The Asante health system includes three hospitals and other medical facilities that serve some 600,000 people across Southern Oregon and Northern California. Asante brings in more than $1 billion in annual revenue, sees 100,000 emergency room visits per year, and has 75,000 annual urgent care visits.

THE PROBLEM

Asante needed a secure, HIPAA-compliant way of communicating among clinical staff members. As pagers were reaching the end of their lives, clinicians and hospital staff were looking for a solution to fill the gap in communication.

Asante has struggled with contacting large groups of clinicians in an efficient manner, which can lead to a delay in care for patients. As patients presented to Asante facilities with medical emergencies like stroke or trauma, many of the providers who are essential in taking care of these patients are community providers, and Asante did not have a streamlined approach to sending them notifications.

"Some of the care pathways require immediate actions from ancillary departments; previously, reaching these support teams by phone or pager was outdated and created potential barriers," said Dr. Lee David Milligan, senior vice president and CIO at Asante.

PROPOSAL

As a result of these needs, Asante engaged vendor Halo Health, which was able to enable clinicians and hospital staff to easily communicate, not only across teams, but also across coordinating hospitals, Milligan explained. This ability provides staff the opportunity to more seamlessly discuss and coordinate patient care while maintaining the security needed to comply with stringent healthcare data privacy regulations, he added.

"Asante was able to create workflows that will send urgent messages to our ancillary departments when an order is placed within the Epic EHR."

Dr. Lee David Milligan, Asante

"Halo provides Asante the ability to send real-time unified communication to all staff, including nonclinical and community partners, to address the needs of the patient," Milligan said. "These messages are HIPAA-compliant and auditable.

"The vendor offers modern solutions that can be used by a variety of devices and are user-friendly," he continued. "The flexibility within the platform allows users to collaborate with others by leveraging the technology they already own. The cloud-based structure provides reliability and accessibility that is not dependent on local resources."

MEETING THE CHALLENGE

Halo currently is used by many of Asante's staff members and community health organizations. In the beginning, it only was used by providers for basic text messaging to other providers regarding patient care. This has evolved into mobilizing alerts, critical result and urgent ancillary order notifications, and the creation of teams for virtual connectivity.

"Clinicians now can message each other instantly to get answers to questions or to have a quick consult regarding a patient," Milligan noted. "Halo has allowed for a streamlined way to communicate with providers directly without having to spend many minutes on hold with answering services or providers' offices.

"The vendor's on-call scheduling was able to integrate with existing AMiON schedules to ensure appropriate on-call staff are only notified based on their work schedule," he continued. "This allows for one place to create paper-free schedules and reduces manual errors."

Images can be shared easily with care teams without the worry of a privacy breach involving personal devices storing PHI, Milligan said.

"Asante was able to create workflows that will send urgent messages to our ancillary departments when an order is placed within the Epic EHR," he said. "Halo blasts can be used to send mass alerts to everyone across the organization. The creation of incident command teams within the platform was widely used during the recent pandemic and wildfire disaster in Southern Oregon, at a time where the network infrastructure was down and Asante was still able to coordinate and mobilize emergency responses."

The communications tool is not only beneficial for the clinical teams but instrumental for providing support and quick response times from the IT division.

"Senior leadership can quickly communicate with key stakeholders, if Asante is experiencing a downtime, and pull together team members to discuss and find ways to quickly resolve the issue," Milligan said. "Clinicians can reach out to their Epic support team for real-time assistance."

Halo also is open to ideas for changes within its platform.

"Recently, Asante had a request to add color-coding to messages so staff can quickly identify which location is responsible for the message," Milligan explained. "This enhancement would greatly improve efficiencies within our TAC workflow where multiple messages can be sent for many different patients during a short period of time."

Halo has agreed to send this idea to their development team for potential change in future releases.

RESULTS

Asante was able to achieve STEMI accreditation by using the communications tool to send one alert to activate the clinical response team. STEMI accreditation requires that cardiologists, cath lab personnel, phlebotomists, imaging technicians, house supervisors and charge RNs receive the same notification at the same time.

Previously, Asante was not able to meet this requirement.

"And Asante has been able to increase timeliness of care by implementing notifications when certain orders are placed in Epic," Milligan said. "One example is sending an arterial blood gas (ABG) order to respiratory therapy when someone presents to the ER with diabetic ketoacidosis symptoms.

"This notification has greatly reduced the amount of time for clinical decision-making and getting the right care to the patient at the right time."

ADVICE FOR OTHERS

"Fully understanding the use-cases for this technology and setting expectations when needed is key," Milligan advised. "Alert fatigue is continuing to become a larger issue, and Asante wanted to be cognizant of this with the clinicians. Asante has created numerous policies around etiquette and when to use the technology appropriately.

"Developing ongoing training programs for new and current users of the technology is important," he added. "Many inefficient workflows are discovered by frontline staff, and if they have the knowledge of what the technology can do, then they are empowered to find solutions."

Patient care decisions are made by using the secure message technology. Ensuring there is a diligent audit workflow for compliance concerns that may arise is key, he concluded.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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