Replacing Pagers with Secure Messaging to Improve

Communication & HCAHPS Scores

Greg Slattery Vice President & CIO

Community Hospitals & Wellness Centers

About CHWC

3 Campus Health System in Northwest Ohio

Specialty in cardiac cath-lab, surgery care, radiation oncology, pain centers

113 Beds

Communication Challenges Rural Area = limited options Paging “Wait and hope”

method delayed communication

Paging reliability was declining Heavy overhead paging caused

noisy hospital Providers carrying both pagers

and cellphones – risk of insecure texting

Younger employees = ‘whats a pager?’ ‘are you kidding me?’

We knew we could do better! “I don't know about these things. But I'm 19 now, I remember as a baby my older brother used to carry this around. He worked at a hospital. “ - from a YouTube video

CIO Objective: Replace Pagers!

Phase 1 (0-6 months)

• Internal Alignment & Awareness

Phase 2 (6-12 months)

• Replacing Pagers with Smartphones, iPods & Desktop Communication

Step 1: Get Department Buy-In

Board, Department Head and Individual Department Presentations Convince Paging Was

Outdated Technology Convince Secure

Messaging could be better way

Be honest - old method was not 100% , neither is cell /wifi

Step 2: Survey Paging & Smartphone Use

Inventory all existing paging devices

Evaluate TCO (devices + repairs + towers=TCO)

Survey departments about paging use - How many? How often? Type?

Review Call Team paging workflow

Survey departments about smartphones

How many people use them?

How often are they used vs. pagers?

My favorite

Step 3: Establish Secure Texting Policy

CHWC Policy Structure

No insecure texting of PHI Allowed!

Only secure vehicle is Imprivata Cortext

Several Departmental Polices updated

Ohio Board of Pharmacy roadblocks

Updated BYOD Policy

Reimbursement for Using Cortext – if user submitted charges, $0 so far

Step 4: Clinical Awareness & Training

• 3 Days: 10-12 30 minute Training Sessions – Users had to attend at

least one session

• Education Topics: – When to use Imprivata

Cortext (AUP) – Cell & Wifi Coverage

Expectations – Escalation & Redundancy

policies – Auditing capabilities

Step 5: Identify User to Device Mapping

Physicians & Call Teams = CHWC & Personal Smartphones

Nursing = Desktop & Shared CHWC iPhones

Secretarial = Desktop-Only

EVS/Therapy = Shared iTouches

Step 6: Identify Workflows

In-House

• Overhead Paging

• Inter and Intra Departmental Communication

• Mobile Workforce

• Multi-Campus Workforce

• Critical vs. non-Critical (does not replace email)

Call Backs

• Individual on-call support

• Cath lab call team

• Surgery call team

• Licensed Practitioner (limited=policy review)

Step 7: Enable Communication

Before & After Workflows Before Cortext

• Overhead Page, hope heard and find a phone

• Look up number or ask operator page = “page tag”

• Team/Individual Pager then wait per policy

• Page recipient/find a phone

• Describe wound or problem

• Written call log or no log

After Cortext

• Direct communication or direct call back request

• Directory in Cortext with office or cell call back/text

• Secure Group Text with real-time feedback!

• “On my way” or start a conv

• Send secure pictures

• Auditable including msgs

Workflow Before After

Finding a Provider Look up number or ask operator page = “page tag”

Directory in Cortext with office or cell call back/text

Contacting a Provider Overhead Page, hope heard and find a phone

Direct communication or direct call back request

Care Coordination Team/Individual Pager then wait per policy

Secure Group Text with real-time feedback!

Wound Sharing Describe wound or problem

Send secure pictures

Auditing Written call log or no log

Auditable including msgs

Step 8: See Results!

Retired 100% of hospital pagers

~25% Increase in HCAHPS Scores (hospital quietness and staff responsiveness)

Cost Savings $10,000 year*

Auditable Communications

Smart Devices = Future Platform for Other Healthcare Apps

Culture of Quiet

* Primarily from Centrex Downtime Lines & paging equipment repairs /replacements

Lessons Learned

1. Start early on education and expect push back

2. Point out the weaknesses & costs of the old technology methods

3. Look into not-for-profit, gov programs from cell providers for free or discounted cellphones, hotspots, data plans www.verizonwireless.com/government

4. Do in phases, CHWC low criticality depts first to work out kinks

5. Phasing allows your IT team to learn how to manage and exploit

6. Cisco - Meraki - Free MDM solution & Apple Configurator

7. Allow departments to do parallel tests – they will see the light

8. Some users will try to go to fast – do policy work ahead of time

9. Let peer pressure get stragglers on board (example: my CEO!)

10. Encourage additional apps/uses of smart devices

11. Educate patient and families about use of devices (not playing games)

Questions? gregslattery@chwchospital.org