Communication tools designed for specific care pathways can speed up care by streamlining connections between providers, but as Bon Secours Mercy Health in Ohio and other providers have found, integrating those tools directly into the electronic health record can make a big difference.
Ateeq Haseeb, M.D., chief medical information officer for Bon Secours Mercy Health's Toledo region, recalled the bad old days when everyone was carrying beepers. “You had to page the doctor and wait half an hour, and you didn’t even know if the doctor got it,” he said. “Then if they are not on call, and somebody from their team is on call, there is no way you can route it to that doctor.”
Several years ago, Bon Secours Mercy’s Toledo region started using communication tools from a company called PerfectServe. “That was exciting, because now you could send the page through a text mechanism, and the doctor gets it on their phones or their devices,” Haseeb said, and I can see if it's read or not.” That was phase one, but it was still challenging, Haseeb said, because it relied on doctors downloading an app and using it.
In March 2021, the health system rolled out a new deployment of PerfectServe in seven hospitals with almost 7,000 clinical staff members. Haseeb said 60 to 65 percent of those employees are already using it regularly. Whereas the previous app-based version took some time to pull out your phone and send messages to other providers for consultation, the new version works from within the clinical record. “If I'm in the medical record of patient John Doe, and I need John Doe to get a consultation with a gastroenterologist, in two clicks, I can have that happen,” he explained. “One click opens the PerfectServe window. It says new message, and it auto-populates the name of the patient, the date of birth, the location of the patient, room number, hospital. And if I want to add anything, I can add details about the medical consult needed and then click send. That's it.”
Haseeb said that cuts about three minutes from busy staff members’ time of care for each patient who needs a consult. That could be 30 minutes per shift. “That's very precious time,” he said. “I think the satisfaction level has been there, and it has decreased the time required to initiate that consultation.”
“Our IT team that was definitely involved, especially with the integration into the EMR, because you don't want any breach of anything into your EMR, because that can be huge,” Haseeb said. “So the IT and security became involved. The technical team worked really hard on the back end as we piloted this, and got it up and running.”
Ben Moore, PerfectServe’s chief product officer, notes that the EHR integration using application programming interfaces allows them to seamlessly follow the existing workflow of the physicians and the nurses without having to leave the EHR. “Auto-populating all that patient information is just a huge time saver,” he said.
PerfectServe also allows for the requests for consultations to be automatically routed following the clinical schedule. “We're not allowing the wrong doctors to be messaged at the wrong time,” Moore said. “By hooking into Epic at Mercy, we were able to put our routing right into the heart of the EHR essentially, which really reduces friction and improves speed to care.”
He noted that people commonly use text messaging with delivery receipts, “but actually making that work in a healthcare environment within the context of an EMR delivers tremendous value, but is maybe a bit more challenging to build and get off the ground than it sounds.”
The University of Tennessee Medical Center did a similar integration with PerfectServe and its Cerner EHR last year. In an internal study, the organization found that care team messaging within the EHR yielded increased nurse and doctor satisfaction and decreased time to initiate communication.