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Leveraging Provider Communication for Better Care Coordination

Vanderbilt University Medical Center providers are utilizing an EHR-integrated communication platform to optimize care coordination.

Provider communication is key to improving care coordination.

Source: Thinkstock

By Kate Monica

- With EHR systems now commonplace in hospitals and health systems nationwide, many healthcare organizations are turning their attention and resources toward EHR optimization to improve care coordination.

Before Vanderbilt University Medical Center (VUMC) went live with an over $200 million Epic EHR implementation in November 2017, health system leadership decided to simultaneously launch an EHR-integrated health IT solution designed to optimize provider communication, patient data access, and care coordination for clinicians.

That solution was Mobile Heartbeat’s MH-CURE — a clinical communications and collaboration platform.

MH-CURE offers healthcare organizations a smart-phone enabled way to streamline clinical workflows and care coordination. The EHR-integrated platform promotes provider communication through voice calling, voice-over IP, secure text messaging, and alerts. Providers can also utilize MH-CURE to send images and videos.

“We had implemented our platform before Vanderbilt decided to move to Epic,” Mobile Heartbeat Vice President Jamie Brasseal told EHRIntelligence.com. “We initially integrated with their homegrown EHR via some custom interfaces, and so we were taking some patient data and taking the care team directly and integrating that into our solution.”

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VUMC adopted Mobile Heartbeat’s health IT solution in an effort to reap the benefits of more dynamic, timely provider communication among its workforce of over 19,000 clinicians and medical staff. Prior to implementing the communication solution, care coordination at VUMC was lacking.

Most notably, VUMC lacked an efficient way to relay information about a patient’s admission, discharge, and transfer (ADT) status. ADT notification use has been shown to reduce hospital readmissions, improve care coordination, and cut costs for healthcare organizations.

“VUMC did not have a way of sharing ADT notifications,” said Brasseal. “They did not have a solution that integrated with the EHR.”

Without a way to communicate ADT status information, hospital staff struggled to streamline transitions of care. 

Providers often communicated by phone— a relatively ineffective method of sharing information among busy hospital staff with different schedules.

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“Say I’m a provider and I do a procedure, and I want to know the pain levels for the patient that I did a procedure on,” offered Brasseal. “How do I figure that out? Maybe I pull out my laptop and go into the EHR. If the nurse assignment is in the EHR, I have to connect with the nurse, which means going to the switchboard, or the desk, or the nurse’s station.”

“If she’s busy, I have to leave a message, and then she has to call me back,” he continued. “And then maybe when she calls me back, I’m busy.”

To sidestep the potentially drawn-out process of getting ahold of other healthcare providers by phone, providers can instead communicate through the MH-CURE platform. The platform allows providers to see which nurse is assigned to the patient, and send a secure text message directly to that nurse.

“Effective provider communication takes something that could be a 15 minute process, and turns that into a 15 second process,” said Brasseal.  

VUMC also utilized the platform to close the communication loop between providers. The health system’s nurses, physicians, and other medical staff members wanted a health IT solution capable of providing assurance that their messages had been received, viewed, and answered.

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“We also wanted to give them a platform with a single app on a single device so that nurses and physicians aren’t carrying multiple phones and pagers,” explained Brasseal.

In addition to improving integration and communication for VUMC providers, the solution has also enabled clinicians to more easily access information about fellow caregivers and hospital operations.

A care team directory imbedded into the solution gives care providers insight into what other providers are doing, who they’re caring for, and what their availability is — without requiring that providers ask each other directly.

The communication solution leverages ADT data via an HL7 feed to populate the care team directory, Brasseal explained. The care team directory shows users the identity and status of each provider part of the care team assigned to a specific patient.

“When providers click on a patient, they can see who their care team is,” stated Brasseal.

Providers can also view a list of all of the patients in their unit, and look up information on any of the patients they’ve been assigned.

With the care team directory, providers can see whether the clinicians part of a patient’s care team are on the phone, out to lunch, or otherwise occupied. Providers can also look up the names of other clinicians to see which patients are under their care.

“This allows the caregiver to quickly find information about that patient and who’s responsible for them,” explained Brasseal. “Providers can communicate with the appropriate colleagues — such as specialists or pharmacists or case mangers — very quickly, and without having to leave the patient’s bedside, or go search for that information at the nursing unit or in the EHR.”

In addition to the mobile version, VUMC’s Epic-integrated MH-CURE solution is also available to providers in a desktop iteration.

“That’s for folks that don’t leave the desk, like a unit secretary or a monitor tech,” clarified Brasseal.

Ultimately, Mobile Heartbeat’s primary aim is to enable nurses and other providers to spend less time trying to coordinate or retrieve information from other providers and more time interacting face-to-face with patients.

“Turns out that nurses are one of the most mobile workforces there are,” maintained Brasseal. “They walk an average of three to seven miles per shift. We try to cut that down. We try to keep the caregiver at the bedside next to the patient.”

The solution also allows clinicians and hospital staff to integrate other Epic apps into the platform so that clinicians can view and access a variety of information in one place. 

“We have APIs that help them integrate other apps such as scheduling, and a multitude of clinical apps that they want to put on the platform, so we allow them to integrate with Mobile Heartbeat in that way as well,” said Brasseal.

At VUMC, the solution integrates with Epic apps including Epic Rover and Epic Haiku. Rover is Epic’s mobile app geared toward streamlining clinical documentation and barcode validation, while Haiku allows clinicians to access schedules, patient lists, health summaries, test results, and physician notes.

Users can access these apps within Mobile Heartbeat to avoid the administrative burden of multiple log-ins.

In the future, Mobile Heartbeat executives hope to develop solutions geared toward improving patient engagement.

“We’ve got a lot of requests about how a provider or acute care facility would communicate with the patients or a patient’s family,” said Brasseal. “That’s definitely on the roadmap.”

Ultimately — whether patients or providers are utilizing the technology — Brasseal maintains Mobile Heartbeat developers will always innovate with a singular goal in mind.

“We’re trying to make it easier for clinicians to do their jobs and provide better patient care,” concluded Brasseal.



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