In an article published online October 23 in the Journal of Digital Imaging, a group led by Brian Kolowitz shared their experience with software they developed called Unite, which makes use of technology used in social media with the goal of closing the gap in existing healthcare communication processes and systems.
"The Unite system combines social technologies' features including push notifications, messaging, community groups, and user lists with clinical workflow and applications to construct dynamic provider networks, simplify communications, and facilitate clinical workflow optimization," wrote a team led by Brian Kolowitz, a principal architect at UPMC.
Communication within healthcare organizations is always problematic. Thanks to inefficient communication systems and difficulties identifying appropriate providers to contact, clinicians spend a significant amount of time every day on these tasks, Kolowitz told AuntMinnie.com.
In addition, inefficiencies in communication can prolong patient discharge, delay treatment, and potentially impact patient care, he said.
"EMR [electronic medical record] and other HIT systems do a great job of managing the patient record, but don't currently have a solution for all aspects of communication within the organization," Kolowitz said. "Limitations include vendor dependency and transactional triggers (e.g., HL7, DICOM, etc.). Providers use many systems while providing care, and no single EMR system can solve the entire communication need."
For example, while off-the-shelf products can do a fine job of delivering a message to known individuals, they aren't set up to deal with situations in which the exact recipient may not be known (such as needing to contact the neurology resident), Kolowitz said. Modes of communication also differ.
"That's where Unite comes in, by focusing on intelligent connections rather than secure delivery of content," he said. "Privacy and security is always a risk, but minimizing noise and maximizing relevance will allow us to gain efficiencies that are not available today."
The Unite project aimed to connect everyone who participates in the care of a specific patient from the onset. Unite's developers designed the software as an extensible platform that consists of both standalone applications and widgets that can be embedded within existing clinical applications on platforms including Windows, iOS, and Android.
Unite aims to promote physician mobility through the tracking and delivery of important clinical events, as well as enabling communication on mobile devices, the researches noted. Unite's most important feature appears to be Provider Timeline, which, supported by Unite's Provider Presence indicator, allows users to quickly identify the correct provider and their status within the context of a patient, according to the group.
"These features are supported by mobile device integration and timely delivery of notifications," the authors wrote.
By developing a social network that's integrated with healthcare information systems, researchers can also capture and study the way in which providers communicate, according to the team.
"With Unite, a rich set of usage data tied to clinical events may unravel alternative networks that can be leveraged to advance patient care," the authors wrote. "It may be possible to determine (1) who providers communicate with most often, (2) under what clinical situations do these providers communicate, (3) what providers are on the critical communication path, and (4) what impact does latency in the communication process have on patient outcomes."
After an initial rollout of Unite to a limited set of users about a year ago, the group elected following the trial period to expand their enterprise communication strategy, Kolowitz said.
"We're back in the development phase and expect to deploy the next version within the organization early next year," he said.
Unite will be deployed as both a platform and a standalone system in the first half of next year, and the team is also working on integrating Unite with a variety of other systems, Kolowitz said.
"Improved providers' communication and automatic notification of clinical events are expected to improve patient outcomes, resource utilization, and workflow efficiencies," said co-author Jim Venturella Jr., chief information officer of UPMC Physician and Hospital Services.
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