Organizations struggle to find balance between today’s mobile clinical communications tools and frontline workflow needs

Healthcare organizations are undergoing a transformation as desktops are replaced with mobile devices to improve workflows and care team collaboration. These efforts, however, are undermined when clinicians fail to use hospital-issued mobile clinical communications tools and instead use workarounds, such as sending unsecured texts from personal phones, that put an organization at regulatory risk.  

A prime reason clinicians are taking matters into their own hands? Those mobile communications tools they were issued don’t actually meet their needs. Or, they do meet the needs of a subset of the care team, but not reliably because of a facility’s wireless service. Adoption rates also may be hampered because only a subset of the care team can use the app, or users weren’t adequately trained during rollouts and are neither comfortable nor confident in their use.

“It’s a rapid-paced environment, so introducing technology of any kind is going to initially disrupt your workflow and your thought process and slow you down. So, introducing technology into the healthcare environment has to be done very carefully,” said Joyce Sensmeier, RN, vice president of informatics for HIMSS North America.

Gaining buy-in through better clinician input

Smartphone technology has the potential to improve care collaboration and patient care by delivering relevant data from disparate information sources into one place. “It helps me share with my patients what I’m doing and why I’m doing it,” said Ashutosh Goel, MD, senior vice president and CIO for Bronson Healthcare Group in Michigan. “And it helps to have it all in the palm of my hand. It makes it a lot easier.”

But Goel and others admit physicians and clinicians still rely on outdated communications tools, such as pagers, for their convenience, reliability and cost. A survey of 620 hospital-based clinicians highlighted in the July 2017 Journal of Hospital Medicine showed pagers remain the most common technology for patient care-related communication. Almost 80 percent said they had a hospital-issued pager, and 49 percent preferred to receive patient-related messages using pagers.

“It’s the technology they are used to,” Sensmeier said. “It’s quick and easy, and they don’t have to learn anything new, and it’s a one-way communication. That fits their work style.”

But physicians like Goel, who uses five different clinical mobile apps on his smartphone, believes such asynchronous communication is evolving. At Bronson, its 800-bed hospital recently installed a mechanism to send pager-like text messages to physicians’ cellphones when they are on call. “That has helped tremendously in communicating quickly while preserving the less disruptive nature of pagers,” Goel said.

Re-architecting networks for a more wireless world

Another major culprit for low-mobile clinical communications adoption rates is inconsistent network reliability and voice quality. “I’ve seen where a wireless barcode scanner for medication management works on one side of the room but not for the patient on another side,” said Kelly Aldrich, DNP, RN-BC, chief clinical transformation officer at the Center for Medical Interoperability. “These connectivity issues frustrate our clinicians because we’re not giving them the proper infrastructure their mobile devices need.” 

“So, based on the lack of appropriate technology tools in the clinical environment,” she said, “clinicians, in order to improve their workflow practices, start using their personal phones to text one another. The problem with that was it’s a HIPAA violation and opens the possibility of patient identification errors. It’s a problem that I don’t think gets talked about enough.”

Cross functional engagement and a comprehensive roadmap are needed for long-term success

Beyond ensuring that everyone understands a technology’s intent and is comfortable with how it is to be used, organizations that develop a mobility roadmap that considers all clinical workflows and builds a trusted, layered medical-grade wireless network will see better success and adoption.

That requires ongoing training to raise the usefulness – and usage – of mobile clinical communications tools. Everyone from nurses and physicians to pharmacists and clinical nutritionists needs to understand proper use of a device and apps to securely access data and prevent an inadvertent leak of patient health information. It also requires health IT leaders frequently promote and communicate the strategic charter for mobile initiatives.

Goel also advises focusing on the value proposition to raise adoption rates for mobile clinical communications, such as saving time and reducing workflow disruptions. “Instead of saying, ‘I need you to use this phone so I can call you when I need you,’ pose it as, ‘If you use this phone, I will only call it when I absolutely need you. Therefore, you can put your mind at ease at all other times and actually get other things done.’”