The COVID-19 pandemic has accelerated major shifts in healthcare technology, from remote working to telehealth. For hospitals and healthcare systems, COVID-19 has exposed critical gaps in communication that affect patient outcomes and challenge business continuity. One of these gaps is reliance on outmoded communication tools such as the pager.
First adopted by the Detroit Police Department in 1921, pagers spread to hospitals starting in 1950. Back then, pagers were the height of innovation—and a status symbol for the doctors who carried them everywhere. Today, in the era of smartphones and electronic health records (EHRs), pagers are painfully obsolete.
However, many hospitals still use pagers to communicate urgent information around patient care. Nearly 80% of hospital-based clinicians who responded to a national survey still used pagers, according to a 2017 study in the Journal of Hospital Medicine.
Although healthcare systems have long recognized the shortcomings of pagers, they’ve been slow to upgrade their technology. For years, the unique pressures and regulations within healthcare have made it difficult to build a viable alternative to the pager. Hospitals have struggled to find cost-effective collaboration systems that maintain HIPAA compliance and reliably support mission-critical communication.
While far from optimal, pagers were a “good enough” solution—until the virus upended the healthcare communication paradigm. The pandemic has highlighted the importance of a unified clinical collaboration platform. Now, more hospitals and doctors are retiring the pager in favor of more dynamic tools to communicate on patient care.
New Teams, New Challenges
Prior to the pandemic, teams formation and communication were already becoming more complex and the software to support them more sophisticated. The pandemic has thrust healthcare professionals into newly formed teams, requiring them to collaborate across specialties to treat critically ill patients. Teams have had to work in new ways to test, triage and treat a high volume of ICU patients; deliver care via telehealth; and launch vaccination sites. In this rapidly evolving environment, providers have had to communicate with their colleagues, often for the first time, without missing a beat.
Pagers have not been sufficient for these new demands for many reasons. For instance, pagers do not support two-way conversations. To respond to a page, providers must drop the task they are working on, find a landline phone, dial the right extension and wait for someone to answer. Sometimes, they are routed to the front desk on the hospital floor, where they wait to be transferred. It’s a major disruption to answer simple, yet critical, questions—like whether a patient needs a blood transfusion.
Pagers also don’t support role-based communication to allow people to reach the right person at the right time. With role-based communication, providers can reliably reach the person on call within a given specialty. This is particularly useful when providers need to consult physician groups—for instance, a cardiology group—but don’t know which cardiologist is currently on call. Pagers aren’t smart enough to know these nuances, so teams must reference schedules that may be outdated and call down a list of names in hopes of reaching the right person.
Navigating the Rapid Shift to Technology
Since pagers don’t support the pandemic-era workflow, teams have been forced to improvise with a mix of digital and analog tools. Unfortunately, this rapid transition has posed security threats and privacy risks, especially for providers handling sensitive healthcare information.
Many collaboration tools on the market, such as video conferencing platforms, weren’t designed for the unique needs of healthcare providers. These tools suffice for administrative tasks, but they’re not viable for clinical collaboration in the long term. While government officials have temporarily accommodated emergency communication needs, regulators and patients alike will expect healthcare leaders to adopt more stringent policies around patient data moving forward.
The pandemic has also challenged business continuity on another level. In the hardest-hit regions of the United States, hospitals brought in semi-retired physicians and other medical volunteers to care for patients. Healthcare systems suddenly had to expand their user base, provision new users and integrate them into new workflows. Without a unified clinical collaboration platform, healthcare IT teams faced an immense technical burden – at a time where introducing change in an acute care setting was a challenge, in light of COVID-19.
Here again, pagers fall short of meeting the needs of modern healthcare teams. At their core, pagers are simply an alert system. They can tell providers that a team member needs their expertise, but they can’t facilitate sharing knowledge in real time. Pagers also don’t allow providers to prioritize responses based on the level of urgency—they buzz or beep the same for every incoming request. Providers learn, like Pavlov’s dogs, to drop their tasks every time the pager interrupts them.
And critically, pagers don’t allow multiple providers to access a single source of truth for a patient’s care. With pager-based communication, information is flowing in all directions, but it’s not centralized anywhere—causing confusion and contradictions among providers and ultimately creating delays in care.
Accessing a Single Source of Truth
Clinical collaboration platforms solve the problems inherent in pagers. They allow providers to use role-based communication to reach the right person at the right time. Role-based communication is an example of what PwC Health Research Institute calls “human-centered design.” In the Institute’s recent survey, 94% of provider executives, 92% of life sciences executives and 91% of health plan executives said improving the clinician experience is a priority for their organizations in 2021.
Clinical collaboration platforms allow providers to see, discuss and refine a patient’s care plan, ultimately improving outcomes such as quality care, patient throughput and hospital readmissions. With clinical collaboration platforms, providers can know what type of request is coming in—high priority, urgent or emergent—by what type of chime or vibration they hear. Being able to mitigate distractions allows providers to stay focused at the bedside as much as possible. And equally important, real-time collaboration improves the patient experience, translating to greater patient satisfaction. Healthcare is better when patients know their providers are on the same page.
From an IT perspective, clinical collaboration platforms support the needs of a workforce in flux. Unfortunately, COVID-19 will not be the last global healthcare crisis. Healthcare systems need to be agile enough to accommodate a burgeoning team as needed and rapidly bring new team members into the fold of clinical workflows.
Innovating Beyond the EHR
In the post-pandemic era, clinical collaboration is the next opportunity for healthcare systems. As EHR systems reach a mature stage of adoption, healthcare systems have maximized the potential of these systems. Hospital leaders have been head down with EHR implementation, hiring consultants to optimize the EHR and training clinicians how to use these platforms. Over the years, leaders have realized that EHR systems have an important role, but their scope of capabilities is focused on documentation, billing and other administrative functions.
It’s time for healthcare systems to turn their attention to the next big space: mobile, cloud-based clinical communication and collaboration. EHRs host a treasure trove of data, but providers don’t need all of it at the same time. In fact, the sheer volume of information in the EHR has been linked to increasing levels of physician burnout. In a national Medscape survey, 79% percent of respondents said their burnout began before the start of the pandemic, and 47% said that burnout has a “strong or severe impact” on their lives.
A clinical collaboration system can integrate with the EHR and other critical systems to “push” and “pull” the right amounts of information. Segmenting and organizing this data within a clinical collaboration platform can deliver major clinical and technical return on investment. On the clinical side, streamlined collaboration can improve referral patterns, readmission rates, length of stay, patient satisfaction and the ability for providers to speak with one voice.
The clinical collaboration space is fast-moving, and it comes with its own learning curve. Asking providers to learn another system is a challenge not to be understated. However, clinical collaboration platforms have a key advantage over pagers: the ubiquity of smartphones. We expect the intuitive ease and user experience of smartphones to translate across all areas of life. Now that the technology has evolved to support secure, reliable communication within hospital settings, the appetite for change is evolving.
The PwC Health Research Institute’s Top Health Industry Issues of 2021 report echoes this sentiment, stating: “Digital technology, if made right, could be the antidote to countless pain points that physicians encounter every day, leading to more efficient and satisfied doctors, happier patients and more patient referrals.”
Increasingly, hospital systems are willing to move beyond disparate systems like pagers, email, texting and paper schedules. The new paradigm for healthcare teams is not only communication, but true collaboration. COVID-19 put healthcare systems through a trial by fire, highlighting the need for dynamic team workflows. With the pager finally on its way out, healthcare systems can move toward secure, real-time, role-based collaboration that supports their focus on delivering excellent patient care.
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ABOUT THE AUTHOR
Jose Barreau
Jose Barreau, MD, is CEO and co-founder of Halo Health. Dr. Barreau’s passion – to improve patient care through better communication – is the foundation for the Halo Clinical Collaboration Platform. Dr. Barreau is board-certified in internal medicine, hematology and medical oncology. He completed his fellowship in hematology and oncology at the University of Cincinnati. Prior to his retirement from active practice, he sub-specialized in breast cancer treatment.
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