab tests via CPOE Request to Phlebotomist via EHR Ordering physician likely spends time frequently checking EHR for results Phone tag between Lab and ordering physician Results published Draws blood, delivers vials to the Lab Test results entered in the Laboratory Information System (LIS) 5
SAMPLE USE CASE CLOSING THE CLINICAL LOOP lab tests via CPOE Request to Phlebotomist via EHR Acknowledgment and audit trail sent to EHR Results directly to ordering provider Results published Draws blood, delivers vials to the Lab Test results entered in the Laboratory Information System (LIS) CRITICAL TEST RESULTS MANAGEMENT (CTRM) MAKING A DIFFERENCE 11% Improvement in ED patient Discharge Time National Patient Safety Goal (NPSG) 2 Improve the effectiveness of communication among caregivers NPSG.02.03.01 Report critical results of tests and diagnostic procedures on a timely basis SAMPLE USE CASE AFTERHOURS ANSWERING SERVICE Patient calls after hours Answering service pages physician calls answering service for details Answering service checks multiple times to see if encounter has been closed calls patient and updates EHR 6
SAMPLE USE CASE AFTERHOURS ANSWERING SERVICE Patient calls after hours Answering service securely texts physician with message, patient s number, and EHR path calls patient and updates EHR texts answering service they close the case ANSWERING SERVICE SUPPORT Contributing to process improvements Save time for physicians Prevent transcription errors by sending information digitally Faster care for patients More efficient for call center to close out tickets SAMPLE USE CASE INPATIENT MEDICATION REQUESTS Nurse pages physician for Rx request calls back for details enters had to make a call Nurse checks EHR multiple times for Rx 7
SAMPLE USE CASE INPATIENT MEDICATION REQUESTS Nurse securely texts physician with detailed medication request enters via CPOE Nurse alerted when available STREAMLINED TREATMENT REQUESTS BENEFITS Significantly reduced physician call-backs More time with patients Faster treatments Happier staff Orders usually available in 15 minutes CLOSING THOUGHTS EHRsare designed for documentation, not purpose-built for workflow integrations and communication Key elements of communication: Getting hold of the right person On their preferred device And keeping track of every step Don t just automate current processes use the opportunity for business process engineering 8
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