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How a N.J. Medical Center Has Saved Millions With mHealth Technology

June 3, 2014
by Rajiv Leventhal
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Smartphone app has improved efficiency through better communications across the medical staff

Communication breakdowns in healthcare affect care teams and their patients at every stage of the care process, from diagnosis to treatment. Without a network to enable rapid connectivity and remote communication, clinician efforts are hindered while quality of care, patient satisfaction and cost efficiencies suffer.

To quantify the effect that communication breakdowns could have on health systems, The Joint Commission, a healthcare system standards and oversight organization, has indicated that nearly 80 percent of serious medical errors and medical mistakes are caused by poor communication between healthcare providers or healthcare teams, especially when a patient is transferred from one facility to another.

Undoubtedly, the time it takes for clinicians to reach each other drains staff productivity and creates delays in decision-making regarding critical patient-related issues. To this end, just a few years ago, officials at the N.J.-based LibertyHealth Jersey City Medical Center estimated that medical staff spent about 15 percent of their day (or a month every year) trying to get hold of other physicians rather than taking care of patients.

Additionally at the 300-bed facility, surgeons reported 2-4 hour delays between the time that consults were requested and the time that they were notified, while residents reported up to two days’ lag time in getting response on consults. What’s more, after procedures, surgeons also faced difficulties communicating their findings and recommendations to referring physicians, who were often disconnected from the hospital’s communication system.

These numbers were derived from interviews conducted by Practice Unite, a Newark, N.J.-based subset of Navio Health, a healthcare communications vendor. Over a year ago, Navio Health’s core product, Practice Unite— a customized, HIPAA-compliant smartphone application designed to improve communications and speed up workflow—was implemented at Jersey City Medical Center, with the goal of solving this increasing healthcare communication issue.

“In any industry, communication is always a challenge, as no matter the sector, communication is the key to holding together the workflow,” says Stephen Li, Jersey City Medical Center’s CIO. “In healthcare, with all the changes that we’re witnessing, that communication challenge gets magnified because of the regulatory changes that are coming right after one another. Pagers are still common, but you have to wait until someone gets back to you. As such, society has embraced smartphones as the center of their communication,” Li says.

Going beyond secure texting to help healthcare organizations make major efficiency improvements using practical, customized mobile applications, Practice Unite provides a platform for communication and collaboration that connects care teams and their patients.  For instance, older patients who go into the emergency department might forget the medications they are currently on, meaning there might be some medication interaction that will potentially affect the patient negatively, explains Li.  As such, the physician will have to check with that patient’s primary care provider (PCP), which can be very difficult to do because PCPs are extremely busy people, Li says. “I experience this situation with my parents, who are both approaching the age of 90. They’re kind of sure about their medications, but also not so sure,” admits Li.

Millions in Savings

Since implementation of the Practice Unite application, the results have certainly been there. After about a year of using the technology, Jersey City Medical Center officials believe that the app has saved the organization at least $2 million in three key areas. The first has been in the observation unit; like many hospitals, Jersey City Medical Center created a care unit specifically to manage its observation patients. The success or failure of this observation initiative has depended on the ability of care teams to diagnose, treat, and either admit or discharge patients in less than 24 hours. (The Centers for Medicare & Medicaid Services (CMS) reimburses hospitals for observing patients using composite ambulatory payment classifications, a system that reimburses acute care facilities for outpatient services).

Typically, when a patient enters the observation process, a cascade of phone calls begin that are meant to connect the treating physician with the patient’s primary care physician, consulting specialists, nurse practitioners, nurses and therapists. These care team members must rely on inefficient forms of communication to share lab results and other clinical data in order to make treatment decisions. Depending on the nature of the case, this can involve repeated calls to operators and answering services throughout the patient’s stay. Consultations requests transmitted through traditional hospital communication channels can take hours to reach specialists, and cause further treatment delays, according to Adam Turinas, CEO of Practice Unite, who worked with Jersey City Medical Center to obtain the details of the organization’s savings.

At Jersey City Medical Center, people running the observation unit say they were able to discharge 20 percent of patients a day earlier because of the app, as physicians were able to receive and share critical patient information in the form of secure images, texts, and real-time laboratory feeds using their mobile devices. Doing so effectively eliminating all delays caused by traditional forms of communication, Turinas says, further estimating that this reduced length of stay translated into saving the hospital $720,000 a year.