Optimizing clinician-to-clinician and staff-to-clinician communications has been problematic for hospitals and other patient care organizations throughout the history of healthcare. But at the 250-bed Orange Coast Memorial Medical Center in Fountain Valley, Calif., Scott Raymond, R.N., executive director, strategic innovation and information technology, has been leading an initiative to make the lives of that hospital’s clinicians easier and to boost productivity.
Raymond and his colleagues have been partnering with the Knoxville, Tenn.-based PerfectServe, and have implemented that company’s advanced clinical communication and care team collaboration platform, in order to speed and streamline communications. Since implementing the platform in 2012, Raymond and his colleagues have been able to document a significant reduction in communication cycle times. Prior to implementation, nurse-to-physician contact time averaged 45 minutes; post-deployment, this time period was markedly reduced to 14 minutes. Additionally, the number of steps to complete a communications event between nurse and doctor were reduced from 10 to one. Ultimately, Raymond and his colleagues are working to make the communications system patient-centric.
Recently, Scott Raymond spoke with Healthcare Informatics Editor-in-Chief Mark Hagland, regarding the initiative. Below are excerpts from that interview.
Could you share with us the origin of this initiative, and your strategic goals going into it?
Certainly. So, about four years ago, I was asked to come up with a vision and a strategy for clinical communications going forward, and at that time, the iPhone had just come out—the iPhone 3GS, or a similar model. We’re an iOS company for management and senior executives, with about 2,500 iOS devices deployed. So we were initially looking at the iOS as the platform for communications; but we were using old technology in the clinical space, with nurses and ancillaries, using a stock VoIP phone. So I was asked to help develop a strategy for a unified system. So I was asked to develop a clinical communication and collaboration strategy. It’s becoming standard to bring clinicians onto a communications platform. So I came up with a vision statement and a diagram or graph of our system that had an iOS at the center of that platform, with a phone system, alerts and alarms, giving the clinicians presence, and other applications that would help capture rounds for nurses, and bring in alarms from patients.
So what we had had up to that time kind of looked like an octopus with multiple communications. And we didn’t want to have to cobble together a bunch of different applications, because just as it is with unified communications in a regular space, in this case, too, we didn’t want to have to do a lot of interfacing, integration, or pulling a lot of different applications together. It becomes very difficult and just doesn’t work that well. If you’re trying to seamlessly hand off phone types—if you had a phone call from a doctor and want to text him information or send it in other ways—that’s tough. You hear about a lot of point solutions like Tiger Text. But we didn’t want that, we wanted a unified communications system for the clinicians. And all the communication and messaging that comes from the hospital out to the clinicians outside the four walls has been difficult over the years, just with standard phones, so having a platform for getting the information to the clinicians in the ways they want to receive it, was important for us.
Then what happened?
Two things came together at once. I was looking at trying to enhance communications not only from inside the hospital but outside its four walls as well. And I was put in charge of clinical communications and collaboration form a hospital and system perspective. So first, we came up with that strategy. And right around the same time, I worked for our for-profit innovation fund that invests in healthcare IT, and I consult with that group, and they asked me to look at this from an investment standpoint as well.
So I was looking at this from two different angles. I looked at a large number of solutions providers. And we decided to look at PerfectServe, because they had a physician-centric system that they moved into a hospital-centric system, and that’s where we got involved with PerfectServe from a pilot standpoint and also from an investment perspective. So for purposes of disclosure, we’ve also invested in this.
So Orange Coast Memorial acted as the alpha site for the system?
They had other customers using their hospital system; we weren’t the first. But they we jumped in early on in that development. And they took a system that was physician practice-centric, and enhanced the software to make it possible for the hospital to communicate with physicians more directly. When we got cut off… the platform went from physician-centric to clinician-centric, and we’re moving towards patient-centric. Imagine the patient as being at the hub. So if I’m the nurse and need to contact a respiratory therapist, I find the respiratory therapist connected to that patient. And so if you have the hub, if you have the patient, it makes it easier to communicate. It becomes easier in an ACO model.
You’re in an ACO, right?
Yes, in an IPA and insurance company. But we’re also in Vivity, a joint venture with Cedars-Sinai, UCLA, and Torrance Memorial.
So tell me about the initial pilot.
It was in 2012 when we did our pilot; we implemented it here first at Orange Coast Memorial Medical Center here in Fountain Valley. We did an initial pilot, and then we rolled it out to the other hospitals, after about three years.
How many doctors, nurses, other clinicians are now making use of the system?
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