We’re working on a Unified Communications strategy at UCHealth. We have a history of implementing multiple communications channels over the years:
Bell-boys
Bell-boys (the precursors to pagers), with verbal alerts. You call a phone number, you record your 8 second message, and a minute later, someone, somewhere in the hospital hears this coming from the bell-boy at at their hip. Usually, you say: “This is East-8. Please come to bed 8217. Patient vomited blood.”
Worst case, you have excited nurses who don’t give you complete information. My favorite bell-boy utterance: “Doctor! Come Quick!”
Hmm. Which floor wing of the hospital? Which of the 12 floors?
Pagers
Then, there have been actual pagers, those infernal beeping machines that were the bane of residents and attendings worldwide (but the badge of honor for medical students offered one for the first time).
Of course, there’s Pager Inversus, but that is a blog for another day.
Doc Halo, Vocera, Tiger Text
And then came the flowering of 100 new ideas. “Hey, I think my department could really use X. We don’t really like Y because, X is better. Everyone know that. And because our organization in years past did not have a well-centralized decisionmaking body, every department went and did as they liked. As a result …
Pandemonium
Why can’t the nurses and operators page me in time? They are SOOOO SLLOOOWWWW. We need to hire more.
Well, imagine this. The number of places a nurse has to look in the paper or electronic chart to find the contact information for any one physician or APP was in non-overlapping, non-cross-indexed dictionaries:
- Handwritten pager number in the progress notes
- Call my service and my staff will then reach me on my private cell. I don’t give that out
- Look me up in Doc Halo’s website
- Look me up in Tiger Text index
- Look me up in Vocera
Fortunately, we finally have a tool in Secure Chat in Epic EHR that will replace all these technologies.
Network Effects
(image from wikipedia.com)
Over years, the building of telephone networks made owning a telephone increasingly valuable. The larger the network and more people you can reach, the more useful the tool.
The opposite is also true: the more different and non-connected communications tools you use in an organization, the worse it gets, and the harder it is to reach anyone.
I think we’ve finally learned this lesson: Secure Chat it is.
Culture Eats Technology for Lunch
Of course, the IDEA of unified communications and getting rid of older networks, like pagers, other secure chat tools in favor of one, seems simple. Don’t under-appreciate the need for LOTS of meetings and discussions.
In fact, it might be time to re-read Leading Change.Have to think about finding the Burning Platform, building Buy-In, building a Guiding Coalition, and so on. Informaticists would say, it is the classic 80:20 rule. Technology, as hard as it is to create, is only 20% of your success. The other 80% is the socio-political skill of those deploying the tech.
CMIO’s take? We are, after years of effort, growing our success. And to celebrate, this song (youtube link above).
