Magazine Article | November 25, 2013

Secure Texting Streamlines Clinical Communication

Source: Health IT Outcomes

By Susan Kreimer, contributing editor

A Canadian hospital installs a secure texting solution to facilitate physician paging and to provide more details about consulting cases.

A mobile software application is paving the way for more secure texts among healthcare team members at The Ottawa Hospital, which has 12,000 employees, including 1,200 staff physicians and about 900 residents. The solution (Amcom Mobile Connect) links to the hospital call center’s directory, simplifying the process of locating physicians. According to Margaret Quirie, The Ottawa Hospital’s director of information organization and access, this eliminates wasted time that used to be spent waiting for pages to be placed manually and acknowledged. It’s also more HIPAA-compliant and may reduce the number of devices that a clinician has to carry.

“Now, all pages are tracked, which helps with audits and risk management,” Quirie said. “It also closes the accountability loop. We know that a person received the page.” Confirmation occurs when the recipient presses a thumbs-up button.

By making paging more user-friendly, the hospital aimed to decrease the number of internal calls made through the call center. Before the new application, the center was processing about 1.7 million internal calls per year, and most of them involved paging requests.

“We have seen a 14 percent reduction in internal calls, which can be attributed to the installation of the Amcom WebXchange and the introduction of Mobile Connect,” Quirie said. “WebXchange allows users to view the directory and on-call schedules online and page a user directly from the Web page.”

Another advantage of this new mobile software application is its capability to transmit more information to physicians about a patient’s condition on a larger display screen than traditional pagers. Glen Geiger, M.D., CMIO at The Ottawa Hospital, explained, “Most of our physicians have smartphones. Some clinicians have been able to replace their pagers, while others are still using pagers along with smartphones. Some staff members still prefer to use their pagers for emergency situations, such as code alerts.”

Pilot Program Helps Avoid Integration Problems
The Ottawa Hospital was already using Amcom’s operator console, Web directory, and on-call scheduling software when its administration decided to embark on a pilot study of the mobile software application. A successful trial ran from February through September 2012.

“One of the reasons we chose Amcom was to avoid integration issues, since the product automatically connected to our call center’s directory,” Quirie said. “The pilot was longer than planned because Amcom rolled out a new version of Mobile Connect, and we wanted to test the new version before we purchased the licenses.”

“After the initial phase, we moved into a more sophisticated approach where we’re automatically routing the consults from the emergency department,” said Dr. Geiger. By tying the EMR and Emergency Department (ED) tracking systems to Amcom, the hospital is making it possible for consulting physicians to look up specifics about a patient’s condition — and their location within the facility — on a smartphone or iPad.

Amcom’s integration capabilities also helped The Ottawa Hospital accelerate the rollout of the secure texting solution not only to corporateissued mobile devices, but to personally owned devices used on the job as well. “In July, when new residents started, we were able to put half of them on the secure texting solution right away,” Quirie said. “We don’t force it on them. It’s a bring-yourown- device (BYOD)-type situation for residents.”

In the latest modification, ER physicians decided to add consult detail capabilities to the secure messaging solution. These features provide clinicians with more information and guidance on the reason for the consult. “These capabilities will be added in February 2014,” Dr. Geiger said. “I consider that a sign of a good pilot when people say, ‘Yes, we like it. We want to do a little more.’”

A 3,000-License Deployment
When the pilot ended, The Ottawa Hospital began purchasing licenses for the new application. It started rolling out the implementation in late fall 2012, mostly to those who expressed interest after hearing about it through word of mouth.

Each user is registered and offered a 10-minute introductory session. To help with the rollout, Amcom offered on-site training, online videos, and a quick-tip sheet. Quirie stated that an Amcom license costs less per person per month than a numeric pager. “This cost savings will likely continue to grow the longer we leverage the solution and the more users and capabilities we add,” she says. “With this in mind, the return on investment for the solution will probably take a couple of years. We are slowly reaching out to different departments within the hospital to get them up and running on the solution.”

The software deployment is occurring across three hospital campuses of the academic health sciences center. Nearly 500 devices have received licenses so far, and the plan calls for a total of 3,000 licenses to be rolled out by late March 2014.

“We’re now extending our secure messaging solution beyond physicians,” says Quirie. “While at least half of the licenses thus far have gone to physicians, others were assigned to pharmacists, nurses, and senior administrators.”

The Ottawa Hospital’s secure texting application also uses encryption, which assuages patient privacy concerns. “Prior to our secure messaging solution, we knew there were some clinicians who used text messaging to communicate; yet we weren’t able to ensure that these messages did not include patient information,” says Quirie. “With our new solution, we know the information being texted through the software is secure.”

Transmission of data occurs entirely within the firewall of the hospital’s server. “The security of the application was very important to us when we selected it,” Dr. Geiger said. “We’re not outsourcing this somewhere else. It’s all internal.”