Health_Care_Communications

The Use of information technology to Further Health Care Communication Heather HCS320: Health Care Communication Strategies June 28, 2010 Professor: Kathie Huttegger The Use of Information Technology to Further Health Care Communication Health care delivery is a high-touch undertaking that requires interaction among all stakeholders within the health care ecosystem. Interpersonal communication is a key part of this interaction and can be transformed by the intelligent use of technology. When discussing connections in health care, often data connections are thought of such as connecting physicians and other clinicians to patient data; connecting diagnostic testing facilities to physicians offices, and physicians offices to hospitals; connecting provider facility to payer, or connecting provider facility to public health departments. The critical role that communications play among people in health care is often neglected. Human beings require communication both for information exchange and for affective content that may accompany the information, such as nonverbal signals like facial expressions or body language. Technology can be applied in various ways to facilitate communication in the highly collaborative and mobile environment that is health care. The current barriers to communicating effectively in healthcare and the limitations of technologies used for communication contribute both to inefficiency and adverse events. In clinical care we often discuss the critical need to have information about the right patient delivered to the right clinician at the right time. What is often forgotten is the critical need for clinicians to connect and communicate with the right person about the right patient at the right time. The inability to do so results in countless wasted hours and untold delays in the delivery and throughput of patient care. According to the Cisco Internet Business Solutions Group (IBSG) analysis, “The financial cost of communication inefficiencies to U.S. hospitals alone exceeds $10 billion annually” (2008), and likely contributes to personnel shortages, staff and patient dissatisfaction, and medical errors. Presenting new technologies is challenging when dealing with an industry entrenched in using the same telephone, fax, and pager systems for decades. Many problems in healthcare stem from the industry clinging to these outdated methods of communication, without understanding the benefits brought about by newer solutions. While physicians have found newer tools such as e-mail useful, they are typically used only in limited situations and not commonly employed to communicate with patients. The reasons for physicians’ reluctance to use electronic communication with patients includes: concerns about malpractice litigation, fears of being barraged with e-mails, and the absence of a model that reimburses them for consulting with patients electronically. Communication in healthcare fails for many reasons: necessary personnel cannot be identified or located; they may not be available or may not respond in a timely manner; or the communication channel of choice may not be well suited to the task at hand. E-mail would not be used for time-sensitive issues such as a patient having a heart attack, or in situations that require a dense exchange of information. Pagers, for instance, are more appropriate for time-sensitive issues, while telephones, in-person or videoconferencing meetings, or web-based collaboration tools are more efficient options for exchanging dense information, such as detailed case reports. Because case reports require much discussion among physicians, using email only slows down the discussion process. Failures also happen when the person initiating communication does not choose the optimum channel to accommodate the recipient, but rather to accomplish his or her own goals expeditiously. Interruptions are common in healthcare and quite disruptive. Frequently, inappropriate communication choices may be made because the hospital lacks other satisfactory communication channels. The inability to contact the right person quickly also creates inefficiency among staff and affects patient care. In a survey of communication among hospital nurses, which was part of a study commissioned by Cisco, Forrester Research found that the majority of nurses felt that they would save 30–60 minutes per workday, time they could spend caring for patients directly, if they had instant access to experts. Eighty-four percent felt that the time they spent trying to reach people had a direct impact on patient care because of delays and time spent away from patients, while 65 percent estimated that they spent upward of 20 minutes each day trying to contact people, with many spending well over an hour. Hospitals are ill-equipped to shoulder the burden of these inefficiencies. Another reason is that many hospitals are suffering financially, the American Hospital Association reports that 25 percent of U.S. hospitals are losing money, and those not struggling are experiencing thin margins (2006). Poor communications also affect patient safety. The Joint Commission, a U.S.-based organization charged with improving the safety of healthcare delivery worldwide, examined sentinel events as a way of understanding dangerous medical errors. Barriers to implementing modern technologies stem not only from outdated technology infrastructures and a conservative industry culture, but also from a lack of interoperability among databases and applications. For example, numerous directories, on-call databases, and coverage lists must be able to work together to streamline the process of identifying the proper contact. Many types of communication take place among clinicians, and between clinicians and patients. A number of interactions exist based on the participants and the tasks. Although health care delivery is ideally patient-centric, in practice it is clinician-centric because clinicians participate in more varied types of communication than do patients. The types of communication and tasks in which clinicians partake include providing direct care to patients; collaborating about patient care within or among institutions; discussing test results with other staff; and working with administrative staff, public health departments, and other organizations. Many communication channels are used in healthcare, each with different properties. These channels may be synchronous or asynchronous, mobile or fixed, secure or non-secure. Because of this, participants must decide which channel best suits the issue about which they need to communicate. Synchronous channels such as telephones and face-to-face meetings allow both parties to communicate at the same time, enabling information to flow freely in real-time. Synchronous channels are ideal when discussing time-sensitive issues and exchanging dense information. It is not always convenient; however, for a patient and physician to schedule time to communicate using synchronous channels because they can lead to delayed care, telephone tag, and frustration when these channels fail to connect, some healthcare issues remain unaddressed. Yet generally only pagers and synchronous communications are available for patient-physician communication. Asynchronous channels such as email, fax, and blogs enable each party to communicate when it is convenient. These channels may be used safely for issues that are non-urgent or time-sensitive. Because time is not a factor when using asynchronous channels, both patient and clinician can be more reflective in their messaging. Another characteristic of communication channels is whether they are fixed or mobile. Thanks to advances in technology, many communication channels that were once fixed are now wireless, such as telephones and text messaging. Technology can be applied in various ways to aid communications among physicians, and among physicians and patients as well as to facilitate collaboration. They include: web-based messaging, presence servers, IP video telephony, and web-based collaboration. Contacting the right clinician for the right task at the right time is critical in healthcare. So is choosing the right tool by which to communicate. Although medical technology has evolved, the tools with which clinicians communicate today are decades old, now with a greater variety of communication options from which to choose, users can pick the most appropriate technology for a given situation. The benefits of these options can be enhanced with tools that enable users to identify easily whether intended recipients are available and through which means, permitting rapid connection through a variety of channels, and allowing parties to transition smoothly from one channel to another. By harnessing the power of the panoply of communication options without introducing additional complexity to an already complicated and frenetic environment, unified communications offers tremendous benefits to patients, clinicians, staff, and healthcare providers. Healthcare providers are urged to expand their thinking about the role communication technology plays in healthcare. They must review their current communication challenges, and then deploy advanced technologies and solutions to assess their impact. Institutions that fail to recognize and address their challenges will continue to experience the same obstacles and frustrations that have plagued the healthcare industry for decades, leading to billions of dollars in excess costs to U.S. hospitals and a negative impact on patient care. References Cisco Systems. (1992-2010). Healthcare -Industry Solutions - Cisco Systems. Retrieved from http://www.cisco.com/web/strategy/healthcare/index.html Cisco IBSG analysis, 2008 “Unified Communications Industry Study,” Forrester Research, Inc., 2006.