Five years ago, “clinical mobility” for hospitals and health systems meant buying and deploying a large fleet of computers-on-wheels. Carts mounted with laptops and monitors plugged into walls and could only go mobile for a couple of hours on a cooler-sized battery pack. The carts required constant recharge, backbreaking maneuvering, and cumbersome cleaning procedures that resulted in widespread clinician dissatisfaction. Nurses and physicians dreamed of documenting and driving workflows on the smartphone-based devices they were already using every day.
Fast forward two years to 2014, when going mobile meant finding a HIPAA-compliant way for clinicians to communicate with one another via their personal smartphones. A few providers made the switch from voice interaction badges to smartphone-based devices for care team communication, and as more followed suit, two types of end-user mobile communication technologies emerged—basic and platform.
Basic included secure messaging-only services delivered via the cloud. Smartphone-based platform communication solutions lived behind the provider institution’s firewall, offering voice, text, and some integration of alerts. The cloud-based texting products experienced initial success due to the industry’s focus on reducing HIPAA exposure and the appeal of implementing products and services that didn’t require integration into a hospital’s existing infrastructure. However, these messaging solutions didn’t provide for real-life clinician workflows and couldn’t harmonize with a hospital or health system’s existing infrastructure.
While platform technologies can help achieve faster, more accurate communication, they too don’t resolve key disconnects between ongoing clinical workflows and clinical communication, leaving care teams without the prioritized data and patient context needed at any given moment. As a result, these first-generation smartphone platforms lingered in various stages of trial and re-trial through hundreds of pilots and countless device choice iterations without making much of an impact.
In the past two years, our conversations with hospital CIOs, telecommunications technology leaders, clinical informaticists, and nursing and physician leaders have revealed growing frustration that is common in the evolution of new technologies. The adoption of basic and platform products certainly checked the box for compliance teams but delivered very little clinical utility and left users wanting more. Early adopters’ experiences have informed a new set of questions and requirements every provider should consider as they go mobile in 2017.
- Device Choice – Provider organizations are making a clearer distinction between shared devices and BYOD devices. With shared devices, health systems are more in tune with their unique needs for security provisions, mobile device management, charging solutions, single sign-on, battery life expectancy, and device lifecycle management. User experience must be included in decision making. Finally, understanding that the mobile application, device, and network all need to be considered for optimal performance is key. It may not be the device.
To combat provider organizations’ limited reach to purchase smart devices for each member of the care team, many health systems are taking a new approach to BYOD. Future-focused organizations are adopting mobile communications platforms and apps that allow clinicians to streamline care using their own device.
- Clinical Workflow Integration – It is important to consider how much of the point-of-care workflow can be consolidated onto a single app and a single device, as this lowers cost of ownership and increases facilitation and cross-functional coordination. How many care team roles can be linked through the solution – all of them enterprise-wide or just a few? Finally, clinical mobility technologies must integrate with existing IT infrastructure and clinical systems.
- Platform Scalability, Reliability, and Manageability – Can the software platform scale with the provider organization’s growing business and user base without a surge in costs? A clinical mobility solution should be a natural plug-in to existing investments, rather than a bandage to sub-optimal solutions already in play.
The new imperatives for clinical mobility illustrate what the technology research company Gartner calls the “trough of disillusionment” in their Hype Cycle framework—the phase where first-generation solutions in any category lose their luster as the true requirements of the field become clear. Clinical mobility has certainly come a long way, and the need for unified clinical communication and workflow solutions that will enable provider institutions to thrive is now clear. The drive to simplify the experience of care by unifying workflow with communications will only become stronger and more valuable for hospitals and health systems, and the technologies that can do so seamlessly and intuitively will end up on top. There is an exciting journey ahead.