Report: Clinicians Use Inadequate Message Devices

Seventy percent of doctors and nurses interviewed recently carry two or more communications devices, none of which meet clinician needs, according to a report by Spyglass Consulting Group.

Doctors and nurses are loading up on multiple communications devices, none of them adequate to their needs, concludes a report by Spyglass Consulting Group.

According to the report, nearly 70 percent of interviewed physicians and nurses carry two or more communications devices, and some clinicians wear "batman utility belts" that carry a few pounds of devices. Yet over 80 percent said theyd prefer carrying around a single, integrated device instead.

But neither technology or hospital workflow is set up to help that happen, said Gregg Malkary, director of Spyglass. "If you want to have fewer devices, it means these solutions need to be better integrated—and theyre not."

Malkary thinks that the best solution would be a "universal inbox" that would not only collect messages from multiple sources but also help organize and prioritize them.

Ideally, the devices would provide patient information and aid collaboration with colleagues to boot.

But a welter of challenges confront this ideal. These include everything from inadequate cellular coverage, to privacy and liability issues, to workflows that punish clinicians for taking time to communicate with patients or colleagues.

"A lot of folks get paid based on how many patients they see, so every minute on the phone with a patient or colleague goes against their monthly income," says Malkary.

All this works against the development of communication and collaboration tools that could help clinicians get information to and from people who need it.

Moreover, many clinicians purchase at least some of their mobile devices themselves. That discourages use of more integrated and thus pricier equipment, particularly for nurses.

But it doesnt work against a proliferation of devices.

Messages are rarely forwarded to an individuals pager. Instead, physicians pick up additional pagers with each assignment. A physician must physically carry another pager if serving as a rapid responder. When one physician covers for another, she carries the others pager. The menagerie of beeping devices competes for clinicians attention.

Over four-fifths of physicians and half of nurses carry at least one pager around. For physicians, alphanumeric pagers are the most popular (used by about 70 percent of respondents), followed by smart phones (used by just under 60 percent).

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Nurses, who travel less between clinics, were more likely to use voice over IP (used by about 30 percent), than either of these devices.

But none of these devices are ideal. Smart phones can get e-mail and voice, but are too big; cell phones threaten to interfere with hospital devices and dont work well in old, large hospitals.

VOIP phones dont work when clinicians travel between facilities, and only about 10 percent of physicians in the survey use them.

Weight and size were deemed most important characteristics for mobile devices, with 82 percent saying these are the most critical factors. Broadband Internet access came in third place, with 32 percent.

Malkary said that the proliferation of devices is so entrenched that, in the absence of adequate software, clinicians use their hardware for managing communication.

Collections of devices can shield clinicians from unimportant messages. For example, trusted colleagues may get a cell phone number, with everyone else shunted to a pager or answering service.

Results are based on interviews with 100 technology-savvy clinicians at hospitals, home health centers and academic medical centers across the country.

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