Carl Weinschenk spoke with Gregg Malkary, the founder and managing director of the Spyglass Consulting Group. This week, Spyglass released a study, "Healthcare Without Bounds: Point of Care Communications for Nursing," that looked at communications within hospitals.
Weinschenk: What did the study look at, and how was it conducted?
Malkary: The study is an end-user market study. It looked at the current state of communications adoption by nurses across the U. S. in acute care environments and home health. It is an outgrowth of a similarily named study done in 2006. We interviewed over the telephone more than 100 nursing thought leaders all over the country. We did this over a three-month period. We explored work flow inefficiencies, communications with colleagues and patients, current usage models for mobile devices, solutions they were using, and some of the barriers to widespread adoption.
"In a nutshell, what's going on is communications is anything but unified in health care. The only way for nurses to communicate effectively is to carry many different devices on a belt."
Weinschenk: What did you find?
Malkary: One of the top-level findings is that there are significant communications problems for hospital-based nurses at the point of care. The fact remains that many organizations today buy through their purchasing department solutions that simply are incompatible with each other. That makes it difficult to communicate with patients and collaborate with care team members. Hospitals are using solutions from different vendors with different handsets over different wireless frequencies.
Weinschenk: What's the bottom line?
Malkary: In a nutshell, what's going on is communications is anything but unified in health care. The only way for nurses to communicate effectively is to carry many different devices on a belt. If you are the charge nurse, you may have a pager and maybe another if you are a member of an emergency response team. ... You see how these add up on the belt. Because multiple devices each carry critical and non-critical messages, there is no way to filter, manage and prioritize messages, so we have a mess.
Weinschenk: Are there other issues?
Malkary: Another key problem is that wireless networks are not optimized to support communications in hospitals. A lot of the facilities are older and hard to retrofit for Wi-Fi. They do not have uniform coverage throughout the facility. They often have dropped data and voice connections. That makes it difficult to document patient care at the bedside and use VoIP to communicate with other members of the team. The second major point is that hospitals are investing in communications but many deployments around VoIP are limited. It's very expensive, so they are deploying it in specific departments in the hospital. They are only giving the handset to limited members because they're $800 or $900 bucks apiece fully loaded, with all the expenses of getting things online.
Weinschenk: What else did you find?
Malkary: There also are unintended consequences of using technology like VoIP. In theory, it's greatThe problem with using a VoIP phone is when the nurse is with a patient, they have to triage incoming calls at the bedside. She could be doing something critical such as administering medication, and that is disruptive to their train of thought. This can introduce errors into the process. It could also violate HIPAA. You could be talking about another patient in front of another family, which is a clear violation of the law.