Next-gen clinical communication: Real-time location, context-aware and mobile
Communication technology has evolved quickly in the last few years, and this has enabled new trends in healthcare delivery. While this is the case throughout the industry, it is especially true in hospitals and health systems where a significant amount of time and energy have been invested into providing improved communication and data sharing among clinicians.
The Centers for Medicare and Medicaid Services Administrator Seema Verma recently stated that “one of the most common complaints from patients and providers is the inefficiency of EHRs to effectively coordinate care for their patients.” And this is where effective clinical communication technology can help.
In the Spyglass Consulting Group’s healthcare study, “Trends in Clinical Communications and Collaboration 2018,” researchers found that 90 percent of hospitals surveyed are making significant enterprise-wide investments in smartphones and secure mobile communications platforms to drive clinical transformation and address the mission- and patient-critical communications requirements of clinical and non-clinical mobile workers within the hospital and across the care continuum.
Hospitals surveyed identified common communications challenges experienced by mobile clinical workers that include: communications overload, lack of standardized processes and dissatisfaction with existing communications products including overhead paging systems, landline phones, VoIP handsets and EHR-based messaging tools.
With the transition toward patient-centered care models and value-based models, hospitals surveyed are evaluating next-generation communications platforms and upgrading their technical infrastructure to help achieve the Triple Aim framework by reducing healthcare costs, improving care quality and outcomes, and increasing patient and staff satisfaction.
Next generation communications platforms, according to the survey, will include a range of new features.
Customers should expect cross-platform support that allows clinicians to use a different mobile device or web-based interface to support anytime-anywhere communications/
"The next step for communication is the move to context-aware, secure, real-time communication platforms."
Eric Chetwynd, Everbridge
Unified communications, to that end, will enable clinicians to use different communication modalities including Voice over IP, secure text messaging and video conferencing.
Another useful and improved functionality will be enterprise-wide directories that integrate with the on-call scheduling system and care assignments databases to connect clinicians with care team members.
Building on top of that, event-driven communications features will mean clinicians can receive critical notifications, even from hospital legacy systems, that deliver actionable content to close.
And as with so many aspects of health IT, expect analytics to come into the picture with reporting tools for measuring the effectiveness of communications tools and ultimately drive clinical workflow improvements.
That’s not all. Other experts point to a variety of next-generation changes they expect in the future.
Context-aware, real-time communication platforms will become a standard, said Eric Chetwynd, general manager of healthcare solutions at Everbridge, a critical event management technology vendor.
“Many hospitals have invested in secure texting solutions over the past few years,” Chetwynd said. “These solutions are intended to fill the gap of real-time clinician-to-clinician communication on a daily basis versus documentation-based communication in the EHR. The next step for this type of communication is the move to context-aware, secure, real-time communication platforms.”
These types of systems tie into both the enterprise architecture of health systems as well as the clinical collaboration tools that clinicians rely on, such as EHR alerts and nurse call systems, Chetwynd added. These systems also are becoming more and more context-aware; for example, who is on call for this communication, who is currently on the floor, who is the care team for this patient, who can the facility escalate critical communications to if the first responder is unavailable, he explained.
Suzanne West, chief nursing officer at Critical Alert Systems, a vendor of secure nurse call systems, said direct system integrations versus middleware will be an important next-generation consideration.
"Technologies can dramatically enhance bed-level presence of staff, patients and equipment, spawning better data accuracy and enhanced opportunities for clinical performance improvement initiatives."
Suzanne West, Critical Alert Systems
“For clinical communications, particularly mobile technologies and telephony, use of middleware often means sacrificing functionality, flexibility and continuity of extremely valuable clinical data,” she said. “Although it does offer a degree of cost savings and the ability to sustain legacy applications, reliance on middleware to do the work of interoperability will ultimately diminish the ROI, particularly as communication technologies become more feature-rich.”
Also, next generation real-time location service (RTLS) will come to the fore, West added.
“One of the most exciting and innovative developments I envision is the impact of next-generation RTLS positioning technologies on clinical communications platforms,” she said. “Technologies like Sonitor’s Forkbeard can dramatically enhance bed-level presence of staff, patients and equipment, spawning better data accuracy and enhanced opportunities for clinical performance improvement initiatives for hospital administrators.”
And mobile computing apps will have a significant role to play in the next generation of clinical communication technologies, said Gregg Malkary, managing director at Spyglass Consulting Group, a health IT consultancy.
“Hospitals are evaluating opportunities to leverage existing smartphone investments to support the computing requirements of the clinical and non-clinical mobile worker,” Malkary said. “For example, a staff nurse would be able to leverage the smartphone for barcoding medication administration and other simple nursing documentation requirements. An IT professional could leverage the smartphone for trouble ticket management. And a housekeeping professional could leverage an application for bed management.”
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