Health IT

Paging Dr. Smartphone: Healthcare Communications at a Crossroad

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Embracing new technologies could save U.S. hospitals billions of dollars a year.

You’re standing by the fax machine, watching it slowly spit out the information you requested. Your pager beeps insistently, and you pick up your landline to dial the number it displays. There’s no answer, so you leave a message. As you wait for a call back, you power up your laptop to send an email, but you can’t connect to the Wi-Fi network.

No, you haven’t traveled back in time to the 20th century. You’re just a healthcare provider working in a typical American hospital where communication devices that have gone extinct in other industries continue to thrive.

Outdated tools like pagers and fax machines cost U.S. hospitals a collective $8.3 billion each year, according to a new study conducted by the Ponemon Institute and sponsored by the health IT security company Imprivata. Polling 577 clinicians, administrators and IT staff in hospitals of various sizes, the study found that the average doctor squanders more than 45 minutes each day waiting for patient information to flow through inefficient modes of communication.

Respondents blamed these delays on the continued use of pagers, a lack of Wi-Fi access, inefficient email and bans on personal mobile devices. These factors limit face time with patients and lengthen hospital discharge times by 37 minutes, the study found.

“There are a number of communication devices they’re using in healthcare that are causing a real productivity impact,” Ed Gaudet, Imprivata’s chief marketing officer, told HealthBiz Decoded. “They can’t get in touch with the right people at the right time.”

Overwhelmingly, Gaudet said, doctors and nurses yearn to jettison their clunky pagers and receive alerts on personal or hospital-issued smartphones. But while some are already doing so, there remains concern that texting patient information back and forth could risk of violating the privacy and security regulations in the Health Insurance Portability and Accountability Act, or HIPAA. In the survey, 56 percent of respondents said that HIPAA compliance restricts the use of electronic communications, while 85 percent said it reduces time available for patient care.

“The perception is that rigid compliance to the rules comes at the expense of patient care,” said Larry Ponemon, chairman and founder of the Ponemon Institute. “Clinicians felt that these rules were cumbersome and prevented them from using the latest and greatest technology, like the ability to move away from pagers.”

To address HIPAA concerns, some companies now offer secure texting applications that encrypt messages sent by clinicians and automatically wipe lost phones. Doctors and IT specialists believe this technology could streamline hospital workflows, lowering patient discharge times by roughly 50 minutes, according to the study. Seventy-four percent of the survey’s respondents predict secure text messaging either has or will replace pagers within the next two years.

Secure texting could also help fulfill the patient engagement requirements of the government’s Meaningful Use program, which incentivizes providers to adopt electronic medical records, Gaudet said. Doctors will increasingly use Web portals and text messages to communicate with patients, relying less on traditional methods like the telephone and snail mail, the study found.

Within the Pittsburgh-based nonprofit health system UPMC, which operates more than 20 hospitals and 400 outpatient sites, some doctors have traded their pagers for a homegrown smartphone app that promotes collaboration, said Dr. Rasu Shrestha, vice president of medical information technology.

Providers exchange secure messages that automatically reach every member of a patient’s care team and contain a link to that patient’s electronic medical record. “In addition to communicating the message, they’re also immediately able to see the context,” said Shrestha.

“Skeptical Scalpel,” a healthcare blogger who is a recently retired surgeon, remembers receiving his first pager while attending medical school in the late 1960s.

“The amazing thing is the technology really hasn’t changed a lot,” said the blogger, who asked to be identified only by his online alias. “Back then, the issue was finding a phone. You had to make sure to remember you had — at that time — dimes in your pocket so you could make those calls.”

He acknowledged that many physicians lug their pagers reluctantly. But even in an era of sleek smartphones, the older gadget still has value.

“Until phones are as reliable as pagers, I don’t think they’re quite ready for hospital use,” he explained, noting that cellular reception can be spotty.

But it’s not just the peril of dropped calls that keeps pagers relevant, according to Ted McNaught, president and chief operating officer of pager provider Critical Alert Systems, as well as president and of the Critical Messaging Association.

During catastrophic events, cellular networks could become overwhelmed and stop functioning. “Paging is the only communication system we have that continues to work,” said McNaught.“

For some doctors, of course, the old-fashioned pager has one very distinct charm. “The minute you walk out when you’re not on call anymore, you turn the damn thing off and it’s done,” said Skeptical Scalpel.