How To

mHealth App For Coordinated Care Shortens Consult Delivery To Minutes

May 14, 2014 | Adam Turinas

Based on interviews we have conducted with hospitalists, ED physicians, resident physicians and nurses, the delay between a consult being ordered through CPOE and being received by the physician can range from a few hours to as long as a few days. Surgeons reported to us that it could take four hours to get a response on a consult. Resident physicians say that some doctors can take a day or more to get back to them.

One nurse we interviewed said that when she entered a consult into the EMR, it could take 3-4 hours to get a response. Why? These were the steps she has to go through:

1. Nurse searches for consulting physician’s office telephone number or pager information (5 min.)

2. Nurse calls operator to have physician paged overhead  (5 min)

3. Call is placed from nurse to physician’s office

  • If during office hours:
    • Physician may be available to receive message but message is more likely left with office staff, who may or may not record it completely & correctly (1 hour+)
    • Physician may pick up message several hours later
  • If after office hours:
    • Call processed by answering service (10 min)

4. Answering service takes summary of what it believes is most important consultation request information

5. Answering service representative completes current tasks and searches for physician, or physician’s designated “on-call” coverage

6. Answering service attempts to reach physician by cell phone, at home phone or by pager (10 min)

7. Physician either receives message or answering service leaves message

8. If message not received by physician then minutes or hours may transpire before physician receives message or nurse/unit clerk re-starts process (2+ hours)

The per consult average response time is 3:30+ hours. Maybe even more importantly the information is incomplete and questionably accurate. This process can be simplified and the time shorted to a few minutes simply by delivering the consult directly from the EHR to the physician’s smartphone.  Moreover the information will be 100% accurate.

At Practice Unite, we achieve this by integrating the mobile app directly with the EHR. The user receives a distinct alert, opens the app and sees who has requested consult, who the patient is, their DOB, other demographic information their location and reason for consult.

The message is HIPAA-compliant as it is sent encrypted and there is a record of it being sent and read.


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