Automated Roles And Message Routing Improve Physician Satisfaction and Patient Care

When physician practices bring new providers on board, it can be challenging to ensure that patient workload doesn’t disproportionately fall on the established providers. Existing providers are typically paged more often, even if they aren’t on-call, just because they have been at the practice longer and their names are recognized in the community. This results in time lost connecting to the correct provider. It also means that physicians’ vacations and other times out of the office get unnecessarily interrupted. Physician satisfaction and patient care can be adversely affected.

WakeMed Pediatric Endocrinology decided to work with MD Interconnect to address that challenge before adding the next provider. Their on-call schedule was built into the RapidConnect secure messaging platform, and a new role called “Pediatric Endocrinologists On-Call” was created. Local hospital ED’s and community physicians were asked to use this on-call role instead of physician names so that messages would be answered quickly.

The Pediatric Endocrinologists who were not on call were then able set their status as unavailable, so that all messages would automatically forward to their on call partner. This prohibited users from circumventing the role.

See the complete use case here.

Can better secure messaging drive more referrals for Orthopedics and other specialty practices?

According to Wake Orthopaedics, the answer to that question is an enthusiastic yes. After partnering with The North Carolina Football Club (NCFC), Wake Orthopaedics knew that fast and secure messaging would be key to providing timely care including same-day appointments.

With that in mind, they gave NCFC athletic trainers and physical therapists access to the RapidConnect secure messaging app, which now serves as the official communication pathway between the two organizations. Each month, an average of 90 secure texts are sent and received, enabling streamlined communication and a faster, collaborative treatment plan.

“With RapidConnect, appointment scheduling time has been cut in half, and communication to parents can typically take place on the same day. As a result, I send all my players to Wake Orthopaedics,” stated Jason Bailey, Athletic Trainer, North Carolina Football Club.

“RapidConnect has enabled us to build on established provider relationships (both within our system and the community) as well as access new opportunities with regional sports teams, trainers and therapists. Patient care questions, x-ray consultations, and follow-up arrangement are significantly more efficient and it has allowed our practice to increase access for referring providers,” shared Mark Wood, MD, Executive Medical Director, Physician Services, Wake Orthopaedics.

To learn more about how RapidConnect is helping Wake Orthopaedics improve communication and drive referrals, see the complete use case here.

To learn more about how RapidConnect can help you, contact us.

Pagers Putting Hospitals (and Patients) at Risk

With the Kansas City Star article making waves across the nation, there is no excuse for thinking that pagers are still an acceptable option for sending patient health information (PHI). And no one can deny that healthcare workers routinely include PHI in their pages. According to 2017 study by the Journal of Hospital Medicine, nearly 79 percent of 620 hospital-based clinicians said they are provided pagers for communications, while 49 percent said they receive patient care–related communication through pagers.

As the IT worker in the Kansas City Star article demonstrated, anyone with $20 and TV antenna can now easily stumble over or intentionally access PHI. Awareness of the security risk posed by sending PHI via pager has increased nationwide.

What is being done about it?

Red flags should be flying. Not the kind with the white cross in the middle but the kind that indicate “Danger ahead. Stop, or proceed with extreme caution and at great risk!” Using pagers to send patient health information, as practiced today in most healthcare organizations, is unsecure, puts a system at risk for significant HIPAA violations and compliance fines and creates additional vulnerabilities for the patients themselves.

To further emphasize the importance and urgency of action, just last week an administrative law judge ruled that the MD Anderson Cancer Center in Houston must pay $4.3 million in fines over a stolen laptop and two lost USB drives; an amount that cannot be easily ignored.

So the question has shifted from “can we use pagers for sending patient health information?” to “how quickly can we move to an encrypted method of communication?”. Now, more than ever, speed of deployment is of great importance but training, reliability, accuracy, and patient safety cannot be short-changed. Traditionally, changing communication tools, workflows, processes and expectations in a hospital has been more like moving a barge than racing a speedboat. Speed was definitely not a top consideration option. Several high profile incidents have changed this. Speed is now required.

Finding a Balance

So how do you quickly provide a compliant system without jeopardizing patient care?

First, every system must immediately educate employees and providers on acceptable pager use and explicitly prohibit patient health information. Actions must be taken to monitor accountability to the policy. Informal polling often finds that there continues to be confusion over what information is considered PHI and if there are certain situations where it is still “OK” to use the pager for PHI.

Second, an encrypted method of communication must be made available to all providers. This method needs to be a simple solution for quick deployment, but also a robust system that can support increased usage and complex workflows in later implementation stages. The simplest solution will be a download and go mobile communication app, which encrypts in rest and in transit.

Finally, the chosen encrypted method of communication must be easily monitored and provide tools for accountability. Monitoring will need to include real time alerts, escalations and read times analysis in order to ensure the smooth and quick flow of patient care information.

There are many more questions to be asked and issues to be addressed in the months after initial implementation such as questions involving system integrations with call schedule and EHR systems, access points, and adoption by the referral community. These questions may need to work their way through hospitals at a more “normal” speed and will benefit from the deliberate and collaborative ways that change has been traditionally implemented in large systems. Finding that balance is key.

Let us know if you would like to learn more about secure communication alternatives that are designed for physician adoption, to support health system integration and to deliver immediate value.

Easing physician burnout with better physician-driven communication

Physician burnout is an increasing problem in US health care systems. In the MedScape LifeStyle Report 2017: Race and Ethnicity, Bias and Burnout of 14,000 physicians, 51% reported burnout, versus 40% in 2013, an increase of more than 25%. Among Family Medicine providers, the reported burnout rate is 55%.

An understanding of the causes and impacts of physician burnout can help health care systems implement solutions to better support their physicians so they can reduce burnout.

Causes of Burnout

Physicians simply don’t have enough hours in the day to meet all of the demands of their jobs.   A report from the Centers for Disease Control and Prevention indicates that physicians would need to work 21.7 hours a day to provide complete preventative, chronic and acute medical care to their patients. Add to that all of their administrative tasks, and the job can be overwhelming. In fact, the top cause of physician burnout according to the MedScape LifeStyle Report 2017 is “too many bureaucratic tasks” followed by “spending too many hours at work,” and “feeling like just a cog in a wheel.” Many physicians will indicate that they spend too little time taking care of patients and too much time on regulatory compliance, documentation and administrative tasks.

 Physician Burnout and the Impact on Care

Physicians experiencing burnout report being overwhelmed by their responsibilities and unable to successfully complete their jobs. This leads to increasing feelings of pessimism, hopelessness and emotional and physical fatigue. Their sense of what they can personally accomplish diminishes, as does their overall interest in work. Physicians who report burnout often have less energy, may start to question their abilities and may reduce their hours or stop practicing all together.

Not surprisingly, physicians with burnout report being more distracted and less able to focus on patient needs and may make more mistakes. Due to their experience of low energy, they also may take short cuts in patient care.

Addressing Physician Burnout

Health care systems recognize the problem of physician burnout, and some are implementing initiatives to address the issue. The Mayo Clinic is focusing on ways to build collaboration and companionship amongst physicians, while the Cleveland Clinic has implemented training sessions to improve patient communication skills. Addressing the challenges that physicians face in the workplace can yield positive results. Initial studies indicate that improvements in leadership, workflow and communication are helping to reduce physician burnout. Additional solutions include teaching physicians ways to deal with stress including mindfulness and stress reduction.

Solutions that improve communication and reduce bureaucratic tasks can also be helpful. Our RapidConnect secure messaging communication platform was developed by physicians to help alleviate some of the things physicians find frustrating and most wasteful of their time. RapidConnect reduces communication barriers and streamlines collaboration with other physicians and caregivers. It also gives physicians more control over how and when they respond, or even who responds on their behalf -- by working within their existing workflow and/or staff hierarchy. This improves overall physician and staff efficiency, freeing up time for meaningful patient interaction.

To fully address physician burnout, more initiatives are needed that will assist physicians with managing all of the demands on their time while reinforcing their sense of value in their work. The good news is that health care systems are recognizing the magnitude of the problem and more are working on initiatives to prevent physician burnout.


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.

Healing What Ails Healthcare Technology Adoption

The marriage between technology and physicians is not always an easy one and there have been a lot of bad breakups over the years. After all, physicians went to medical school to treat patients, change the world, etc. They did not set out to learn a new technology every time they turn around and/or to play a leading role in technology implementations. Yet today, they are finding themselves playing that role and feeling the frustrations that go along with that.

There is no shortage of research that talks about the challenges vendors face when it comes to technology adoption with physicians (and healthcare in general). Look no further than the EHR (electronic health record) technology market to learn more about those challenges and the lessons learned from them. In a 2015 study by Physicians Practice, physicians cite a long list of technology challenges (many of which relate to their experience with EHR technology), including: a drop in productivity when rolling out new technology; lack of interoperability between technologies; meeting regulatory requirements; cost to implement and use technology; resistance to technology; security and training.

MD Interconnect co-founder Dr. David Hoover was all too familiar with those challenges, having been on the user side (the resistance side may be more accurate) of numerous technology rollouts. He knew that MD Interconnect had to do things differently to ensure successful adoption.

With this in mind, the MD Interconnect team took a two-pronged approach to adoption. The first approach may seem obvious: design a product that solves a meaningful problem, but design it with your users (i.e. physicians, etc.) and their workflows (maybe not as obvious) in mind. Surprisingly, many technology companies develop a product that solves the first issue (meaningful problem) but neglect to consider the second (user workflows and preferences). Consequently, they experience poor adoption, limiting and or even eliminating the product’s ability to succeed.

The second approach is equally important but often overlooked - build an implementation process tailored to address a physician’s unique objections/concerns with an understanding of their job, their workflow, their practice, etc. With that in mind, you need to make it as easy as possible for them to get on board (hand-holding as needed), quickly demonstrate the value of using the technology (what’s in it for them), and ensure that they are motivated to continue using it (continued engagement, tracking, etc.).

When it comes to developing a secure communication solution for hospitals, there are some basic features and functionality that every solution must have at its core. The solution must successfully facilitate the delivery of messages between users. And, the solution must address mounting security requirements that hospitals face, including the need for HIPAA compliance. There are a number of vendors that offer products that address those core requirements, but MD Interconnect created a solution that goes beyond these basic requirements to engage users and ensure adoption. You can learn more about the company’s physician-driven design in this previous blog post. Here are some of the factors MD Interconnect considered while developing a product with adoption and sustained engagement in mind:

  • Physician adoption is of the highest priority. Lead with them and the rest will follow.
  • You must make it quick and easy for messages to be read, and provide visibility to senders about that status.
  • You must consider a physician’s personal preferences about when they should be reached and when they should not.
  • Call schedules and call hierarchies must be integrated into the communication platform.
  • It should also support the teaching hospital hierarchy and include residents, APPs, fellows and attendings at the appropriate times.
  • You must consider times when a physician cannot safely respond to a message, making it easy (and secure) for a proxy to respond on their behalf. See this blog post on RapidPair to learn more.
  • You must address the differences between cell phones and pagers, as well as the unique challenges, benefits, and behaviors associated with each.
  • Your pricing model must encourage adoption by the entire patient care team/community.
  • The ability to easily forward a message chain to a support team, including clinic schedulers and bed management must be built into the solution.

With RapidConnect, MD Interconnect knew they had a great product that hospitals, physicians and patients would benefit from, but they also knew their job wasn’t done. See our next blog post on what it takes to ensure a successful implementation and ongoing user engagement.