Most EMRs today have a secure text messaging component as part of their offering.While it is desirable to have everything in one suite of products, there are few EMR secure messaging applications that actually meet the functional requirements and user preferences of today’s physicians.
The following checklist provides an overview of several features and components that organizations should consider when evaluating whether to use the embedded EMR messaging application, or look to an outside “best of breed” software provider.
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Team Engagement/Message Routing
Service lines have varied workflows that can engage team members at different times of the day depending on the type of message, as well as the availability of personnel. Often, one or more persons will be covering multiple functions within the service line and then switch during the day. The switch occurs more often these days due to resident work hour restrictions and addition of advanced practice practitioners (APP). (Usually these rules are noted by *** at the bottom of the call sheet).
Does Your EMR Messaging Application . . .
Differentiate message routing based on patient status (inpatient/outpatient)? Route messages differently for established patients versus new consults? Support sending messages to multiple people covering a role and lets receivers know “who has the ball?” Automatically route messages to care team members such as residents, fellows, PAs, ANP, etc., based on patient status and doctor/physician relationship and the service line preference? Allow for multiple call schedules associated with a single role?
Outpatient Community/ACO Engagement
Outpatient messaging volume will be less than 20% of total message volume, but this area has the greatest potential to impact patient experience and collaborative patient management. Furthermore, by engaging the community, you increase referrals and decrease leakage from your network.
Does Your EMR Messaging Application . . .
Allow for broad distribution to outpatient-based physicians, including regional referring doctors without running afoul of anti-kickback laws? Make it easy for physicians to log in and stay logged in to messaging system? Provide onsite training and on-boarding process for community physicians? Allow outpatient practice call schedules to be viewed in system? Provide information about patients who are being directed to an Urgent Care/Emergency Department/ or inpatient admission?
Physicians Usability
To actively engage your highest paid resource, it is vital for the platform to offset concerns over increase in access, i.e., “People can already page me, call me or text me on my phone.” New technology must make their lives easier.
Does Your EMR Messaging Application . . .
Allow providers to easily control when others can reach them without signing in/signing out at every transition? Automatically limit access based on call schedules? Allow a staff member proxy into a physicians’ messages WITHOUT accessing the physician’s phone or asking for their EMR password? Allow physicians to transfer their on-call status to someone else from the mobile app (a virtual “hold my pager” function)? Send consult requests to correct service line resource even if the “on the front line” resource is not the Consulting Physician of record in the EHR? Have so many security hoops to jump through —changing passwords, log out timers, etc.—that you risk non-adoption? Find every clinical resource on the app, regardless of whether the resource has downloaded the app?
Training/Supporting Change Management
Many people have used their phones for email, photos and texting but not much else. Understanding app notifications and how phone and app settings can impact your response times is critical. Many physicians consider cell phones personal assets more than business property.