There are nearly one million physicians in the U.S., many of whom constantly move between their offices, clinics, and various departments and other facilities in and around affiliated hospitals. They possess a constant need to access clinical information and to communicate with colleagues and care team members.
It was not too long ago when these physicians would be checking their pagers for messages from other doctors. But times are changing, and those pagers have turned into smartphones with text messaging capabilities. In fact, in 2012, a survey from the Lexington, Mass.-based Imprivata, a healthcare IT security vendor, found that more than 70 percent of IT decision-makers in hospitals in North America said they expected secure text messaging to replace paging in the next three years, as smartphones become more of a tool in the hospital environment.
Three years have not yet passed, but the trend is coming more quickly than even the industry might have expected—the transition from pagers to text messages has already begun among doctors, and most are finding the switch seamless and efficient.
In Anchorage, Alaska, Michael Levy, M.D., emergency physician at Alaska Regional Hospital, was so motivated to improve his communications with other physicians, he helped create Fractal OnCall Solutions. The company, formed in April 2013, has since developed a product for the iPhone and iPad called CallDR, a multimedia consultation and secure messaging system for mobile telemedicine, says Levy.
Levy says that he needs to talk to other physicians regarding their patients on a daily basis, so prior to callDR, he would have to break what he’s doing, go to a secretary who has other things going on, and ask him or her to contact a certain physician. “And that physician isn’t exactly waiting by the phone for me to call them,” Levy says. “So I go off and do my thing, and it’s likely that I’m involved in doing something very difficult for me to extract myself from when the call comes back in 10-60 minutes. Needless to say, it’s an inefficient process.”
But with callDR, continues Levy, physicians can now navigate through a quick menu and provide some written information—via text or speaking into the phone—as well as take images, and then send the whole thing as package. “The physician on the other end gets a ‘ping,’ and this helps solve what I think is a huge problem in being able to work efficiently and accurately,” he says. ‘We’re some of the busiest guys around—you can’t expect to call your CEO and expect to talk to them right at that second, and that’s the level at which we’re operating at.”
Meanwhile, the six-hospital integrated delivery system, Orange Coast Memorial Medical Center (OCMMC), based in Fountain Valley, Calif., communication amongst providers is especially crucial due to the distance between facilities, says Scott Raymond, executive director, information services. “We aren’t trying to solve one single problem, but rather the global problem of getting care to patients quicker, which we call unified clinical collaboration,” he says.
To this end, OCMMC has tapped the Knoxville, Tenn.-based PerfectServe for its unified communications platform. Similar to Levy, Raymond also makes note of the organization’s “stone age” methods of communication before deploying PerfectServe. The back-and-forth loop of communication sometimes took as many as six hours to close says Raymond, who did a time motion study to get the specific numbers.
Right after PerfectServe, the average time it took to close the loop from the first line of communication to the last was 15 minutes, while the median was six minutes, Raymond says. “The greatest outlier we had after PerfectServe was 100 minutes, and we had very few outliers because almost all of our target physicians for this app were utilizing it at this point,” he says. “I call it the 50 percent initiative, because right off the bat, we had a 50 percent improvement in all areas.”
A few thousand miles away, in the southeast, Quality Independent Physicians (QIP)—a group of more than 1,000 physicians in private practice working together to care for their patients in the Louisville and Lexington, Kentucky areas as well as the Southern Indiana counties of Clark and Scott— started a Medicare Shared Savings program accountable care organization (ACO), employing nurses to hospitals and nursing homes to follow those Medicare patients around who were attributed to the organization, says Tom Samuels, QIP’s CIO. “At the time, we were struggling with a way to communicate with our doctors in a quick and real-time fashion, and still be HIPAA (Health Insurance Portability and Accountability Act) compliant,” Samuels says, adding that QIP also needed a solution that would be easy enough for physicians to use.
QIP ended up choosing Louisville-based startup Red e App, a real-time private mobile messaging platform, to allow on-site clinical staff to communicate back to the in-office doctors. “It looks and feels like texting or like an e-mail, and we can communicate directly to the doctors about patient information to get real-time feedback, get status on a patient, or let doctors know what is going on with a patient,” Samuels says.