Examining mobility and 3 major differentiators that make Mobile Heartbeat’s MH-CURE a Clinical, Unified, Communication solution.
Data and Dialog – the Two Keys to Mobility
As I present our clinical communications solution in hospitals across the country, one of my favorite trivia (read “ice breaker”) questions, especially among the younger audience, is to ask, “Before the Smartphone, we had what we called the mobile phone or cellphone. What was it called before that?” After 5-10 seconds of silent discomfort, I provide the first hint: “There was a time when someone could only call you at home or at work or some other landline.” The silence usually continues, which brings on the second hint. “Something was invented that made you reachable by phone between home and work — while you were driving.” With little delay, comes the reply, “the car phone.” Yes indeed, the car phone.
As liberating as it was in the 80’s to have access to voice communications in your car, it pales in comparison to the mobility we experience today. Not only has the emergence of the smartphone provided multiple channels of dialog (voice, text, and video), these handheld computers have mobilized our access to a staggering amount of data. These two key features, dialog and data, are essential to maximizing mobility. While most industries have benefitted from smartphones for years, healthcare (especially the acute care segment) is just now beginning to realize the value.
Differentiator #1: Patient Data Makes MH-CURE Clinical
Over 50 secure text apps have launched into the healthcare industry and the proliferation continues. If you relied on the results of a Google search for “Secure Clinical Communications”, you would think that encryption and security were synonymous with clinical. Not so fast. There’s nothing inherently clinical about encryption. Many industries such as banking, finance, the military and even hospitality have privacy concerns that require data to be encrypted. At Mobile Heartbeat, we believe it’s not HOW data is transmitted (encryption) that makes it clinical, but WHAT data, namely “patient data,” that makes it clinical.
There are 3 critical connections to DATA that constitute the MH-CURE platform as robustly clinical. First, we connect to the hospital’s Active Directory (AD). This is the database that contains all of the authorized caregivers. We synchronize with it and utilize the same username and password that a caregiver uses to access the EMR. Second, we connect to the EMR using an industry standard interface (e.g. HL7) to obtain the census or list of patients. With a list of caregivers and a list of patients, what’s the next logical thing to do? Link them together! That’s the third integration. We connect with (and supplement) staff assignment sources which enables us to display in our app a “patient-specific view” of assigned caregivers which we call the Dynamic Care Team. A complementary view, which also results from this linkage, is a “caregiver-specific view” of assigned patients.
With MH-CURE, clinicians possess a real-time and up-to-date view of each patient’s dynamic care team. This has a dramatic impact on communication efficiency. One of the biggest challenges caregivers face is knowing who to reach concerning a given patient. RN’s, CNA’s, Case Managers, etc. with a complete care team at their fingertips, don’t have to walk to the front of a nursing unit to see which caregivers belong to which patient and whether they’re available, on break or off duty. Physicians and others with external access running MH-CURE on their personal device don’t have to waste time on the phone with a medical receptionist or unit secretary trying to track down the currently assigned RN to inquire how their shared patient is doing.
A term we like to use at Mobile Heartbeat is “directed messaging.” When clinicians are linked to patients then communications, alerts, and alarms can be directed to the assigned caregivers and delivered with “patient context.” Lacking this patient data, the plethora of secure text apps on the market are reduced to nothing more than “generic messaging” tools rather than clinical communication solutions. Yes, they offer encryption, but lacking clinical context means more walking and delays access to data which should be in the palm of a caregiver’s hand.
Differentiator #2: Multiple Forms of Dialog Make MH-CURE Unified
Communications in business and industry are oftentimes urgent but, unlike healthcare, are rarely life threatening. Most non-clinical professionals today schedule their activity in a calendar app and move in serial fashion between conference calls and meetings with convenient 30-60 minute reminders beforehand. This is not the case in a hospital setting. Nurse calls, critical labs, STAT meds, infusion pump alarms are a small sampling of the myriad alerts and alarms that make clinical workflow one of the most “interruption-driven” environments. Caregivers can’t schedule CPR or atrial fibrillation ? they have to respond when needed. This is compounded by the fact that most caregivers are constantly on the move, are caring for multiple patients at a time, and the layout of modern hospitals reduces “lines of sight” — where are they?
It’s precisely this reason that clinical workflow requires multiple modes of dialog. All forms of communication can be categorized as either Synchronous (same time) or Asynchronous (not same time). A voice channel is still by far the most popular form of synchronous communication. It’s ideal for real time interaction. That said, voice has two limitations. First, you have to be available to engage in a voice conversation. Second, you can only participate in one dialog at a time. In other words, you have to stop what you’re doing to make or take a call. It’s these shortcomings that have spawned the adoption of text messaging as an additional channel of communication in healthcare.
Adding secure text messaging as a second channel of communication isn’t simple. For starters, the majority of hospitals provide voice communications on a purpose-built device that resembles the cordless phones introduced over 20 years ago. Remember those? They have a 12-digit alphanumeric keypad with a LCD display the size of a wrist watch. Although theoretically possible, no modern smartphone user wants to revert to texting urgent, clinical messages on a 10-key alphanumeric keypad that forced a previous generation to speak in acronyms (OMG, LOL, BRB, &c).
So why not just replace those cordless-looking VoIP (Voice over IP) phones with smartphones so clinicians can make calls and send text messages from a single device? It’s not that easy. While smartphones are optimal for text messaging, enabling them to make free phone calls on the Wi-Fi network routed through the hospital’s PBX (telephone system) isn’t trivial. Making voice calls over a cellular network is what they were designed for. Having them roam smoothly between Wi-Fi access points requires serious telephony integration. This reality is substantiated by the fact that over 95% percent of the secure texting apps don’t offer any kind of Wi-Fi voice capability.
For doctors and other external users, it’s not a big deal. They can use their personal smartphone to send a text or use the cellular connection to make a call. But, for bedside caregivers like RN’s, CNA’s and others who perform shift-work, hospital administration is reluctant to provide smartphones with cell plans. The increase in cost is huge. Another option is to have these shift-workers download a secure text app to their personal smartphone. So, now they’re supposed to text from their personal device and place calls from their hospital Wi-Fi phone? We refer to this syndrome as “The Split Platform” — one device to text and another device to talk.
In contrast to this inefficient and costly Split Platform, MH-CURE unifies communications by allowing both secure text and high-quality voice over the hospitals Wi-Fi network. This device consolidation is essential to unifying communications and driving down cost.
Differentiator #3: MH-CURE is an Enterprise Proven Solution
One of the persistent challenges of competing in the modern world, is “copy-cat metooism.” Advertising guru, Jack Trout, noted in his book, “Differentiate or Die,” that the advent of the Internet introduced a “site eats site” world. Make a unique claim on your website, show a unique view in the app store and competitors will quickly mock up graphics and incorporate them into their presentations long before any of those capabilities actually exist in their product. The pejorative catch-phrase for this is “vaporware.”
MH-CURE is a real product. To fortify this, we conduct LIVE demo’s onsite ? not demoware nor presentation slides. We hand out smartphones in a conference room setting to caregivers, biomed resources, nursing informatics and IT support personnel. Users make Wi-Fi telephone calls to each other, send text messages and receive critical alerts. From the beginning, Mobile Heartbeat has placed heavy emphasis on making a great product that actually works. Market recognition and advertising have taken a backseat. In September of 2013, this strategy paid off when Hospital Corporation of America (HCA) chose Mobile Heartbeat as their vendor of choice to be the communication solution for their iMobileTM project.
The HCA network consists of 175 hospitals supported by 3 regional data centers (RDC’s). Our product is installed in 2 of the 3 RDC’s and is live in over 10 of their hospitals with a new hospital added each week and a rollout schedule that will have us system-wide over the next 2-3 years. A favorite quote heard at HCA is that our platform represents “the gold standard of secure, clinical communications.”
Final Thoughts on Clinical Mobility
The clinical communications landscape is fragmented. Legacy solutions offer only voice. Dozens of messaging apps offer only text with more appearing in the app store weekly. As far as those unifying communications, most don’t offer a patient-specific context nor have they been proven in a large-scale enterprise deployment.
Some in hospital leadership wonder if the EMR vendors will eventually disrupt the clinical communications space by offering secure text. Certainly some will incorporate messaging, but it’s doubtful they will veer from their core competency and take up integration with the numerous nurse call and telephony systems that exist. Mobile Heartbeat is doing all of this now and our customers are reaping the benefits today.