Improving quality and total cost of care
with better secure messaging
between hospital and community physicians

In July 2016, the US Government announced that the nation’s health care tab would surpass $10,000 per person for the first time in history. That spending is expected to increase an average of 5.6 percent annually through 2025, according to the Centers for Medicare and Medicaid Services. Of the total $3.35 trillion in healthcare spending each year, hospital care accounts for the largest share at about 32 percent.

With healthcare spending on the rise, affordability of care has become an increasingly important issue for health care providers, hospitals and patients. To address those concerns, an increasing number of hospitals and physicians are turning to value based contracts, with the goal of improving both quality and cost outcomes. Under these models, health systems and their affiliated providers are rewarded for collaboratively managing the total cost of care (TCOC), while maintaining or improving the quality levels of patient care.

For those organizations, efforts to manage total cost of care typically involve cost-cutting measures such as the use of generic drugs, shortening or avoiding patient hospital stays, avoiding costly Emergency Department visits, and the elimination of duplicative testing. All of these things have the opportunity to improve care and reduce costs.

One area that many hospitals neglect to consider is their secure messaging solution, which can help facilitate each of these cost-cutting measures and enable better collaboration between community-based physicians and hospital-based specialists to ultimately improve patient care.

To help demonstrate the role that secure messaging plays in the TCOC, we created the following infographic, which walks you through two different scenarios for a pediatric appendectomy. The elapsed time for that typical process is 23 hours. It presents a number of opportunities for both care improvement and cost savings, if the providers had better access to patient information and each other. As you can see, the alternative RapidConnect scenario dramatically cuts the total elapsed time down to 9 hours. It also creates a number of cost saving opportunities, including: the avoidance of an ER visit, a shorter Average Length of Stay (ALOS) and a less expensive (and safer!) imaging option.

Other benefits of the RapidConnect scenario include:

  • No delays in care due to the wrong person receiving the page
  • No need to call in the operating room team overnight for emergency surgery
  • Clarified direction on generic drugs (an additional cost savings)
  • Expedited and efficient communication back to the Primary Care Physician (PCP) on next steps (cost reduction and better continuation of care).

Using a secure messaging system of communication, like RapidConnect, across the inpatient and outpatient environment, enables the reduction of cost to the tune of at least $4200. And of course, the value of better, expedited, patient care is immeasurable.

The key is for health systems to implement a secure messaging platform that will be broadly used throughout the entire health system, including community based physicians and hospital based specialists.

This ultimately improves performance, lowers costs, and improves outcomes.

How does your secure messaging platform measure up, when it comes to Total Cost of Care? Let us know if we can help.


Healing What Ails Technology Adoption, Part 2

As discussed in our previous blog post, Healing What Ails Technology Adoption, MD Interconnect takes a two-pronged approach to successful technology adoption for secure mobile/web communication. That first post focused on designing a product with physicians in mind. Today, we will discuss the second part of that equation: building a successful implementation process. There are many critical factors that play a role in a successful implementation, but let’s focus on five key elements that lead to successful adoption.

  1. Communicate early and often. It is important to ‘set the stage’ with pre-launch communication in regularly distributed materials (i.e. publications, leadership emails, etc.) This can begin as soon as the selection committee (which should include physicians) has made their choice. It is critical to consistently outline what providers can expect in terms of process, timing, training, support and requirements. Providers must understand if any workflow changes will be required of them and why. Updates to implementation schedules/processes can all be communicated in regular briefings to the medical staff. In addition, getting to regularly schedule clinical service meetings to do brief demos of the product helps secure buy-in and reduces anxiety associated with a new technology,
  1. Partner with Physician Leaders Clinicians are more likely to embrace a new technology if their peers are positive about their usage of the product. Positive referrals are the most powerful engagement tool. Therefore, we start with a small group of healthcare providers and ensure they have a great experience. The small group is usually a relatively self-contained communication eco-system (i.e. Children’s Hospital within the Hospital). This allows us to work closely with the entire group and make sure we understand utilization issues that are unique to the individual hospital prior to rolling out to the entire system.
  1. Understand and integrate with physician workflows.

There are significant differences in how physicians work – no “one size fits all” approach will be successful All physicians have a unique workflow. When working with a complete community healthcare system, it is also important to understand the differences between inpatient based physicians (emergency, surgeons, hospitalist, etc) and outpatient based physicians (primary care, medical specialists, etc.) The needs on those two groups can be very different. In that same vein, differences between low volume and high volume users must be recognized and addressed

To better understand these specific workflow needs, we start with a survey of each practice about how communication is handled today, and what challenges each practice faces. Based on that insight, we build out “rules” for how RapidConnect will work to address those unique needs and integrate with their workflows.

  1. Prepare for the 20%

Physicians (like most of us) don’t like training. Burdensome training requirements can be the kiss of death for a new technology implementation.

RapidConnect was built by physicians to be intuitive and user-friendly, with no formal training required for end-users. 80% of users will be able to ‘download and go’. However, a secure messaging system is only productive if close to 100% of the physicians are using it. As such, its important to have specific strategies to support those physicians and clinicians that need assistance.

RapidConnect uses multiple techniques to achieve his. In addition to 24/7 help desk, online ‘how to’ videos and readily available ‘quick tip’ cards, we have a team of resources on site leading up to and during the ‘go live’ phase. These resources round on physician practices, spend time where doctors congregate (ED, OR lounge, physician dining, etc.) as well as participate in physician group meetings to address any issues or concerns. We also invest in training those that surround physicians – namely their nurses and practice managers. With specific training designed for them, clinical staff can support the implementation process. In addition a dedicated account manager will review message traffic, identifying those who seem to have long response times or regularly don’t answer messages. We will proactively reach out to those physicians and practices to address any issues that they may be experiencing.

  1. Facilitate ongoing user engagement

Every day, the RapidConnect support team will review message logs for failed messages or significant delays in response time.

This allows the support team to immediately address problem areas and respond, improving the performance of the product and physician satisfaction.  Poor response times and/or unread messages can jeopardize the adoption of the platform. Doctors in particular will become disenchanted and quickly abandon the new technology if the perceive flaws or unresponsiveness from others.

There have been numerous false starts and expensive failures in the implementation of secure text messaging platforms for healthcare. You don’t want to be one of those! To learn know more about how our RapidConnect secure messaging solution can help you avoid that fate, click here.


Are You Asking The Right Questions In Your Secure Text Messaging RFP?

As discussed in a previous post, there have been numerous false starts and failures in the implementation of secure text messaging platforms in the healthcare environment.  The landscape is littered with expensive solutions that have seen low utilization, projects being shelved and as a result patient health information continuing to be shared via unsecured methods.

The primary reason for this situation is poor adoption by physicians and subsequently inconsistent use throughout the system. Poor adoption leads to overall poor utilization and a lot of wasted time, money and energy.

But physicians and care providers aren’t to blame. The blame falls on the technology itself. Few of the existing secure messaging products were designed to work with physician workflows and account for physicians need to control accessibility.  Most physicians do not want others to have ‘open access’ to them, nor do they want to ‘sign in’ when they are available or remember to ‘sign out’ when they are not available.

While other technology vendors have provided public RFP templates for secure messaging, those templates focus primarily on the core functionality and the technical requirements of an individual product. They do little to highlight those functional features that will actually encourage broad physician adoption. So, while these templates are helpful, they do not necessarily help you achieve your goal of high user adoption.

With the goal of high user adoption in mind, here are seven key functionality questions you should include as part of your RFP for secure text messaging:

  1. Does the technology automatically route certain types of messages to the physicians designated resource? This might be a resident, PA, fellow, or other clinical staff member. Physicians need control over their access and most solutions don’t offer a way to integrate these physician preferences into their applications.
  2. How do physicians control their availability when they are not on call? Asking physicians to check in and check out every time they want to be unavailable is not a viable solution, and quite frankly, physicians won’t do it.  Look for a solution with one time availability set up that accounts for call and clinical duties.
  3. What happens when a message comes to a physician’s phone when they are in the middle of a procedure?  This is one of the biggest complaints about secure messaging applications.  The application should have an ability for scrub nurses or other providers in the OR to proxy into the physician’s account without having to access the phone. This allows timely response without the OR staff having to access doctor’s personal cell phone and pass words.
  4. Does the platform allow for the user to identify and contact the patient’s current care team (including currently attending hospitalists and nursing staff) through one click access? Having to sift through the frequently long and comprehensive ‘care team’ listing in the EMR does little to facilitate fast, seamless interaction to those who are taking care of the patient at the moment.
  5. Does the application integrate with call centers and other communication systems? Doctors don’t want to carry multiple devices. If secure texting is utilized as the primary method of contacting doctors (which increases adoption), the application needs to be integrated into the call center and function within the parameters of the call centers existing workflows
  6. Does the application architecture and pricing allow for broad distribution to outpatient-based physicians, including regional referring doctors without running afoul of anti-kickback laws and incurring additional costs? Many current technologies offer ‘per head’ licensing, which a) limits the distribution of the product, limiting the overall adoption (see point above). Also, the technical architecture needs to ensure the application can be provided to these referring physicians without fear of giving something of value to these doctors.
  7. Does the application integrate with nurse duty phones? Maximizing nurse/patient interactions is critical. If nurses have to use a desktop-based application, this reduces the available time for patient/nurse contact. Similar to the point above, if the system is to be charged for every downloaded application, adding the hospital-based nurses to the installation can be extremely expensive.  Evaluators should look for a product that not only encourages broad distribution, but facilitates that through enterprise-based pricing and integrates with nurse duty phones to maximize patient contact.

Eliminating Distractions, Improving Patient Safety

Introducing RapidPair, the latest enhancement to RapidConnect secure messaging solution.

According to a 2000 report from The Institute of Medicine, To Err is Human, experts estimated that as many as 98,000 people died in any given year from medical errors that occur in hospitals. In 2016, after analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts published that more than 250,000 deaths per year are due to medical error in the U.S. In 2013, distraction from smartphones and other mobile devices was identified for the first time as one of the top 10 health technology hazards by ECRI Institute.

Hospitals and physicians recognize that electronic devices in clinical care environments have exploded over the last 10 years, resulting in an unprecedented level of distractions. They are committed to minimizing those distractions, especially in operating rooms and other procedure related areas, which are at especially high risk for interruption and distraction-related errors.

RapidConnect by MDInterconnect has risen to that challenge with the introduction of its latest feature, RapidPair. RapidPair enables physicians to quickly and easily allow a “proxy” to review and respond to secure messages on their behalf when they are otherwise occupied.
Imagine the following scenario.

RapidPair image 150A physician is in the operating room, performing a life-saving surgery. A message comes in to their mobile device. They know that a message has come in, but can they afford to stop mid-surgery to check that message and/or respond directly? Of course not!

Can they even afford to pause long enough to instruct the circulating nurse how to get into their personal device, to find the app and open the message using their personal PIN? Not really.

Other solutions on the market today claim to offer “proxy” or “delegation” type capabilities to address this problem, but create even more distractions by requiring multiple, sometimes complicated and inefficient steps be taken by the physician and/or circulating nurse.

If a so-called “solution” is too time-consuming, complicated or dangerous to use, how likely are physicians and/or hospitals to actually use it? Hospitals and physicians want a solution they can trust to make their job easier, and one that certainly doesn’t jeopardize patient care.

MD Interconnect took all of these concerns into consideration when developing RapidPair, and designed it to accomplish the following:

  • Require minimal disruption to a physician’s normal workflow
  • Ensure process does not rely on clinicians resetting status each time they 
enter procedure area
  • Ensure that on-call physicians can be reached at all times
  • Eliminate the need for “proxies” to access a physician’s personal device
  • Ensure rapid, secure communication

With RapidPair, the physician simply asks the proxy (i.e. circulating nurse) to check the incoming message. The proxy does this through any computer (not the physician’s personal device) by signing into their own RapidConnect account and accessing the RapidPair function. With minimal disruption to the patient or procedure, they can immediately see the message and respond based on the physician’s instructions. Each proxy can pair up to 10 devices at one time. The clinician is not required to change any settings or status on their own device.

RapidPair minimizes:

  • Distractions in the operating room and/or during other patient interactions
  • Changes to physician behavior and/or workflow
  • Security concerns, with the messaging platform itself and/or physicians’ 
devices

RapidConnect gives physicians the flexibility they want, to choose the options that work best for them, and thus provide the best patient care possible. RapidPair complements other features like QuickCover, Read Notifications, Shift- based Roles, Message Routing, etc. allowing widespread adoption by clinicians enabling a system to implement a secure, team-based, collaborative and effective approach to patient care.