How to align provider-to-provider communication across the care continuum | David Hoover

Better communication between hospitals and outpatient services is imperative for most organizations. Electronic health records were supposed to allow for seamless provider-to-provider communication, and many of them do — for some services and for certain providers in the same facility.

David Hoover

But provider-to-provider communication between different entities (i.e., between a hospital and a long-term care facility or another outpatient service) is often fragile, at best. There are several major reasons for this.

Legacy technology.

Communication tools in the healthcare industry, such as SMS texting, originated in the military, in banking, or in other industries. They weren’t designed for the unique needs of healthcare. Many hospitals still rely on faxed information, one-way paging, or telephone operators to facilitate provider-to-provider communications. Healthcare has been notoriously slow to adopt new technologies. For every service line that’s using state-of-the-art communication tools integrated with an EHR, there are others that still rely on pagers, or whose providers prefer to be called on their cellphones.

EHRs can’t do it all.

Organizations have invested heavily in expensive EHR systems, which have modernized many aspects of care. For example, ordering a consult for a hospitalized patient is fairly straightforward in an EHR. However, getting that order to the right person isn’t always simple. It can require multiple resources and take hours because EHR communication tools aren’t geared for the entire continuum of care. Outpatient providers are left on the sidelines because they don’t have privileges, or they can’t access the medical records. And even when multiple EHRs can communicate, there’s no guarantee the communication will continue: Software updates can cause platforms to get out of sync.

Expanding care teams.

Today, a care team includes not only physicians and advanced practitioners, but also nurses, specialists, residents, physician assistants, nurse practitioners, alternative providers, front-office staff, and providers aligned with other physicians. This makes it difficult for providers to answerthe question, “Who are you trying to reach?”

Furthermore, a physician might not see any members of a patient’s care team because he or she never goes to the hospital. Or the practitioner might get a list of 20 people who are on call at that point for a service line in the hospital. Scheduling and on-call hours might fall to one office manager, which can be overwhelming.

The results? Delays in patient care, longer hospital lengths of stay, frustrated consulting providers, and burned-out front-office staff.

A better way to communicate

As hospitals and health systems realize they need better communication across the care continuum, they’re searching for a way to connect all providers — even community providers — with one clinical communication solution.

Here are 5 things to look for in a provider-to-provider communication toolset.

1.) A work-with, not do-over approach.

With so much already invested in an EHR, it’s vital for any solution to work with the existing system as much as possible. Look for tools that integrate with the EHR and allow communication with outside systems while streamlining the administrative and clinical workflows that are already in use.

2.) Secure HIPAA-compliant communication.

A critical part of the provider-to-provider communication process is managing provider call schedules that are maintained on different platforms. A cross-continuum communications solution has to work with disparate systems, each with myriad moving parts and different modalities. But patient privacy regulations — and bad actors — aren’t going away. Make sure your P2P solution secures all communications from end to end through strong encryption and authentication features.

3.) Successful communication the first time.

As with any technology, first impressions count. If providers have a bad early experience, they lose faith in the platform. By the third failure, they’re back to their old way of doing things, and you’ve lost the opportunity for buy in. It’s important to select tools that can consistently connect providers every time, any time, and anywhere.

4. Timely orders to the right providers.

The solutions must ensure that a consult is automatically delivered to the right person — the first time. Look for automated message routing based on factors such as clinical service resource availability (residents, physician assistants, etc.) time of day, or consulting physician workflow and preferences. The system should support preferred workflows for not only the consulting provider, but also for the ordering physician. In addition, the solution should enable providers to queue messages as appropriate, prioritizing urgent needs ahead of consults that can wait.

5. Access for all team members.

In addition to providers, care teams include nurses, front-office staff, receptionists, and referral specialists. Look for a communications platform that accommodates these team members and streamlines their workflows as well. Streamlined workflows produce more timely care, which can reduce patients’ length of stay.

The benefits of improved communication

Implementing provider-to-provider communication that spans the care continuum is challenging, but health systems and hospitals that embrace the challenge are realizing important benefits. The most immediate is improved communication, and more of it, among more providers. 

An effective P2P communication tool can expedite administrative and clinical workflows across the care continuum by providing accurate orders and ensuring the orders go to the right providers. This reduces provider frustration, which can reduce burnout. The streamlined process doesn’t require additional access or more on-call time for providers. Rather, it hones workflows already in use and optimizes provider availability with the right message at the right time. When a provider is not on call, none of the messages go to that provider.

Most importantly, optimized provider-to-provider communication provides better patient care and outcomes, because patients are getting the care they need with less waiting and fewer communication gaps. Transparent communication enables real-time tracking of new consults. And faster consults improve patient throughput. Providers can make care decisions quickly and efficiently because they don’t have to go through three or four on-call providers to talk to the correct expert.

Better communication is vital for improving patient outcomes and provider workflows. Make sure your provider-to-provider solution can deliver better communication across the care continuum.

Dr. David Hoover, MD, is chief medical officer at Proficient Health and a practicing pediatric surgeon.