When I started medical school, I always envied the attending physicians who would get paged during lecture. The intrigue of what was in that message and what life-or-death decision was about to made – it seemed so exciting and just reinforced my decision to enter medicine.
Well, now I’m a bit older, perhaps a bit wiser, and I’ve learned two things. First, at least half of those pages weren’t worth the fraction of a millivolt it took the pager to display them. Second, pagers are a horribly inefficient way to communicate.
Take a single call night. Over the thirty or so hours, a good night would be one hundred pages. Assuming it takes one minute to find a phone, return the call, and hold for the person who sent the page, that’s nearly two hours wasted without a bit of useful information communicated. Fortunately, we at least have text pagers so in reality the inefficiencies are less but there are plenty of institutions that still use numeric paging. And even if the text pagers eliminate 75% of the inefficiencies, that’s still far too much wasted time.
At HIMSS this year, Avaya – probably familiar to many of us as the company that runs our internal VoIP networks – announced that their communications system Mobile Checkout would now support the iPhone and iPad. Avaya makes a pretty simple value proposition – that using their products reduces inefficiencies by streamlining communications and therefore saves money and improves patient care. Now, they are taking a big leap forward by embracing the key philosophy that has defined some of the most striking innovations in mobile health technology.
Avaya’s system is pretty straightforward. Basically, the provider – physician, nurse, case manager, etc – comes in to work and goes to the “checkout station.” Here, they pick up an Avaya mobile deivce and then scan a barcode on their mobile device and their ID. The system then assigns a phone number to that device as well as an ID. That person can then be called through the Avaya system from other “checked in” devices, landlines, and so on. They can be reached both directly or via their ID (e.g. Floor Charge Nurse, On-Call Resident, etc). Using an RFID, it can help staff find each other – for example, I could walk on a floor, look at a screen, and instantly find out where the nurse for a particular patient is.
The primarily benefit here is that it lets me communicate with healthcare team members faster and easier. I find that one of the barriers to a true team approach in healthcare is often as simple as minutes wasted trying to get in touch with eachother. Anything that lowers that barrier will promote more communication and improve teamwork.
Until recently, there was a big flaw in this system – specifically that it was restricted to Avaya mobile devices. One theme that we have seen over and over again in the mobile health world is that some of the best innovations are built on the investments of others. Take for example the mini-NMR for cancer diagnosis or the lens-less microscope to diagnose epidemic infections – the shared feature here is that they leverage the billions of dollars invested by the consumer electronics industry in mobile devices rather than reinventing the wheel.
When it comes to internal hospital communications, there are several key advantages in doing this. First, it allows the smartphone to become a shared platform for many tasks – communications, bedside imaging, vital signs assessment, and more. Second, it allows providers to carry devices that provide far more information at the point of care. Given an iPhone loaded with Medscape, Procedures Consult, and so on in comparison to the Avaya handset – I’d take the iPhone every time. More importantly, it allows the provider to carry a device that can leverage the ingenuity of the entire developer community, which the Avaya handset could never do.
There do remain some key weaknesses here – for example, it seems as though this would use a person’s own phone plan voice minutes and text messaging. Despite this, adding iPhone/iPad and Blackberry support was a huge step in the right direction.
Frankly, just not ever having to hear that awful pager beeping sound again was enough of a reason for me to want to buy in to one of these new systems. But in addition to sparing me that pain, implementation of these kinds of mobile communications platforms will soon change how healthcare providers work together and improve the care we deliver to our patients.
In our next post on this topic, we will look at offerings from Vocera.