Hospital and health system leaders are moving forward with alacrity to modernize their mobile communications systems, which span a range of smartphone capabilities and clinical communications and collaboration (CCC) solutions, in order to improve care delivery, operational efficiency, and staff, especially clinician, satisfaction. Thus are the top-end results of a study based on a survey conducted last year of over 100 hospital and health system leaders by the Menlo Park, Calif.-based Spyglass Consulting.
Spyglass Consulting posted a press release to its website on the subject, on Feb. 22. It began: “Today, Spyglass Consulting Group released its most recent healthcare report entitled Trends in Clinical Communications and Collaboration 2021. Study shows that 90 percent of hospitals and health systems surveyed had made significant enterprise-wide investments in Smartphones and Clinical Communications & Collaboration (CCC) solutions to drive clinical transformation and address the mission- and patient-critical communications, collaboration, and documentation requirements of patient care teams, medical support staff, and non-clinical mobile workers within the hospital and across the care continuum.”
Indeed, the press release noted, “With the passage of the Affordable Care Act, healthcare providers surveyed are rapidly transitioning toward patient-centered care and value-based reimbursement models. Clinicians are under increased pressure and scrutiny to communicate, collaborate, and coordinate care more effectively across a wider array of team members within the hospital and across the care continuum. Hospital IT has a business imperative to evaluate and deploy next generation smartphone-based solutions to address existing communications gaps and inefficiencies and achieve the Quadruple AIM framework.”
Indeed, among the top findings of the survey were these:
Ø During the COVID-19 pandemic, healthcare provider interest and focus on CCC solutions was strong. Majority expanded existing CCC deployments to address the communications, collaboration, coordination, and documentation requirements of essential frontline workers, medical staff, and ad hoc care teams across the care continuum who handled monitoring and managing contagious and sometimes severely ill COVID-19 patients.
Ø Adapted mobile communications strategies. Providers adapted their mobile communications strategies to address the business, clinical, and operational realities of the pandemic. They optimized their business operations, streamlined clinical workflows, increased staff productivity, and improved staff/patient experience.
Ø Expanded usage of alarm management and clinical surveillance. Providers expanded their usage of alarm management and clinical surveillance tools. This helped frontline workers identify, monitor, and manage patients considered at-risk of deteriorating or life-threatening conditions, especially when taking care of patients who are on ventilators.
Ø Leveraged Telehealth and other digital health tools. Providers leveraged Telehealth and other digital health tools to enhance patient/provider communications and encourage patient self-sufficiency as a proxy for not being able to see their primary care provider or medical specialist.
Ø Realized value of hands-free communications. Providers realized the value of hands-free communications devices powered by speech recognition. These devices enabled frontline workers, who were fully gloved, gowned, and masked, to use their devices without having to leave the room or take off their personal protective equipment to communicate and collaborate with colleagues, care team members, and medical staff.
Ø Enhanced enterprise-wide contacts directories. Providers enhanced their enterprise-wide contact directories to include representatives from public health authorities, diagnostic laboratories, local hospitals, and community-based resources.
And a few top data results were as follows:
Ø Seventy-three percent of hospitals report that CCC investments are a high investment priority for hospital, up from 55 percent in the 2018 report.
Ø Seventy percent of hospitals have identified or are in the process of identifying compelling ROI models to justify new or incremental investments in a CCC solution, up from 48 percent in 2018.
Ø Forty-nine percent of hospitals had developed, and 42 percent were developing, enterprise-wide mobile communications strategies, up from 27 percent in 2018.
Following the posting of the press release, Gregg Malkary, CEO of Spyglass Consulting, spoke with Healthcare Innovation Editor-in-Chief Mark Hagland regarding the findings of the survey, and its implications for the industry. Below are excerpts from that interview.
Overall, what was your reaction to the survey results that you compiled in your company’s study?
It was kind of a shocker, because hospital IT budgets are plummeting across the country. Interestingly, telehealth was a big growth area. But the other thing that was of interest was in organizations that had already been developing platforms to begin with. There was also
What most stood out to you about what they told you?
The biggest shocker was that COVID-19 was an accelerator, if you already had a CC&C platform—Vocera, Voalte, or any other brand. With the increasing surge of patients and frontline workers, there was now an imperative for them to get a lot more efficient, in environments that were more difficult to work in. They realized that their strategies were limited, and they needed to better be able to communicate across their local communities, and with local public health and the CDC. And many vendors were called in to help them with expansion and with workflow.
Ninety percent of organizations already had CCC systems, right?
Yes. A lot of organizations had already embraced the idea of smartphones and secure communications. They had implemented solutions like TigerConnect's TigerText, but had not really been using them. So these solutions have been evolving.
What’s going to look different going forward, in this area?
The physician-nurse communication dynamic continues to be a problem and a dilemma. Certainly, a lot of these platforms are leveraging middleware platforms. Voalte has acquired Excel Medical. So they’re expanding systems and are incorporating alarm management, which really requires a much more sophisticated IT staff, to send out alarms and coordinate care among the care team. And a lot of organizations are experimenting with areas like sepsis, fall risk, MEWS scores, to identify life-threatening situations.
So this has all become a part of the mix to change care settings. With COVID, you may have a problem with breathing, right? So there are a lot of algorithms that vendors are acquiring. So that’s one of many areas of focus where there could be huge opportunities for supporting practice based on evidence-based medicine. The question is how accurate the algorithms are; sepsis is the only we know that works.
What are health system leaders finding are the best forms for alerting clinicians?
We know that any communication is an improvement over the old analog pager systems. So it could be as simple as sending a text message; but it could also provide context. Nobody’s talking about emails; but it could be an MMS—a secure text message with data points. It could include an EKG. Or it could create a link to the patient’s medical record number using Epic Rover or Cantu or Haiku; and that’s an existing capability under Epic.
Now, one issue that comes up is, when you start to provide secondary alarms, clinical alerts, medical record prompts, are we exacerbating alert and alarm fatigue? And if the nurse is already in the ICU, why send out an alarm? We’re still in the early stages of working all of this out.
How should CIOs, CMIOs, CTOs, think about this technology?
They should look at the problems they’re trying to solve, and the individual components of those issues. Are they trying to improve outcomes on sepsis, fall risk, etc.? Think about what you’re trying to do, and move gradually. You don’t have to buy everything at once. And there’s a lot of evidence of what works now, much more than several years ago. There are consultants focused on alert and alarm fatigue, for example. And if you rush into it, you risk alert and alarm fatigue.
So the technology is better now?
Yes, it’s better, and we have a lot more experience.
What are the biggest mistakes that hospital and health system leaders have been learning from that were being made five, three, two years ago?
I think the change management element was something that needed to be understood. When you look at the solutions involved, the reality is that you need to hold the hand of the organization, and involve your organization in continuous education. What we’ve found is that, in organizations suing this for some period of time, the clinicians like it.
We still have issues around physicians and nurses not communicating effectively. Some of it relates to reimbursement, honestly. Physicians only want to respond to things that they have absolutely have to respond to, especially when they’re seeing patients. So they don’t want to have their cell phone numbers regularly used. And they don’t want to carry additional devices, like Vocera, that nurses do. They also don’t want AirWatch and other mobile device management solutions that can swipe their devices if lost. They slow the device down, and they feel like Big Brother is watching.
What are you most excited about, going forward?
I love the idea that now, with the emergence of telehealth, they’re getting patients involved. They’re expanding CC&C systems, making patients a part of the care team. There really wasn’t another option in that regard. But there’s a lot that could happen that’s an extension of that. How can we expand the options beyond video in the home to where patients can be sharing key data points for providers? And to make you feel more empowered and educate you about your condition? I don’t think we’re that far along in that area.
So I think this is another natural extension, but which also provides opportunities for patients to schedule upcoming appointments, etc. And during COVID, the nurses are really busy. So if they can send an automated text message allowing them to see that the patient is in surgery or is on a ventilator, etc., there’s a lot of information that can be shared that doesn’t require face-to-face interaction.
Is there anything you’d like to add?
As individual consumers in our lives, we’ve all got Google, Siri, now, so those ideas are already familiar. And this whole idea of being able to use voice-activated speech to enable communications and send information, is an important area, and CCC vendors can introduce those elements into their products.
