Managing the surprisingly troublesome impact of real-time healthcare on clinical decision-making

We live in an age of instant gratification. From the texts we send friends and family to the orders we place on Amazon.com, we’ve come to expect immediate results: instant responses, next-day shipping, etc.

The idea of immediacy in healthcare communications is not new. In fact, in 2015, healthcare analyst Gartner outlined a vision for what it dubbed the “real-time health system”—a landscape where healthcare professionals will be constantly aware of what’s happening within their systems and with their patients.

As a person living in the digital age, you’ve probably experienced real-time awareness in other parts of your life: the repetitive dings of received text messages, the intermittent beeps of calendar alerts, the near-constant hum as your smartphone vibrates over and over to let you know your mother, children and cousins have uploaded photos to Facebook, Instagram and Snapchat. In fact, as I’m typing this piece, I’ve heard alerts for two personal text messages that I’ve yet to look at (the temptation is maddening), four work-related emails (that I did have to stop and look at), a notification that someone commented on a thread I replied to on Facebook and more.

While there’s definitely a benefit to each of us knowing what’s happening in our expanded universe in real time—and we can easily draw a direct line to the benefits that doctors, nurses and patients would experience if they could communicate instantaneously while coordinating care—the influx of information is simply overwhelming.

And when alarm fatigue sets in, important messages get missed, the communication cycle breaks down and what was once a valuable resource becomes a liability. Overwhelmed and inundated clinicians cannot optimally use their invaluable expertise to make effective clinical decisions that deliver great health outcomes.

Aggregating, analyzing and managing the distribution of clinical information

Managing the flow of data and alert fatigue is a real challenge that clinicians and the IT teams that support them need to understand. Clinicians need “just the facts, ma’am,” so to speak, and they need to know which set of facts pertain directly to them and the patients for whom they are caring. Receiving more than enough information is not always a good thing, especially when the situation calls for fast thinking and quick decisions.

Investments made in technologies implemented over the past several years have enabled healthcare as an industry to generate very large amounts of digitized clinical information. The challenge is to aggregate this patient data in real time to generate new knowledge about a patient and distribute it in a way that does not inundate the clinician recipients with unnecessary information. Physicians and nurses should receive information they need in order to act in that moment. Everything else is noise.


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Implementing communication-driven workflows

Once new knowledge is made available and deemed relevant to a given clinical situation, it’s important to enable workflows that drive this information to the right care team members, who can take action in that moment. Hospital-based communication workflows must encompass all modalities, adhere to strict security mandates and facilitate reliable exchanges among clinicians across boundaries (e.g., acute, pre-acute and post-acute care settings). This kind of clinical integration is the future of healthcare communications.

If clinicians are inundated with unnecessary information, messages and alerts, combined with a communication workflow that creates barriers to a) finding the right care team member to contact, b) finding the contact method that the clinician prefers and c) knowing whether the intended recipient received the message, the workflow is flawed and is inhibiting the decision-making that leads to higher standards of patient care.

Leveraging clinical expertise

The personal judgment of experienced healthcare professionals is irreplaceable in effective, real-time decision-making. Technological advances are no doubt improving healthcare, but human intuition can never be replaced by a new device or software. However, that intuition can be inhibited by technologies if they are not strategically implemented and managed. In this sense, real-time healthcare could, ironically, be eroding quality.

To truly leverage the hundreds of collective years of clinical expertise housed in the minds of your hospital’s medical staff—the expertise that yields great outcomes—you must remove the barriers to effective communication. Collecting patient data in real time is an important part of that. But analyzing and aggregating that data into digestible, valuable pieces of information that can be easily shared and collaborated on is the follow-through that is often overlooked.

The gravitation toward instant gratification isn’t going away. And it’s important to understand that the concept doesn’t apply simply to generating patient data as healthcare events are occurring, but also to the ability to extract the significant portions and begin collaborating with the broader care team to interpret the data and derive a plan to deliver high-value care.

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The role of secure communications in your clinical integration strategy

If you could take one solution with you on your journey to clinical integration, what would it be?

Clinical integration is the unification of healthcare data, services and coordination across acute, outpatient and post-acute care. It portrays an environment where waste and inefficiency are all but eliminated from healthcare communications, costs decrease and care improves. It’s the future of medicine.

You wouldn’t be far off course if your first thought was to rely heavily on the EHR to support your clinical integration strategy. While the EHR is a valuable tool for sharing patient information within hospital systems and broader care networks, it lacks a fundamental quality that bridges the gaps between Meaningful Use and true clinical integration.

Fully realized clinical integration can only occur when the barriers of communication have been broken down, and interdisciplinary clinicians can accurately and reliably coordinate care in real time across organizational and geographical boundaries. As with most things related to healthcare communication and the sharing of information across disparate networks, securing those communications has been and will continue to be a primary focus for healthcare IT leaders. In an environment where healthcare organizations are driving toward an end-goal of clinical integration, enabling secure communications alone just isn’t enough.

To achieve clinical integration, clinicians need a solution that enables immediate, accurate, reliable and secure communications.

Immediacy in healthcare communication

Real-time communication is a crucial element of delivering high-value care. In the most critical emergencies, every second counts. The time that clinicians waste identifying the right on-call care team member to contact, and then trying to reach that person, can quite literally be the difference between life and death. Even in non-emergent situations, early detection and treatment are well-known effective preventers of worsening conditions.

Yet it’s all too common for inefficient and broken communication workflows to create time-consuming hurdles for clinicians to clear—sometimes even to just begin the conversation.

Clinically integrated settings approach clinician-to-clinician communication with a sense of real-time urgency. That’s not to say that every message should be sent with an emergency status, just that the process of identifying the provider you need to connect to and the delivery of that message should be seamless and immediate.

Reaching the right care team member on the first attempt should be an important metric for all hospital systems. To keep performance numbers high in this area, you must ensure clinicians always know exactly whom to contact for any given medical issue.

However, most clinicians today initiate time-sensitive contact to the broader care team by thumbing through a lengthy paper-based on-call schedule, making a call, and then waiting to receive a response.

Real-time clinical communication and collaboration tools immediately deliver secure communications, and even allow the clinician initiating the communication to see in real time when messages are delivered and read.

Contact accuracy

Reaching providers on the first attempt is important, but it’s just as important to reach the right provider—the one who can act on the medical issue at that moment—via his or her preferred method of contact.

It’s not uncommon for providers to have a different preferred contact medium for every variance of their schedule. And it’s not uncommon for those schedules to change at a moment’s notice. Yet many hospitals, in both small and large systems, only print the schedule and patient assignment lists once per day.

Clinicians in this setting have no way of knowing if they are accurately reaching out to the right providers via the right contact method. Manually producing a list of whom to contact and how is a process riddled with opportunity for inefficiency and inaccuracy.

Dynamic Intelligent Routing™ eliminates those opportunities for communication breakdown. A distinct capability of PerfectServe, Dynamic Intelligent Routing analyzes workflows, call schedules and contact preferences, enabling clinicians to reach the right person at the right time with just the tap of a button.

Reliable communication workflows

If your clinicians depend on inaccurate call schedules or outdated, cumbersome processes to drive clinical communications, your communication workflow isn’t reliable.

When clinicians can immediately contact the care team member they need via that provider’s preferred contact method, communication workflows become reliable and trustworthy, which leads to high adoption and improved patient care, no matter the care setting.

From improved care coordination to reduced costs

Inefficient communication workflows not only interfere with the realization of clinical integration, but also they inflate healthcare costs. For example, if a radiologist identifies a critical result in an outpatient test, the radiologist needs to contact the patient’s PCP so action can be taken right away. If the communication is not immediate, accurate or reliable, the process breaks down and the delay could result in medical complications for the patient that end up costing more to treat.

Moving a patient safely through the admissions, treatment, discharge and post-acute care processes requires a tremendous amount of coordination, good communication and a sound clinical integration strategy. The tools you use to support that communication and collaboration will play an important role in your success.

See how an innovative partner rated Best in KLAS for Clinical Communications after four consecutive years leading the category can help ensure you’ve got the right solutions working for you.

Physician Engagement:
What It Is & Why It’s Important

Physician Engagement Definition | Measuring Physician Engagement | Improving Physician Engagement | Physician Engagement Best Practices

In healthcare, the impact of workforce engagement has similarities with other industries such as productivity, turnover, and financial performance. However, physician engagement also impacts the health, safety, and well-being of patients. The good news is clinical communication and collaboration solutions can address those common denominators and support key stakeholders.

What is Physician Engagement?

Engaged physicians take greater care of their patients, reduce medical costs, and are more efficient than their unengaged counterparts. The Health Care Advisory Board states that creating organizational alignment is one of the most challenging initiatives, but the most crucial to success—impacting cost, quality, and experience initiatives.


PHYSICIAN ENGAGEMENT DEFINITION
A strategy that focuses on streamlining communication, building relationships, and aligning physicians with the values, vision and mission of their organization and with other healthcare stakeholders to continuously improve care and the patient experience.


 

Why is Physician Engagement Important?

Physician engagement is critical for a successful patient care experience. When physicians feel a lack of association, it manifests itself in ways ranging from physician burnout to a poor patient experience.

Engaged physicians are 26% more productive than those less engaged, adding an average of $460,000 in additional patient revenue per year.

Physician employment does not automatically equal engagement. Communication and collaboration skills are a must-have regardless of the number of employed physicians. High levels of physician engagement have been correlated to increased productivity, the generation of more referrals, expanded influence amongst peers and medical staff, and a greater inclination to driving organizational strategy and change.


BENEFITS OF PHYSICIAN ENGAGEMENT
  Reduced referral leakage.
  Increased in-network referrals.
  Higher engagement of patient population.
•  Improved patient care delivery.
  Enriched physician development and performance.
  Decreased burnout and turnover rates.



Effective engagement strategies require a multifaceted approach. One that includes retention, clinical and cultural fit, onboarding, benefits, leadership development, formal recognition, and physician burnout.

 

Measuring Physician Engagement

Surveys

Consistently measure and invite physicians to share their needs and challenges to gauge physician sentiment and identify gaps within care teams and workflows.


Run monthly engagement surveys for insights into how physicians perceive your organization and its services. Using that information, closely examine the factors that contribute positively or negatively to engagement and create a plan to improve physician’s everyday experience.


 

Scorecards

Help physicians understand what is expected of them in a transparent way while measuring productivity and performance metrics.


“We feel transparency is extremely important in order to change behavior. The scorecard gives a comparison of provider to provider within the same specialty. And then it’s a provider to their individual practice. And then it’s that provider to the network.”

 Travis Turner, Mary Washington Healthcare


 

Dashboards & Reporting

Employ platforms that enable your organization to visualize sufficient, real-time data that drives organizational initiatives and empowers physicians to have the autonomy to course-correct quality to improve care delivery.


Develop an in-house practice transformation dashboard to show overall movement of your practice through the phases of your organizational initiatives. Here’s an example of a dashboard used in the special report Practice Transformation Analytics Dashboard for Clinician Engagement, published by Annals of Family Medicine.

physician-engagement-dashboard


 

Accountability Tools

Implementing a solution that provides your organization and physicians to practice accountability enables both personal, peer-to-peer, and clinical autonomy. Solutions that use read receipts, automatic escalations, and self-managed scheduling can foster opportunities for meaningful dialogue and potentially reduce burnout.

There are hundreds of ways to slice your data. Look back to your guiding questions to determine the most important KPIs for your organization’s unique goals and priorities.


Check out this snippet from our webinar with Mid-Atlantic Nephrology Associates to learn how they utilize our Tracking and Reporting capabilities for transparency and accountability across their organization.

Mid-Atlantic Nephrology Associates reduced operational costs by over $9k by modernizing practice communication for a network of more than 52 facilities, 50 providers, and 1,700 patients.

Improving Physician Engagement

Provide Pathways to Influence

Create physician-led channels to the executive suite to share their voice in decision-making to reframe the narrative of physicians being personnel, to being partners, by creating a forum for open dialogue between executives and physicians.


Invite physicians to join in leadership by developing a roundtable discussion. This fosters an environment where physicians know their voice is heard, helps identify leadership opportunities, and shows commitment to invest in formal and informal opportunities to develop physician leaders.


 

Launch a ‘North-Star’ Initiative

Workflows and systemic factors are universal and aren’t limited to one group of care providers. By demonstrating the intent of how multiple initiatives interconnect, it streamlines the number of things physicians are asked to do on top of their patient care routines. As an example, Figure 1 shows how the factors and behaviors that build a safer culture, drive positive outcomes.


physician-engagement-strategy-northstar

Note: Figure adapted from Bisbey et al. (2019)


 

Create a Data Strategy

Data should be used and not simply collected. An effective way to drive physician engagement is to build a comprehensive data strategy that improves transparency and helps physicians understand the objectives their organization is driving.


North Memorial Healthcare adopted an enterprise data warehouse (EDW) with visualization capabilities to enable physicians to get near real-time answers to their clinical quality improvement questions. The physicians could then see how their decisions affected length of stay (LOS) and how specific changes in clinical processes would improve LOS. By accessing the data, it was easier to convince physicians to make the needed changes.


 

Form Leadership Development Programs

Physician relationships with staff, background, outlook, and training are different from hospital leaders. This can create challenges in how rapidly physicians are able to respond to marketplace and regulatory change. Adopt intentional leadership development programs for physicians who are not only formal leaders but also informal leaders.


•  Hold annual leadership summits with executives and c-suite.
•  Establish physician champions to present peer-selected awards.
•  Kick off meetings with peer-recognized moments of excellence.


 

How Does Technology Improve Physician Engagement?

Physicians are trained to be patient care providers, not data-entry administrators.

Physician engagement in technology is critical for the future of care delivery, and physicians are eager for solutions that streamline clinical practice, allow more face-to-face time with patients and improve outcomes. The secret is to improving physician engagement in technology adoption is to illustrate why the technology is needed, involve physicians in the selection and implementation process, and provide data to show the benefit.

While there is apprehension about the impact of technology on payment, liability and quality of care, achieving more balance in providers day-to-day is possible with the right solution. When looking for a clinical communication and collaboration platform, look for solutions that have considered end-users in the build of their user interface and capabilities, interoperability across technology, and the capabilities to streamline workflows to increase operational efficiency.

In an environment that is inherently high stress, recognizing physician needs can empower them to implement new technologies. As a result, this can improve satisfaction levels, assist in making better care decisions, and support patient engagement and satisfaction levels.

Find out how the right solution can support your physician engagement strategy.