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Are Clinicians Struggling to Find Context?

· Kim Tucker,

Clinicians are constantly interacting with other clinicians, technical staff and support staff as they direct care of and directly serve patients. That’s the key; most of all clinical work is directly focused on patients or collaborating with other clinicians with the goal of caring for patients. Yet, clinicians are constantly challenged by this very patient-centric focus. Why, because most clinician work is unfortunately not delivered in a pure, linear and serial fashion.

So what is contextual communication anyways?

According to Johan Kristiansson, Master Researcher at Ericsson Research and PhD in Media Technology, contextual communication is about bringing together the right information at the right time with the right group of people to collaborate and solve some tasks. It is about improving business processes by providing customized communication tools that are much easier to use than today’s general-purpose tools. This four-minute YouTube video illustrates clinical communication in more detail.

But how does it relate to the work of clinicians?

Clinicians are constantly changing their patient focus as they round, write notes and orders, respond to pages and telephone calls and respond to new data (lab and imaging results, consultation reports, progress notes) in the EHR. Clinicians are constantly changing the patient context within which they are doing their work. Both phyicians and nurses experience this constantly changing patient context.

Today clinicians must commonly recreate their own context every time they think about or act upon a patient. This means they plumb their memories, seek information from informal notes in pockets and various “peripheral brains” and click and click and click through the EHR seeking data points to inform a decision.

Nurses do this in the hallway, just before entering a patient room, especially at the beginning of a shift. Practitioners undertake to recreate context before they encounter a patient in an ambulatory setting or on inpatient rounds, write progress notes and enter orders. A practitioner entering a medication order in the EHR may be met by a “pop-up alert” creating the context of the apparent potential for a drug-drug, drug-allergy or other interaction, a limited context for decision-making indeed.

Stop searching for data and consider the possibilities:

Communications that deliver the context along with the message accelerate the clinician’s time to decision and consequently action. As importantly, contextual communication allows the time and the relaxation of mind for the clinician to consider the possibilities rather than anxiously search for the data that can drive the answer.

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