Improving Clinical Communication with Mobile Device Implementation

Introduction: ECU Health implemented mobile devices across nine hospitals, offering web-based calling through Banyan and Rover, an Epic application used for documentation. This implementation improved communication by allowing end users to bypass the unit manager or secretary and call team members directly. Secure messaging through the Rover application using secure chat replaced the previous platform, Cortext.

Purpose: The retirement of Impravata Cortext necessitated a new secure messaging platform. Clinical staff and physicians expressed concerns about only being able to use the secure messaging platform within Epic on their workstations, as they are often not at a computer. They also highlighted delays in patient care caused by having to call team members and wait for the call to be routed correctly.

Method: Discovery sessions were held at each facility to gather information for setting up the mobile devices. Clinical informaticists met with service line, nursing, and ancillary team delegates to learn about the current state and make decisions on the future state. Decisions included the phone directory, dynamic roles, and status displays. Timelines were established for go-lives and eLearning modules, and tip sheets were created and distributed. Ground control devices were placed in accessible locations for easy device check-in and checkout. The phased rollout began with smaller regional hospitals and ended with the larger medical center. Clinical informaticists provided onsite support and logged issues in Service Now. The go-live included mobile devices with Wi-Fi calling, a directory with dynamic role assignment, secure chat within Epic, and expanded Rover functionality. During the implementation, network issues were identified due to the addition of extra devices. SSIDs and APs were updated to support the increased load. Clinical informatics and the networking team partnered in rounds and testing to ensure the reported issues were resolved following extensive network assessments and resolution.

Results: Documentation time for nursing decreased by 24%. Flowsheet macros saved nursing over 7.5 million clicks since September. Rover usage increased to the 90th percentile, including nursing, therapists, lab, and ancillary staff. Team member satisfaction dramatically improved with the rollout of mobile devices, secure messaging, and Wi-Fi calling.

Conclusion: The implementation of mobile devices and secure messaging at ECU Health significantly improved clinical communication and workflow efficiency. The phased rollout strategy, combined with dynamic role assignments and comprehensive training programs, ensured a smooth transition and high user satisfaction. The success of this project demonstrates the potential of mobile health and telehealth technologies in transforming healthcare delivery. By adopting best practices in training and education, healthcare organizations can optimize technology use and enhance patient care across the continuum of care.