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10/27/2011
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Unified Communications Touted For Healthcare Efficiency

UC technologies can help healthcare organizations adapt to pay-for-performance reimbursement models, finds IDC study.

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In the complex data-driven world of healthcare, where clinical teams need to quickly access information from different locations, unified communications (UC) technology is a necessary investment to help increase efficiency, enhance operational performance, and improve patient safety, according to a IDC Health Insights report.

The report, Business Strategy: Unified Communications Optimizing Healthcare Operational Performance, found that the integration of data, voice, messaging, location awareness, and event management can be a valuable strategy for healthcare environments where the speed required to process patient information is critical to the decision-making process.

When health IT managers consider UC, they must also keep in mind that new care models such as accountable care organizations are transforming healthcare into a more collaborative and coordinated enterprise that requires a team effort from physicians, nurses, and caregivers who will be required to improve patient outcomes and quality measures across the full continuum of care.

[For background on e-prescribing tools, see 6 E-Prescribing Vendors To Watch.]

"The highly mobile and collaborative nature of today's healthcare is highly conducive to deploying mobile UC," Lynne Dunbrack, program director of connected health IT strategies at IDC Health Insights, told InformationWeek Healthcare. "Changing reimbursement strategies from fee-for-service to a pay-for-performance model under accountable care organizations will require improved coordination of care and collaboration among caregivers, especially for patients with multiple chronic conditions who are treated by various specialists."

The report says that UC can bring together a full range of technologies including telephony, voicemail, instant messaging, video, Web conferencing, and short message services (SMS), which run on mobile devices and computer workstations to provide real-time delivery of communications based on the preferred method and location of the clinician.

Dunbrack, who is the report's author, says she sees a growing role for UC in a number of areas:

-- As care teams constantly move from patient to patient and also transfer patients between care facilities, UC technologies can improve workflow and increase staff productivity.

-- UC can improve decision support with the use of highly portable smartphones that enable clinicians to instantly access peer-reviewed bodies of knowledge. Wireless push technology incorporated into the smartphone platform automatically updates these reference guides, eliminating the need for clinicians to remember to download updates on a regular basis.

-- Integration of UC into a hospital's transaction-based applications can eliminate the manual initiation of telephone calls. Integrating mobile UC into these applications enables required follow-up actions to be communicated automatically at minimum cost, and with a high degree of certainty that the communication is delivered to someone who can act on it in a timely manner.

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Matt V.
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Matt V.,
User Rank: Apprentice
10/28/2011 | 5:57:33 PM
re: Unified Communications Touted For Healthcare Efficiency
There sure are limitations. A solution like this is based on a number of elements (products) working together smoothly in a "technical ecosystem" approach.

Some vendors went the turn-key route to control all of the elements and provide the complete solution, ranging from the call manager, the wireless LAN infrastructure to the handsets. While it is seemingly attractive to go this route (low barrier to entry and lower risk), you are now stuck with that vendor and you may not be getting the best solution possible. Your internal processes also may be different than what the turn-key solution offers and often, you will have to adapt those to make it work, rather than having the flexibility to have your tools customized to mirror and support your internal processes and procedures.

However, if you are looking for "best of breed", you will have to deal with a number of different parties, vendors and products( or application software). A good system integrator can help, otherwise you will have to take on the effort yourself, which can seem like a daunting task at first.

Given the (current) lack of interoperability standards, you need to look for any interoperability testing that the vendors have done with eachother and a level of integration that gives you the comfort knowing that the solution will work. That's where leading products and vendors will stand out.

And the upside is so worth the price of admission; a custom solution that supports your internal processes, increases efficiencies and has the buy-in from the staff ("how did we ever do this without..."), rather than resistance from the people who have to use it every day.

Imagine the Chief Nursing Officer and the CIO both being happy with the solution, a true "win-win".

And while all this may sound like Utopia, just talk to other hospitals or healthcare facilities at industry events and you will hear about what works (and what doesn't) already today.

Lisa Henderson
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Lisa Henderson,
User Rank: Apprentice
10/28/2011 | 1:11:02 AM
re: Unified Communications Touted For Healthcare Efficiency
Not having that in-depth knowledge on the limitations of smartphones in the healthcare setting, the outline you have makes sense. But there must be limitations to this also?

Lisa Henderson, InformationWeek Healthcare, contributin editor
Matt V.
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Matt V.,
User Rank: Apprentice
10/27/2011 | 11:30:29 PM
re: Unified Communications Touted For Healthcare Efficiency
Yes, there is tremendous opportunity for wireless unified communication in healthcare.

And if you believe the hype from cellular operators that promote the use of smartphones, they seem to have the key.

The only problem is that they are trying to fit a square peg into a round hole with the only goal to increase the ARPU (Average revenue per user) and ultimately, their revenues.

Let's start with the obvious: healthcare facilities are usually indoors and cell phones have traditionally been notorious for poor indoor coverage. That isn't necessarily bad; anyone who has ever heard the interference of their GSM phone with other electronic equipment like speakers would not want those to be in close proximity of sensitive medical equipment to treat or diagnose patients in an ICU.

The list goes on: healthcare applications are "real-time" and, as anyone who has ever experienced delays or outages with cellular SMS service can attest to, text messaging on cellular networks can be unreliable. If you dig into the "terms for specific wireless data services" you may be shocked to see that cellular carriers offer no guarantees for successful transmission or delivery confirmation of SMS messages. If you need logs or a way to audit information (think insurance), you are out of luck.

Limited capacity is another problem; the more users outside the healthcare facility consume network capacity, the less is left for applications that may need more data or faster data transmission inside.

And when it comes to location awareness, the U.S. Federal Communications Commission (FCC) only requires that Wireless network operators must provide the latitude and longitude of callers within 300 meters, within six minutes of a request by a PSAP. Accuracy rates must meet FCC standards on average within any given participating PSAP service area by September 11, 2012.

Let's face it, cellphones (and even smart phones) are not built for the demanding environment that healthcare facilities represent. Even the police and other first responders, while they may be carrying cellphones, rely on purpose built communication devices to get the job done in mission-critical applications.

So what's the solution?

Let's look at purpose built indoor wireless LAN ("Wi-Fi") networks.

Designed to provide the coverage where needed, supporting Quality of Service (QoS) that gives priority to voice or video traffic. Many medical devices already use Wi-Fi today.

RTLS systems can provide real time location with accuracy levels that can pinpoint the device to the right floor and the right room inside a building.

Enterprise-Grade VoWLAN (Voice over IP over Wireless LAN) phones are designed to be rugged, in order to survive the demanding environment in modern hospitals and other healthcare facilities.

They offer user replaceable batteries that will last for a shift (or longer) and can be easily swapped when the next healthcare professional takes over.

The really good ones offer noise cancellation, so even if you use the phone when it gets loud and hectic, the message will come through loud and clear (leaving less room for error or misunderstandings).

And they have evolved to keep up with Unified Communication, with graphic displays, push to talk capabilities and messaging integration.

Integration with nurse call systems lets the patient talk directly with the nurse, even when she is away from the nurseG«÷s station.

Integration with patient monitoring systems sends the alert straight to the nurse so she can check on the patient.

Built-in barcode readers help with positive patient ID (photos or even patient electronic medical records displayed right on the phone). And Medication Administration systems use all of that to further reduce the possibility of medical errors.

In the end, that's what it is all about. Reducing medical errors, increasing patient safety and giving medical professionals the tools to help them do their job better and more efficiently.
UC with the right processes, applications, devices and networks can do just that.
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