The healthcare industry abounds with stories of medical errors brought about by nightmarish communication. Health providers are hoping for significant improvements in this aspect of their organization. Below is a story of a healthcare nirvana.
You are a physician accessing the Electronic Medical Record (EMR). During your perusal, something catches your eye. You wanted to consult the neurologist in your team, so you access a portal within the EMR and search for your colleague’s name. His name appears, and upon clicking it, a chat box opens together with workflow processes you do with him. You sent him the detail you saw on the EMR, routed securely to his device. You ask him what he thinks. In turn, the neurologist replies to you through his device where he received the patient’s info. He then proceeded to give instructions to people on his team. He saw that his team is performing at peak because the device says all his team members are accomplishing their tasks. Everything is good, you say, never better… and then you wake up.
You wake up, and you realize you are a nurse and not a doctor. You wished you could stay in bed longer, but then you needed to get ready to work for more than 10 hours that day.
You start your day at work rushing. After endorsement, you already have a lot on your hands. You need to clarify a doctor’s order, contact the pharmacy, call the blood bank, verify the correct covering provider, talk to your head nurse, and prepare for a report. You cram everything in your head, hoping you won’t forget a thing, but even before you get those things done, there seem to be more people to talk to, and more information to be validated. “Could it get even more complex than this?” you ask. And you answer yourself yes. The reality is the nightmare, and the dream is the ideal.
Being in healthcare today, especially being involved with patient care, means expecting to be overwhelmed with complexities in different systems and processes. There is compelling need for a more effective but simplified communication that will enable coordination of care and collaboration. Changes happen everywhere from care delivery to reimbursement. There are also many providers who treat patients, working across various settings with different care teams. The network in which providers and other healthcare workers work is a web without a standard structure. Communication across the lines on this web becomes unclear, delayed, lost or misconstrued. Another factor that adds to the complexity is that in every setting, people, processes, approach and preferences also vary, creating gaps, breakdowns, and roadblocks to the timely and efficient performance of tasks.
So what should become of communication in healthcare?
First, a communication system should exist in an electronic form that encompasses all types of healthcare team members in a variety of settings and that which would enable sending messages and feedback in real-time. A nurse should be able to communicate to a provider who is also servicing the out-patient department. A therapist should also be involved in a common collaboration platform when the need arises. When transitioning patients, there should be a way to handle hand-offs, being clear at all levels before discharging or receiving patients. Ideally, added important features should be there, such as directories, access to workflows, documentation and file sharing with collaboration-enabled features, notifications, alarms and task-tracking. It should have standardized options to send their messages across, enabling feedback.
One other important thing is, clinicians and other workers should always communicate on the matter of learning. Although learning is an altogether different aspect of care provision, it does affect patient outcomes because safety standards and clinical updates can be applied by learning them first. Critical updates should never be left pinned on the cork board or talked about over a single meeting because they need to be readily accessible as a reference whenever the need arise.
In an organization that deals with patient care, communication should also enhance work processes. Workflows should be available for viewing. Workgroups should have a common platform to collaborate, to schedule and to mobilize members. The messages should have intelligent routing, say if the physician is in surgery, and cannot attend to reply to a message, an assistant can receive it given the right authority to answer a query. This feature should enable customization based on their preferences.
The goal is to make communication more standardized with a structure, with more options and features to bridge gaps and prevent breakdowns within its complex web. The idea is to make it happen in real-time in a manner clinicians want to when they want to.
Simplifying communication in healthcare is indeed a challenge, and the right solution can bring significant benefits to healthcare delivery. We rely on technology to do this, but we need great minds to come out with the best structure and to put that technology to good use. When this is realized, a good part of healthcare delivery goals would have been achieved.