Purposeful Use of Secure Instant Messaging Improves Communication, Speeds Throughput

Timely and accurate face-to-face, telephone and pager communications are essential to facilitating critical, time-sensitive patient treatment. But what’s the best communication method for non-urgent physician communications?

Choosing the right method of communication is as important as the message itself. Patient safety, quality care and team coordination depend on it.

Typically, pagers have been used to communicate both critical and non-critical instances. But this model can be difficult for physicians to delineate between the two types of messages and can lead to unnecessary phone tag situations and delays.

Patrick Grady, MD, Chair of the Department of Medicine at Avon Hospital, finds that secure messaging platforms, such as Epic’s Secure Chat, enable efficient communications among the entire care team. Secure Chat is a HIPAA-compliant instant messaging technology, integrated into the EHR, and therefore easily accessible by the patient’s care team.

“The tool’s asynchronous nature means that I can send a message that does not require an immediate response so it won’t interrupt the nurse in the patient’s room. Conversations are attached to the specific patient and you can reference messages from the last 14 days. It is extremely efficient, and it affords everyone time to respond thoughtfully and accurately.”

‘Avon ED HUC’ group enhances throughput

To streamline the process of coordinating hospital admissions from the emergency department, Avon Hospital teams found a creative way to leverage Secure Chat using the ‘group chat’ feature.

Previously, the Internal Medicine hospitalist team would rotate half-day shifts carrying a pager to help them coordinate and receive patients from the emergency department (ED). This method left physicians overwhelmed by the large number of pages, which led to long call-back wait times — all while they were also trying to manage their own patient panel.

Dr. Grady explains, “If I was in a goals of care meeting with a patient and their family, I would come out after 45 minutes to pages regarding five new admissions. Then, as the pager holder, it was up to me to call the ED physicians and distribute the pertinent patient information to each accepting provider.”

To address this issue, a group chat was created that included the ED health unit coordinator (HUC) and all admitting providers for the day. Instead of sending a page, the HUC enters a call-back request in the chat, and the next person to accept an admission makes the call.

This new process not only reduced call-back times from 30 minutes to about 1-2 minutes, but also allowed the admitting provider to speak directly with the ED provider about the background, concerns, and treatment plan for the patient. This straightforward approach helps minimize the number of information handoffs and potential for errors.

Best practices for hospital providers

The technology can also be leveraged to expedite discharge planning. Treatment teams at Avon Hospital use group conversations for follow-up after their Plan of Care Visit rounding. If needed, additional specialists are pulled in to discuss adjusting medications or the need for additional testing. Follow these tips to get the most out of secure messaging tools:

• Include Case Management soon after admission to start discharge planning.
• Reach out to nursing staff early on in the day so they know who to contact.
• Create groups to facilitate specific non-urgent workflows that currently rely heavily on paging.
• Promote collaboration by including the entire treatment team in one conversation.
• Add other members of the care team as appropriate such as physical and occupational therapists and dieticians.
• Use instant messaging to follow up on next steps from patient rounding.
• Take advantage of available features within the platform such as:
  • Attaching the patient to the chat – this makes it easy to jump into the chart to review documentation and place orders.
  • Setting your availability status to let your colleagues know when you are in a meeting or out are out of the office.
  • Enabling auto-forwarding features to ensure messages are received by the person covering for you.