Why healthcare needs real-time, asynchronous communications

Another day, another study confirming what SOME of us have known all along—by utilizing mobile communication applications (such as secure texting) in lieu of outdated devices like pagers in healthcare, clinicians, administrators, AND patients are seeing tangible benefits.

But without the numbers to back them up, claims of increased productivity and better patient outcomes are difficult to demonstrate—unless you're already using secure messaging, of course. We've assembled some of the best claims below.

Shorter Hospital Stays

It naturally follows that care teams communicating more effectively would lead to shorter hospital visits for patients, but the latest study from two Philadelphia hospitals quantified exactly how much.

Monitoring two separate hospitals during a secure messaging pilot, researchers found that the average length of stay for patients being tended to by secure texting-enabled care teams dropped 0.6 of a day IMMEDIATELY (from 6.0 to 5.4), and ended up averaging to a 14% reduction in time of hospital stays over the one year study (a total reduction of 0.77 days).

With 35.1 million inpatient stays annually, and the average cost per inpatient day hovering around $1986, the improvement to hospitals' bottom line sits close to $1500 per inpatient—saving the industry, as a whole, $52B annually.

A More Efficient Workforce

The lack of a real-time, asynchronous communication channel in healthcare can have a drastic impact on care team productivity. Anyone who's used a pager in the workplace is more than familiar with the downtime required to get in contact with the proper party. A 2014 study from the Ponemon Institute found that the amount of time wasted due to inefficient communications during 3 critical workflows (admission, transfer, and emergency response team coordination) was costing hospitals $1.7M annually.

The study found that the majority of time necessary to complete these workflows was being wasted due to the lack of a real-time communication component. By applying a secure messaging solution, admissions could be reduced from 51 minutes to 18 minutes; transfers from 56 to 21 minutes; and emergency response from 93 to 53 minutes, representing a total efficiency savings of 57%.

Our own research found that at one of our client hospitals, their Emergency Department overflow workflow was improved nearly 500% from 30 minutes to 5 minutes to alert all necessary parties.

Real-time secure messaging solutions offer the opportunity to access the people and information you need, when you need it—no standing around waiting for a callback, no furtively hoping someone responds to a page, and insight into who received a message and when.

Fewer Errors

Hospital communication workflows are built on a shaky structure of interruptions. Disruptive pages, telephone and face-to-face conversations, and multi-tasking contribute to an inordinate amount of otherwise preventable hospital errors. This can literally mean the difference between life or death; in a retrospective review of 16,000 in-hospital deaths, communication errors were found to be the leading cause, twice as frequent as errors due to inadequate clinical skill.

As one studyfound: "Those who work in an interruption-driven environment are likely to suffer failures of working memory. As interruptions occur, interfering with the active cognitive rehearsal of what is to be done and generating new tasks for their recipients, prospective plans may be partly or fully forgotten."

The patient safety impact of interruptions is well-documented in healthcare. Interruptions contributed to 43% of medication errors. Distraction factors were a leading contribution of wrong-site surgery errors, according to JCAHO. The number of interruptions a clinician encounters correlates directly with their level of authority, with senior physicians and RN managers receiving *23.5 and 24.9 interruptions per hour* (or roughly one every two and a half minutes), respectively. And, most damningly, interruptions occurring in healthcare impacted direct patient care tasks or patient interventions nearly 43% of the time. The majority of these interruptions aren't arising externally, or from the patients themselves, but rather from coworkers and other clinicians attempting to communicate or seeking clarification or instruction.

The solution to reducing, if not eliminating, interruptions in hospitals and healthcare environments lies in asynchronous communication mediums (such as secure text messaging applications). In fact, as the authors of **Improving Clinical Communication: A View from Psychology** state:

"Asynchronous communications technologies such as messaging, voicemail and email, with acknowledgements, could fulfill the initiator's need for immediate task completion without generating an interrupt for the recipient. The cognitive benefits of asynchronous communication for both message senders and recipients could be substantial."

For callers, the ability to send a communication knowing instinctively it will be routed to the appropriate receiver greatly reduces the number of pending tasks in working memory; every time a message is sent via the app, a pending task is completed. For recipients, the receipt of fewer interruptive calls and ability to access key messages without interruption contributes to greater chunks of uninterrupted time and greater ability to rehearse and recall existing outstanding tasks. By utilizing mobile messaging, clinicians can accomplish more tasks, fewer errors in task completion, and fewer forgotten tasks. "These probable benefits from moving some communication tasks from synchronous to asynchronous channels would result from a decreased incidence in the factors contributing to memory errors, such as distraction, interference, and new involuntary additions to prospective memory," the authors concluded.

When hospitals and healthcare systems evaluate and implement secure text messaging solutions, the driving force is usually simply a desire to apply a HIPAA-compliant channel to their electronic communications; however, with the right tool in place, as evidenced above, the benefits can extend far beyond that.

*Derek Bolen is the Communications Manager at TelmedIQ, a cloud-based Healthcare Communications Hub® that unifies secure mobile messaging, workflow automation, scheduling, EMR integration, answering service, nurse call, and paging systems.*

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