Upgrading Hospital Communications Systems to Improve Patient Care and Reduce Costs

Will O’Connor, MD, chief medical information officer for TigerConnect, discusses the importance of efficient communication systems in hospitals, shortcomings of current systems, and improvements that can be implemented to make professionals’ jobs easier and provide the best possible care to patients.

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Welcome back to Pop Health Perspectives, a conversation with the Population Health Learning Network, where we combine expert commentary and exclusive insight into key issues in Population Health Management and more.

Today we're joined by Dr. Will O'Connor, Chief Medical Officer for TigerConnect. He discusses the importance of communication systems in hospitals, where current systems fall short, and how they can be improved to make professionals' lives easier and provide better care for patients. Dr. O'Connor?

Will O'Connor, CMIO at TigerConnect. I'm a physician by background. I have been a physician now for 26 years. My specialty is orthopedics. I've been working in hospitals now for about 35 years. Right when I turned 16, got a job as an orderly in a hospital and I have held a number of jobs in the hospital, which has given me a very balanced look at health care over time.

I've been an orderly. I've been a transporter. I've been a nurse's assistant. I've been an ER tech. I've been a phlebotomist. I've been an EKG technician. And then obviously, after going to medical school, I was a doctor as well. A very broad background in health care and then a broad background in health care IT as well.

I started working with the early electronic medical records as soon as I started medical school. I've been working with health care IT now for close to 30 years as well.

Obviously, in the time of 2021, and even earlier years, technology has been growing. Can you talk about why the health care industry has historically been so resistant to changes in communications technology?

Health care, more so than other industries, has always been resistant to change, for some reason. New treatments, new therapies, new ways of doing things are often slow to take hold. That's part of it. The other part of it, especially recently, has been an over focus on the EMR to the detriment of other technologies.

The bandwidth, the funds that providers have to spend on technology, is often spent on the EMR and can come at the expense of other needed technologies, communications being one of them.

How does poor communication lead to high costs for hospitals, health systems, and patients? How can technology solutions help improve these challenges?

It's really easy to see as a patient, or as a consumer, if you've ever been in a hospital, if you've ever had a family member or yourself been very sick, you can see there's a lot of disjointed communication, especially across a hospital network and especially if you have a complex condition.

Ultimately, what you get is slow and inefficient care. Poor communication contributes to medical errors. In fact, it's one of the leading causes of medical errors and also substandard care, suboptimal care, care that could be delivered better but is not, because of a lack of communication and coordination.

This is easy to see, too, as a clinician. It can be one of the hardest things to do as a physician is to sometimes find another physician, or find out who the nurse is taking care of my patient. It can be a daunting task.

Then if I do know who that person is, in today's environment, it can be difficult to try to contact them. Maybe they have a pager, and I have to page them and then wait for them to call me back. They don't know who's calling. They're just getting a blind page.

When you think about the technology that you use in your everyday life, try replacing that with email, or fax machine, or pagers, or other disconnected systems that we have these hospitals and these providers using, and that is really what leads to the bad, expensive and substandard care.

It's almost hard to believe that we're still using pagers in 2021, and that we're still using fax machines to communicate very vital and time sensitive information. These are people's lives and health that we're dealing with here. To communicate in the way that we are, in most places, is just not acceptable anymore.

COVID laid to bear some of these communication problems, when you think about what it's like to be a physician and even worse to be a nurse with the tools that we're giving them today. Think about what it's like in a hospital as a nurse that you're working. You may have a dozen different inputs.

You may be getting voice calls. You may be getting alerts from your nurse call system, patients pushing their call bell in bed. You may be getting alerts, beeps, dings and buzzes from ventilators, from other types of monitors connected to the patient, from the pulse ox. You may be getting alerts from your EMR. You may be getting fax alerts.

We, as consumers, don't deal like that. We've had our communication inputs organized. As a nurse, you can see how this would be very disjointed. COVID laid to bear patients died because of this. Ventilator alarms were going off and nurses were not getting to them in time, or not prioritizing them, because they had dozens of other alarms and alerts going off.

It highlighted the importance of communication and having a technology where, as an end user, as a clinical end user, I can receive all of my communication inputs in one place, be it text messages, voice calls, or alerts and alarms coming from all these different systems that run inside hospitals, feeding them all to one place.

That became very obvious, during COVID, as something that we, as a health care industry, need to work on and need to work on urgently.

What are the benefits of adopting another standalone solution that staff needs to log into every morning?

Communication deserves to be a standalone solution. Today, we have a lot of disjointed solutions, and we have solutions where communication is not the primary use case. You'll see communication buried in an EMR somewhere as a feature. The benefit of having a standalone communication solution is it allows you to communicate the same way in the same paradigm that you do, as a consumer.

It's adapted for health care, but as a consumer, it's a primary use case. Think about the messages you’ve sent. You probably use SMS or iMessage, maybe WhatsApp or Facebook Messenger. Chances are, when you're communicating with someone, the application of a software you're using, its primary use case is communication. That's the mistake that we've made in health care.

We've tried to bury communication in other things. It needs to be an application onto its own. That's really the benefit of having it stand alone. It replicates that consumer experience, but it hooks into all the pertinent health care information that you need to have, as well as connecting to the people that you need to be connected to.

Having that in a standalone application provides it. It's much easier to use, much more efficiency, a much more complete and easy-to-use solution for clinicians that has benefits to them, how they do their job. It makes them more efficient, with obvious downline benefits to the patient, and just delivering faster, more efficient care.

Do you have any key considerations to look for when these health systems and hospitals are choosing a standalone messaging platform?

There's some key things to look for. You have to look for something that is easy to use. As I said before, make it the primary use case. When people pick it up, they already know how to use it. They almost don't even need to be trained. It's intuitive.

It's built for the user interface, whether it be iPhone, Android, desktop. Whatever it is they're used to using, it needs to work as the person is used to having that user experience on that device. That's the first thing.

Second thing is, it's got to be reliable and secure. Five nines, 99.999 percent uptime, and some security application or certification attached to it such that breaches are unlikely. That's something you definitely do not want. You want to make sure what you're using is secure.

Finally, it's got to be something that connects to everything. As I said before, that's what's causing mistakes. That's what's killing people, not having your communication platform connected to everything, so that you're getting disjointed messages and things like that. It's got to be organized.

You've got to connect it to all of the communication inputs that someone might have. All the people within a hospital and across a network, as well as the right types of electronic systems. Nurse call systems, EMR systems, and then other physiologic monitors, such that you can have all of your communication and inputs coming into one place. Those are the key things to look for.

Do you have anything else you would like to add to this conversation?

For me, what it boils down to is looking at how we can improve, continue to improve as a health care system, and improve the care for our patients. The fastest and easiest way we have in this country to improve—improve cost, improve the quality, and improve the experience of care—is to have meaningful adoption of these connected communication systems to drive these improvements.

To me, it's a very low-cost thing to do. The benefits of it are obvious. It's something that we can implement and implement rapidly, and see improvement very quickly.