Clinical Communication Platforms 2020—Advanced User Insights
The Next Step in the Evolution of Secure Communications

ADVANCED USER INSIGHTS REPORT: CLINICAL COMMUNICATION PLATFORMS

Advanced User Insights reports are designed to help readers understand what is possible at the cutting edge of a given technology: in this case, clinical communications. Readers should not approach this study as an introduction to secure communications, nor should initial purchase decisions about a secure communication solution/platform be made based on the findings in this report.

Rather, this report is intended for organizations that are looking to move from an already mature secure communication approach to full clinical communication across their enterprise, with a willingness to devote significant organizational investment, governance, and development efforts in partnership with their vendor. For these organizations, this report shows the workflows their peers are tackling, potential outcomes that can be realized, and best practices to implement. Organizations can also use this research to gain a more robust understanding of what advanced users have been able to accomplish thus far.

For this research, each measured vendor shared with KLAS a short list of the customers they identified as their most advanced—organizations that have gone beyond the basics of secure texting and nurse communication to deploy an enterprise-wide clinical communication platform that handles the majority of the organization’s clinical communication. For each vendor, KLAS interviewed three to five of these advanced customers about the workflows they have implemented; the insights gleaned from these interviews make up the bulk of the Executive Insights section, with additional details in the Expanded Insights. KLAS also conducted a more in-depth and (in most cases) on-site case study with one customer per vendor; these case studies can be found in the Expanded Insights in the full report.

What Are Advanced Users Accomplishing with Communication Platforms?

In coordination with vendors and their advanced users, KLAS has identified the technology-enabled workflows (grouped into 10 key areas below) being leveraged by advanced users. Epic, Halo, and TigerConnect are validated as supporting the greatest breadth of workflows for advanced users, mostly attributable to the adoption of both inpatient and non-inpatient communication workflows. PerfectServe and Telmediq advanced users have deployed communication workflows across primarily inpatient but also non-inpatient care settings, though with fewer total workflows. Cerner, Hillrom (Voalte), Mobile Heartbeat, and PatientSafe Solutions have a primary focus on inpatient settings; they are less often adopted by advanced users for non-inpatient workflows.

Some vendors (such as PerfectServe, Telmediq, and Vocera) may have enabled some workflows below for one or two customers who are not advanced users and are not represented here. Those vendors whose customers tend to implement all their technology tend to have more workflow breadth among interviewed advanced users. For more details on vendor-reported workflow capabilities, see Expanded Insights in the full report.

For Tight EMR Integration, Cerner & Epic Can Be Good Options; Several Other Vendors Also Integrate 

Organizations continue to look for tight integration between their EMR and clinical communication platform. Organizations who choose Cerner’s or Epic’s communication solutions often do so specifically for that streamlined integration, though some current and prospective customers have concerns. Epic Secure Chat functions not as a separate solution but as a fully embedded piece within the EMR (both the desktop EMR and mobile apps Haiku, Canto, and Rover). Some respondents worry that since communication tools are tied into the larger Epic environment, no communication can occur outside Epic sites or during downtimes and upgrades. Cerner CareAware Connect Communications is a separate app from the Millennium EMR but tightly integrated with it, making it easier to roll out the communication tool to users without an EMR license. Cerner offers separate apps for different use cases (e.g., taking images and saving them to the record); this allows communication to continue during system downtime or upgrades. PatientSafe Solutions is unique as the only non-EMR vendor to have bidirectional EMR integration (with Cerner, Epic, and MEDITECH). To date, this integration includes a few key workflows, including simple nurse documentation and positive patient ID (barcoding) for things like medication administration, blood work, lab orders, and specimen collection. Mobile Heartbeat, PerfectServe, Telmediq, and TigerConnect have demonstrated the ability to give users—wherever they are—access to EMR information, including notes (from Cerner, Epic, and MEDITECH EMRs). Hillrom (Voalte) and Vocera have been slower getting to this depth of information; advanced users hope to have these capabilities by the end of 2020.

Contacting the Right Physician—Telmediq, PerfectServe, Halo, and Vocera Best Provide Technology for Care-Team Identification & Communication

Case Study Participants Note Wide Variety of Outcomes

Collaborative vendor/client development is key for advanced users to achieve a breadth of outcomes from their clinical communication platform. KLAS conducted an in-depth and (in most cases) on-site case study with one organization from each vendor’s group of advanced users, and these case study customers shared what outcomes they were able to realize in partnership with their vendor.

Lessons Learned from Advanced Users

Communication Platform Strategy 

1. While a communication platform can be perceived as expensive, especially when shared smart devices are deployed, the problems it eliminates make it worth the cost—advanced users identify poor communication as a major cause of medical errors.
2. You can replace pagers with a communication platform by having an effective plan that includes governance, wireless technology, training, workflows, etc.
3. Advanced users consistently identified the following steps as key to driving strong, enterprise-wide adoption:
   • Set up strong governance and shared ownership across IT, clinical leadership, and administration.
   • Start with the patient-centered care team communication workflows, including role-based communications.
   • Create a seamless user experience, which can include embedding the communication platform in the EMR for tight integration.
4. Despite worries about patient perceptions, few patients complain about nurses and physicians using commercial phones during care delivery, especially if clinicians communicate with patients about the technology up front.

Internal Needs 

1. The form the governance structure takes isn’t as important as making sure that leadership—executives, physicians, nurses, and IT—are all bought in to the vision and value the investment in enterprise clinical communication.
2. Figuring out an enterprise scheduling approach for physicians and nurses is vital so that users can connect to the right people at the right time (see Expanded Insights in full report for more details).
3. Figure out your wireless needs right out of the gate—test mobile-device access (not just laptops), and measure connection everywhere.

Vendor Considerations 

1. Pick a vendor who is fast to develop rather than a vendor advertising they have everything today—because your use cases will be unique and your tools will need customization.
2. Integration is vital. Your communication approach and goals (i.e., your jobs to be done) should drive your integration path, whether that includes ADT feeds, pulling patient information into a communication thread, bidirectional communication, or integration with nurse call, physiological monitor alarms, or physician on-call scheduling.
3. Consider how vendors can help measure your organization before and after go-live to track benefits.