At any given moment in healthcare, a physician is sharing patient updates with a care team, a clinic is transferring patient records to another facility, and a nurse is transmitting vital data during a patient handoff. Effective and timely clinical communication in its many forms is vital to the delivery of safe, high-quality patient care.
Just as patients entrust their health to the providers who care for them, healthcare professionals must trust each other and their clinical communication system to share accurate data promptly. It's a complex process because the exchange of clinical information isn't always limited to a subset of participants, nor is it confined to a particular communication channel or method. Providers today use tablets, smartphones, and other devices for secure messaging, voice, and critical alerts—ideally on a single platform.
Who's involved in clinical communication?
Clinical communication may occur within one hospital or medical facility or among multiple sites. It involves every person who handles patient information—from physicians, nurses, and support staff, to administrators, committees, and department heads.
Every individual in the chain of communication must ensure that the information they pass along is concise, accurate, secure, and up to date. Errors, oversights, and missed messages have severe consequences for patients who rely on healthcare systems to work. Aside from the human impact that can occur, miscommunication carries financial costs and expends valuable resources like time and manpower.
In fact, a recent study found that roughly one-third of 23,000 malpractice claims reviewed were rooted in a healthcare communication failure. The failures collectively cost $1.7 billion in losses. Unfortunately, human error and technical glitches can (and do) occur with alarming frequency.
Four typical clinical communication events
Excellent and expedient healthcare communication can reduce the occurrence of errors and contributes to better patient outcomes. The following are typical clinical communication events.
1. Care-team collaboration
A large portion of clinical communication occurs between the physicians, nurses, and specialists who care for a patient. Providers share diagnoses, transfer charts during shift changes, alert each other to changes in a patient’s status, and ask questions or provide guidance relevant to the treatment plan.
2. Sharing patient information across departments
Any time a patient is transferred between departments, they will come under the care of a new clinical team. During such handoffs, all of that patient’s data will change hands and form the basis of the new treatment plan. As a result, it's crucial for departments to communicate comprehensively with each other to guarantee a continuum of care and to avoid any oversights that could result in an adverse outcome.
3. Coordinating care between facilities
Another common healthcare communication event is the transfer of a patient’s information to another hospital, a clinic, or a physician practice office. When a hospital, lab, or specialist forwards results to a primary care physician, they're actively involved in healthcare communication.
4. Informing and instructing patients and caregivers
Clinical communication also includes the exchange of information between providers and patients. Post-surgical instructions, prescription information, and recommendations for follow-up care are all examples of healthcare communication. Because patients are not medical experts, providers must offer thorough and easily understood advice that aids patients in manage their health.
Smartphones and clinical communication
According to a recent study by Kantar Media, four out of five physicians use their smartphones at work. A Physicians Practice 2018 Mobile Health Survey reported that most smartphone technology in a clinical setting was used to facilitate communication among medical staff. Almost 70% of hospitals surveyed reported using medical apps as a communication method for staff. As mobile devices become integral to healthcare communication, regulatory authorities and medical system manufacturers are racing to keep up.
Smartphone apps increase patient engagement
The use of electronic platforms in healthcare extends to patients, too. Accenture reports that two-thirds of the largest U.S. hospitals offer smartphone apps and eHealth patient portals to increase patient engagement and encourage people to actively participate in their medical care.
Patients appear just as enthusiastic in their use of mobile phone apps and patient portals:
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Most people have used their smartphone to find medical information, track their personal health goals, record medical data like heart rate or blood sugar levels, and exchange messages and files with their provider.
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A recent Pew Research Center study found that 62% of respondents have downloaded an mHealth app.
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The popularity of medical apps has surpassed mobile banking, job search apps, and educational platforms.
Smartphone apps conserve resources and provide unprecedented access to healthcare, and they save time and money typically spent by hospitals gathering, documenting, and sharing data. They also improve patient outcomes by eliminating delays in communication between caregivers and providing remote and instant access to specialists and other healthcare professionals. The most underserved patients in the most understaffed hospitals likely have the most to gain from mobile app-based clinical communication platforms.
How can we improve clinical communication?
Medical experts worldwide continue to study the impact of healthcare communication on patient outcomes and are developing new strategies to improve the efficiency of information exchange processes among healthcare workers. Large organizations like The Centers for Disease Control and Prevention, The Joint Commission, and The World Health Organization—along with smaller groups in the private and educational sectors—carry out research and surveys that identify the flaws in clinical communication systems.
From their collective efforts, we can draw conclusions about ways to improve healthcare communication, such as:
- Streamline information sources: Bring voice, text, results and alerts together in one single mobile application to reduce confusion, allow staff to prioritize alerts, and get instant access to critical information such as lab and radiology results.
- Collaborate in real-time: Make it easier for healthcare professionals to connect by offering real-time messaging threads that immediately alert all relevant personnel to updates.
- Eliminate security risks: Use regulatory-compliant technology and processes to protect patients, medical professionals, and facilities from the harmful consequences of violating federal privacy laws.
- Unify systems: Integrate existing hospital clinical systems with mobile apps to create a comprehensive clinical communication platform that makes it easy to access and regulate electronic health records (EHRs) across an enterprise.
- Monitor communication: Implement a regulatory process that examines communication data to identify opportunities for improvement.
HIPAA and clinical communication
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federally regulated set of standards that governs how protected health information (PHI) is handled. The legislation was enacted to protect patients from privacy breaches involving their personal medical data. PHI includes all forms of personal data, including digital or electronic records (ePHI).
The HIPAA Privacy Rule explicitly defines 18 types of PHI that must be adequately protected. The following is a list of those data points along with examples for each type:
- Names – first, last, middle initial
- Locations – hospitals, labs, clinics, and private medical offices
- Dates – birth dates, date of death, treatment dates
- Phone numbers – patient and emergency contact numbers
- Fax numbers – personal or business
- Email addresses and social media handles
- Social Security Numbers (SSN) and Taxpayer Identification Numbers (TIN)
- Medical record numbers and patient IDs
- Health insurance account information
- Account numbers – hospital account, patient portal ID
- Certificate/license numbers – driver’s license, professional licenses
- Vehicle identifiers – registration information, license plate numbers
- Device identifiers and serial numbers – medical implants, serial numbers
- Web uniform resource locators (i.e., URLs) – web page addresses
- Internet protocol addresses – the numerical identifier for personal computers and mobile devices
- Biometric identifiers – fingerprints, retinal scans, voice recordings
- Photographic images – photos, videos, x-rays
- Any other unique identifiers – data that could reveal a patient’s identity
Which hospital staff must comply with HIPAA policies?
In short: Every individual who handles PHI must comply with HIPAA standards at all times. Physicians, nurses, EMTs, lab technicians, administrators, hospital executives, maintenance staff, IT staff—everyone who may have access to patient info should be fully trained to comply with HIPAA rules.
The HIPAA Security Rule provides directions for communication or sharing of health records that contain PHI at all levels. This means that the hospital or clinic must ensure the security of its electronic systems and is responsible for the actions of every staff member. Additionally, the provider is obligated to secure its buildings and off-site storage facilities.
HIPAA penalties can be assessed at an organizational and/or an individual level. It is in everyone’s best interest to remain diligent and avoid violating HIPAA standards.
What are the penalties for violating HIPAA?
The penalties for violating HIPAA policy range from monetary fines to reputation damage to criminal charges. Appearing on the publicly available violation list causes public relation issues for hospitals and can have a lasting impact on an individual’s professional career.
Civil penalties are categorized into four tiers depending on the severity of the offense. Tier 1 carries the lowest penalties and Tier 4 carries the harshest.
- Tier 1 – Not aware of the violation, acting with due diligence ($100 to $50,000 each offense, $25,000 yearly max)
- Tier 2 – Expected to have known of the violation if acting with due diligence ($1,000 to $50,000 each offense, $100,000 yearly max)
- Tier 3 – Willful offense corrected within 30 days ($10,000 to $50,000 each offense, $250,000 yearly max)
- Tier 4 – Willful offense not corrected within 30 days ($50,000 each offense, $1.5 million yearly max)
Criminal charges are possible in the most egregious cases. Penalties include fines, restitution, and prison sentences of up to five years. The Office for Civil Rights and the Department of Justice handle HIPAA violations that meet the threshold for criminal prosecution.
Complying with the HIPAA Minimum Necessary Standard
Healthcare providers must take reasonable steps to adhere to the Minimum Necessary Standard. This federally enforced standard covers digitally transmitted data and sets rules that must be observed when communicating ePHI.
Organizations that handle ePHI must do the following:
- Ensure that the EHR system(s) documents and categorizes all PHI
- Keep logs of access events and attempted access events and, if possible, provide alerts when unauthorized access attempts are identified
- Create role-based access restrictions to limit who can see, send, and receive patient data
- Offer employee training programs and implement a disciplinary policy for non-compliance
- Limit information sharing to that which is required to complete the immediate task
- Audit access permissions and implement periodic reviews to identify improper or unauthorized use of restricted data
- Document the organization’s response to known violations, and list any disciplinary actions
A comprehensive clinical communication and collaboration platform ensures compliance with the Minimum Necessary Standard by automating technical and administrative tasks to eliminate user error. It protects users by:
- Date- and time-stamping every communication
- Keeping sent/read receipts
- Automating recipient lists to include only specific care team members
- Providing built-in security and encryption protocols
- Enabling escalation alerts in cases where the intended recipient does not respond
- Providing message threads organized by patient
- Ideally providing a database of authenticated physicians
What is a clinical communication and collaboration platform?
A clinical communication and collaboration system unifies multiple aspects of the healthcare information chain to ensure better medical care for patients and a superior experience for the clinical staff. It differs from traditional medical voice and text messaging platforms in that it seeks to increase efficiency across a broader scope of communication channels and clinical systems (as opposed to just mobile messaging for example).
A clinical communication and collaboration vendor ensures that the system implemented ultimately follows the recommendations of regulatory and accreditation bodies as appropriate (e.g., The Joint Commission). Proper implementation also entails the unification of all key communication channels on a single-source, real-time platform to eliminate security risks and empower analysts to identify opportunities for improvement.
To save time and resources, consider the following practices to ensure the most effective results and the best experience for end users when integrating a new clinical communication and collaboration platform:
Ensure security
Breaches of privacy data are common news headlines, and the organizations involved are often held liable for the leak. HIPAA regulations are also an important factor when setting up a hospital communication system. It's easy for staff to inadvertently violate HIPAA laws, which could result in stiff penalties and continued monitoring.
An efficient clinical communication and collaboration platform adheres to the rigorous standards set by HIPAA policies and by the Health Information Trust (HITRUST) Alliance. HITRUST is an independent testing organization that gives the Certified Security Framework (CSF) certification to organizations that meet their stringent standards. The Halo Platform is HITRUST certified so that patient data is always kept secure.
Unify integration
If the clinical communication and collaboration platform is not integrated properly with existing systems, users may experience problems and will be less likely to adopt the technology. Ensuring that components of both systems are combined into one comprehensive platform will ensure a streamlined experience for end-users.
symplr Clinical Communications, a part of symplr's Workforce Management portfolio, works seamlessly with a hospital's existing EHR and other systems (e.g., private branch exchange, nurse call, and patient monitoring). Staff can access real-time data from any of these sources from any location and on any mobile device.
Provide thorough user training
If clinicians and staff don't understand how to use a system, they are more likely to use it improperly or avoid it altogether. Importantly, symplr's technology is designed to intuitively mirror the usability of common smartphone apps. If a person knows how to text and use other basic smartphone apps, they will have no problem learning how to use symplr Clinical Communications.
symplr provides thorough training for all users and gives them the resources they need to use the platform to its fullest extent. Users have 24/7 access to a friendly customer care team and an online knowledge portal. Ongoing support and workflow optimization is available to solve any technical problems and answer user questions.
What healthcare organizations benefit from a clinical communication platform?
A full-function clinical communication and collaboration system saves time and money for any medical organization. More importantly, it accelerates patient care by enabling the right staff to access the data they need and communicate in real-time. Whether in a large hospital or a smaller clinic setting, a clinical communication and collaboration platform will boost efficiency across departments, ensure HIPAA compliance, and contribute to positive patient outcomes.
Successful clinical communication system deployments are implemented across a health system and broader care community, connecting all points along a patient’s care continuum. This includes emergency and scheduled admissions for inpatient care, physician consultations in the ambulatory setting, and ongoing care and rehabilitation for the elderly and patients with chronic conditions.
Ongoing 24-hour support and highly reliable cloud-hosted architecture ensures that any issues are resolved immediately without down-time. symplr Clinical Communications is a smart choice for care organizations of all types and sizes.
