Executive Summary:
- Getting important information to the right member of the care team in a timely manner is a critical part of patient care
- PerfectServe’s Dynamic Intelligent Routing® is the industry standard for encompassing workflows, both routing and scheduling—it automatically references any number of variables in real time to accurately direct communications
- With its guided workflows and comprehensive mapping, Dynamic Intelligent Routing is better equipped to handle the depth and complexity of real-world clinical communication than role-based routing
- Dynamic Intelligent Routing is also a valuable gatekeeper in the outpatient setting, giving providers the ability to respond to communication from patients in a structured and manageable way
- Much like a car engine with many interconnected parts that starts up with the simple push of a button, it’s not required for the end user to manage the complexity of Dynamic Intelligent Routing to reap its benefits
PerfectServe’s Dynamic Intelligent Routing® is proprietary message routing technology that factors in different variables to determine who should be sent each message or call at any given time. To illustrate how this works, we’ll walk through some relevant clinical scenarios, starting with a simple example—one that usually doesn’t give clinicians trouble in their current environments—and progressing to a more complex example that often leads to delays and frustration in the real world.
A basic example is a nurse trying to reach the provider on call. The system pulls in data regarding the patient in question, the department, and available schedules to ensure the message is routed to the correct on-call provider. It then references the provider’s preferred contact method to ascertain if the nurse should call or send a text message.

ABOVE: An example of a basic Dynamic Intelligent Routing workflow. Real-life workflows typically involve many more variables.
This simple example shows a bit of Dynamic Intelligent Routing’s capability, but when we look at more complex examples like reaching the right hospitalist, contacting a surgeon in the OR, or sending messages to providers outside the walls of the hospital, the true power of Dynamic Intelligent Routing shines through.
To understand how Dynamic Intelligent Routing accomplishes this, it’s important to understand the value of integrations. For instance, when PerfectServe pulls in patient data from the EHR, it can then see both the patient’s dynamic care team and their room number, which fuels part of the routing. When a critical lab result or sepsis alert comes through, Dynamic Intelligent Routing can reference this data along with the physician schedule and routing rules to determine who the current, covering provider is, which may be necessary if the ordering provider is no longer working. Once these factors are accounted for, the appropriate person receives an instant alert.
Dynamic Intelligent Routing has long been an integral part of PerfectServe’s DNA, and it remains one of the primary features that sets our technology apart from the competition. It is core to PerfectServe’s functionality and essential for efficient communication and collaboration.
So how does Dynamic Intelligent Routing work in practice, and more specifically, how does it differ from simpler role-based routing? This is a common question, and the answer is about addressing the depth and complexity of real-life clinical communication in both the acute and ambulatory settings.
Tackling the Complexity of Care Team Communication in the Hospital
Let’s use routing rules in a hospital as a reference point. What if you want to message the orthopedic surgeon on call? With basic role-based routing, the message is sent to the surgeon’s phone. But what if the surgeon has more nuanced contact preferences depending on the scenario? While in surgery, he or she may want the PA to cover their calls; during clinic hours, this responsibility may switch to the office nurse, and for the rest of the time, the surgeon may want calls routed directly to his or her cell phone. Dynamic Intelligent Routing supports—and even encourages—workflow complexity of this nature and ensures that the person receiving the message is equipped to immediately address the issue at hand.
Dynamic Intelligent Routing can also route based on schedules or user logins. Role-based routing works well when, for example, you’re looking for the hospitalist on call and they’re logged into the system. But what if there are ten hospitalists rounding today and you’re not sure which one is covering your patient? The EHR says it’s Dr. Smith, but it’s now 6 PM and he’s no longer working. Or, what if the wound care nurse is performing a sterile dressing change and can’t reply to messages being sent? What if the surgeon covering consults for the house isn’t responding?
For the first scenario, Dynamic Intelligent Routing is capable of organizing any combination of rules, schedules, message types, points of entry, and other information to appropriately direct a message to the right recipient, even if ten different hospitalists are on call. And, even better, it removes the cognitive burden from the sender—all parameters are already built into the system, so directing the message is as easy as answering a few automated prompts to complete the guided workflow.
For the second scenario, Dynamic Intelligent Routing can use a built-in escalation protocol to automatically route any message to the next available team member after a predetermined amount of time has passed. Once the time threshold is met, the message immediately hits the next person’s inbox.
Workflow rules can be created with role-based routing, but they are typically associated with predefined groups, such as “all surgeons can elect to cover calls for another surgeon.” The goal of Dynamic Intelligent Routing is to build these specific coverage scenarios during implementation. This means the surgeon prepping for a procedure doesn’t have to ask a colleague to cover for them for the next four hours—rather, the surgeon’s PA is the first escalation point for urgent calls, the PA’s colleague is the second escalation point, and all non-urgent communication is held until the surgeon is out of the OR. There is no risk or uncertainty, and time spent trying to determine coverage on the fly is reclaimed because these workflows are established in PerfectServe right from go-live.
Additionally, Dynamic Intelligent Routing isn’t only meant for hospital departments covering unassigned consults. PerfectServe’s implementation methodology includes workflows for all provider groups. This allows clinicians to not only engage providers for new patient consults, but also connect with providers regarding established patients who have a new issue. This comprehensive approach allows all communication workflows to be mapped at both the hospital and practice level. This level of standardization is the foundation for automating critical results.
Dynamic Intelligent Routing also extends beyond the four walls of the hospital, supporting communication across affiliated and employed providers, as well as care settings like dialysis or rehab. The patient’s entire care ecosystem is accessible on the platform, meaning effective communication and care coordination doesn’t stop where the hospital walls end.
A Helpful Gatekeeper for Patient-to-Provider Communication
Healthcare organizations are working diligently to make their patient engagement tactics more closely resemble the modern, efficient, and intuitive experiences that patients have in consumer or retail situations. If you can text your veterinarian to set up an appointment or request a medication refill for your dog, you’re probably going to be disappointed if your doctor’s office doesn’t offer similar functionality.
But according to a recent study, doctors say they’ve been overwhelmed by the volume of digital messages received from patients during the COVID-19 pandemic. It’s not good enough just to enable patient-to-provider communication—you have to ensure that patients get timely and helpful responses without unleashing a deluge of messages into providers’ inboxes.
Once again, Dynamic Intelligent Routing is here to help, and we’ll set up another hypothetical scenario to demonstrate. This time, a patient is experiencing stomach pain, but it’s after hours and their primary care provider’s clinic is closed. Because the clinic uses PerfectServe, the patient calls and is met with several prompts from the Interactive Voice Response (IVR) answering service solution. The patient’s answers tell the system if the call is routine or urgent.
Because the patient has a serious clinical issue, they are prompted to leave a voice message for the physician on call. Dynamic Intelligent Routing immediately routes the message by referencing schedules in the system, and the on-call physician then receives a push notification. The message in PerfectServe is easily retrieved by the physician and already includes all necessary patient information.
The physician then sends a text message to the patient and asks if they’d prefer to speak on the phone, via video chat, or in a secure messaging session that allows private information to be exchanged in an encrypted environment. The patient prefers a video visit, so the physician sends a link via text message, and within minutes they’re talking in real time to determine next steps.
In this scenario, Dynamic Intelligent Routing is an important gatekeeper. Because the issue is serious, the patient is immediately connected to help, but the provider has complete control over how and when to engage in live conversation. Additionally, because the system can reference schedules in real time, physicians who aren’t on call will not be disturbed by errant messages. The patient gets the help they need, and the provider receives the message in an organized, controlled manner.
If a patient calls after hours with a routine issue or question—perhaps they want to reschedule an appointment or request a medication refill—Dynamic Intelligent Routing can hold the message (and associated push notification) to be delivered to office staff the following morning when the office opens.
In the near future, PerfectServe will also enable this kind of Dynamic Intelligent Routing-driven workflow with chat bots—both on the provider organization’s website and via SMS text message. The result will be the same, but for patients who prefer visiting a website or sending a text to making a phone call, this will add more paths for structured and efficient communication.
Dynamic Intelligent Routing: Making Complex Workflows Seem Easy
For over 20 years, our mission has been to improve clinical communication by removing the obstacles, delays, and frustrations that patients and care team members face every day. Dynamic Intelligent Routing is core to this mission—it’s the foundation upon which PerfectServe is built. But when you read language like “complex routing algorithms” and “proprietary technology” associated with Dynamic Intelligent Routing, just know that the simple purpose is to make sure that messages, calls, alerts, alarms, and all other forms of communication are directed to an appropriate person who is available to help.
Dynamic Intelligent Routing is capable of ingesting and processing thousands of rules and variables, and the workflow possibilities are endless. At one provider organization, PerfectServe—by way of Dynamic Intelligent Routing—dynamically references 1,819 users, 5,915 schedules, 7,060 notification rules, 3,069 contact rules, and 6,863 routing rules. That may sound like a lot, but it helps to think of it like a car’s engine. Under the hood, there are a variety of intricately connected parts that are overwhelming if taken piece by piece. For the driver, though, a simple push of a button is all that’s required to start the engine.
Making complex workflows seem easy is what PerfectServe does best, and the result for the end user is fast, consistent, and accurate delivery of all communications. It’s all thanks to Dynamic Intelligent Routing.