At PatientSafe, we’re building a culture of openness—equally applicable to our company culture as it is to our product platform design. Without an open platform to share information, we expect communications break down, workflow inefficiency, and institutionalized workarounds. When we present our openness strategy in front of hospital stakeholders and show all the ways we can connect to external alerting and patient information systems, the response is overwhelmingly positive because with openness comes a wealth of workflow enhancement opportunities. But this blog post isn’t about how extensive our HL7, TAP, SIP, and WebServices APIs are. This post is about how subsequently work with our customers on prioritizing integration and interfaces and balance their unique clinician needs, IT risks, and overall resource limitations.
As always, we’ve broken it out to three areas to consider—
- Must haves: what current endpoint devices already support
- Impactful haves: what can lead to key workflow value gains
- To middleware or not to middleware
As hospitals transition from legacy devices to smart phone platforms, it becomes clear that this transition doesn’t happen overnight. As we replace the old with the new, users expect usability, reliability, and functionality to be met and improved. When working our hospital stakeholders (IT and clinical), the first step is to identify all the integration points that exist in the hospital today—this is what we identify as integration must haves. Some examples of these integrations are patient monitoring, nurse call, and telemetry alerts. In a legacy device replacement world it’s a no-brainer that we should never take away functionality.
Once we identify the must haves we can start looking at impactful integrations and interfaces that can significantly improve clinician workflow. The first place to start in considering impact would be to assess our must have integrations and question what the last attainable mile is. For example, if today nurses are able to receive a nurse call alert to their mobile device, providing additional functionality to directly call back into the room would be a natural “last mile” to get even closer to the patient’s needs.
Another area to consider is around patient data access. How many steps (literal and metaphorical) do your clinicians have to take in transitioning between their communications tool and their patient data access tool? What type of cognitive disruption does this cause? Oftentimes being able to establish an ADT feed would provide a huge amount of value if the communications solution is able to integrate this basic patient data into the context of care team collaboration.
The last major workflow impacting integration we work with our customers on is assignment. To provide visibility into a comprehensive list of assigned caregivers is key to effective collaboration. After an in-depth workflow analysis, organizations typically identify more than 3 sources of assignment silos, often a mix of automated and manual processes. It is critical to invest in a clinical communications tool that can automate manual assignment and establish assignment integrations so your organization can get to a single assignment process.
To middleware or not to middleware
This is a question a lot of institutions ask us and our answer is always tailored to what the their unique environment and needs are. Specifically, before deciding on middleware investments, determine the types of alerts and alarms you wish to deliver to the end point application. From here, we help hospitals identify the types of workflows around role-based routing, prioritization logic, and escalation design for each type of alert. For institutions that are looking to send one or two alert types with very simple workflow logic, a middleware investment may not be necessary as long as the mobile application platform is capable of supporting direct integration with the alerting system and has role-based routing with prioritization rules. If your institution has decided to integrate alerts and alarms originating from multiple systems, it would be best to unify this integration with a middleware in place. Not only would you be able to streamline customization for alerting workflows, you’ll also be able to leverage customized reporting and analytics across various systems.
One of our mantras at PatientSafe is that no two hospitals are alike. That said, there are similarities around workflows inefficiencies and technology gaps between healthcare institutions. Investing in a clinical communications platform that is open in its architecture design is critical. Your investment should evolve with the evolution of your organization and the system integrations and interfaces you need today and tomorrow.