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Clinical communication in rural Colorado

Originally posted on¬†Becker’s Health IT & CIO Review.

Q&A with Parkview Medical Center CIO Steve Shirley

Approximately 100 miles south of Denver is Pueblo, Colo., the home of Parkview Medical Center. The 350-bed hospital serves a “catch area” including all of eastern and southern Colorado, where there are a number of critical access hospitals, but no Level II care facility.

As part of Parkview Medical Center’s strategy to serve its patient population, the leadership sought to unify its communication strategy, beginning with moving from a paper-based health record to an electronic one. In the past 10 years, Parkview Medical Center has gone through several upgrades to its clinical communication strategy, which continues to evolve.

The hospital started with a “bring-your-own-device” strategy, but slowly morphed to add a mobile clinical communications strategy, the key difference being BYOD requires employees to bring their own devices, while clinical communication strategies use third-party software to facilitate communication.

Here, Steve Shirley, CIO and vice president of IT of Parkview Medical Center, discusses the hospital’s mobile clinical communications strategy and the future of healthcare’s digitization.

Question: What’s the difference between BYOD and a mobile clinical communications strategy?

Steve Shirley: For us, it’s two different initiatives. BYOD, the way we look at it, it’s that piece where physicians, hospital management and leadership bring their own device and we’re hooking them up with hospital email and contacts.

Our clinical mobile strategy is all hospital-owned devices. In 2006, the first iteration of that system was a single-use device. All you could use it for is bedside and media administration. No communication, nothing else. In 2009, our iteration had changed strategy, so we moved to an iPod. That’s morphed into the iPhone which we use today. Those are all company-owned devices, and they’re all sitting on our wireless.

The next phase for us, which we’re starting this moment, is an effort to minimize systems. Instead of going and getting a HIPAA texting system just for doctors, we’re looking to create an external piece right inside our clinical communication tool we’ve got, so literally that system will handle HIPAA-compliant texting when on the outside, but also give them access to information and do all the things they want to do to communicate with nurses.

Q: What are the key elements of a safe, efficient and effective clinical communications strategy?

SS: First and foremost, the ability to affect a solution that’s not made up of a group of separate systems is so important. Minimizing interfaces keeps this thing a lot cleaner. Another is that the solution we chose, and one we would look for, is one that gives us a device like an iPhone that’s capable of things beyond just the software for which it’s intended.

As an example, our nurses can put their drug dictionary on their handheld device. We also have a process where we show videos to patients as part of our patient education piece. So if you’re in the ER and have back pain, here’s a video about what we’re going to do with your lumbar.

The other piece that was absolutely a struggle for us (but we’ve had some great cooperation and teamwork with MEDITECH) as everybody knows and hears, is difficulty getting vendors to play in the sandbox. We desperately needed whatever we did in our clinical communication strategy to interface back to the EMR so we weren’t working with two separate records. After a lot of work with MEDITECH, we started getting exactly the information we needed.

Q: Why did you choose Apple products as opposed to other smartphones?

SS: We took the opportunity to go out and do a request for proposal and look at everyone in the market. When approaching the point of the decision, patients still say the best device to use is an Android or iPhone. I wanted something that allows us to have more of an open architecture, something we could put apps on. In the case of PatientSafe [Parkview Health’s clinical communication solution provider], since they started with the iPod, it gave us the opportunity to move forward with that.

Q: How do you see the consumerization and digitization of healthcare affecting care delivery 10 years down the road?

SS: Of course there are mutterings that encourage us to get patient portals adopted, but I’m so much more excited about all the evolution of measuring and monitoring tools and things that can anoint a patient to the provider on an ongoing basis more as a preemptive strike to heart attack or stroke. It’s got to get to an automated fashion where our systems will automatically be querying all this stuff and not waiting for someone to manually find it. The plethora of different apps and tools we’re going to get is going to be pretty powerful.

There’s no question the patient portal will gain in popularity, but it’s certainly a two-sided thing. Without doctors, we don’t have a hospital, so it’s different to shift their paradigm, too. They engage with patients in a way they haven’t done before. We’re working with our physicians to give them tools.

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