Electronic Health Reporter

By Dr. Will O’Connor, chief medical information officer, TigerConnect.

The pandemic is highlighting how difficulties with technology are stressing out healthcare employees and negatively affecting the quality of care. It’s a problematic situation, though in truth, it’s only the latest in a long history of tech devices impairing the delivery of healthcare.

Even in 1980, the movie “Caddyshack” had a character literally named “Dr. Beeper.” As the troubles mount, though, it’s an opportune moment to examine the underlying causes of this problem and glimpse at possible solutions.

The problem

Use of obsolete communication devices leads to breakdowns in collaboration between care team members, allied health service providers, and patients. It is a source of frustration and sub-optimal clinical and financial outcomes. In a recent survey we conducted, 53% of care team members said they experienced communication disconnects that affected patients at least once a week. For 12%, it’s a daily experience. Half the respondents felt that a patient’s inability to communicate with a doctor, outside of a visit, was the most frustrating aspect of a hospital stay.

Why is this happening? At the device level, care team members are not provided with equipment that enables them to collaborate effectively. While use of pagers is declining, now employed by about 49% of hospitals, healthcare still outpaces other industries in use of this antiquated technology. In our research, 47% of caregivers perceived that healthcare was either “somewhat behind” or “extremely behind” other industries in adoption of modern communication technology.

Today’s nurses may be carrying up to three pagers. They receive so many alerts that they have trouble separating the signal from the noise—contributing to “alarm fatigue” that is bad for morale and patient care. Faxes, emails and whiteboards continue to abound.

Underlying drivers

Some of the problem is financial. Thirty-eight percent of healthcare CIOs listed ‘EMR optimization’ as their top capital investment priority in the coming three years. This is understandable given the centrality of records and EHR to a healthcare organization and the regulatory requirements that mandate their existence. However, spending on records management, billing, and patient portals does not do much for care team communication and collaboration. While EHR systems now often offer communications via chat or simple text messaging, they are generally not well-suited to the kind of dynamic messaging needed for effective care delivery.

Tech devices also lag in modernization due to a lack of prioritization. Forty-seven percent of clinicians cited digital as a top organizational priority. Yet, healthcare’s current overall digital transformation roadmap has consistently under-emphasized improving and innovating clinical collaboration and communication.

Real life impacts

Use of outdated tech in care delivery can impact patient health. For example, in the case of an ischemic stroke, the sooner the patient receives TPA—the so-called “door-to-needle” time—the better his or her chances will be of making a full recovery. A shorter door-to-needle time means avoiding damage to the brain and impairment of physical functioning. Poor communication and collaboration can stretch out the door-to-needle time, as care team members struggle to coordinate complex care quickly.

Financial impacts

Reliance on sub-par tech devices can also result in significant financial impacts on a healthcare organization. In the stroke example, a delayed response might lead to a longer hospital stay and increased costs. Re-admission is another possible sequel, one that causes further financial loss.

Solving the problem

A new generation of clinical communication and collaboration solutions—using cloud-based apps and smartphones—offers a way out of the troubles that arise with inferior tech devices in healthcare. They enable delivery of relevant information to the right person in real time. This might mean automatically routing patient information to people as they start a shift. Devices can be linked to physiological monitors, EHR systems and nurse call software. Moving in this direction will require an investment, but the payback in the form of improved care and financial outcomes should make the decision to move ahead a relatively easy one to make.