IT managers face an uphill battle convincing hospital CFOs that ripping out their old phone system and replacing it with a unified communications (UC) system will actually save money. Focusing on return
The bottom line on UC systems is that they reduce costs by porting hospitals' calls to the Internet, thus eliminating or greatly reducing those hospitals' reliance on phone company services and the gear it entails. Furthermore, the more well-thought-out a UC implementation is, the faster a hospital gets to its advanced uses, such as direct integration with electronic health record (EHR) systems.
That being said, the IT department and informatics leaders can reap other benefits as well. They can tighten up contacts between physicians and nurses, and reduce the payload of devices that staff carry now by converging pagers, multiple phones and Wi-Fi messaging devices into one "any device, anytime" communications system. Convincing executives of the benefits remains key, experts say.
"Communication remains a challenge. Communication lapses have a high impact on productivity and patient safety," said Bruce Beals, UC team lead for equipment distributor CDW LLC. Beals shared some of his company's market research in a webinar hosted by the Health Information Management Systems Society (HIMSS) that mingled CDW's findings with a 2009 Cisco Systems Inc.-Zogby International study of clinical workflows.
UC systems can streamline communications and give clinicians more time to spend with patients by reducing the amount of time they have to spend coordinating care and later documenting it. Unified communications also can create or expand a facility's current telemedicine services by enabling physician-to-physician videoconferencing and clinician-to-patient conferences. Some facilities, Beals said, also use videoconferencing to enhance translation services: When remote translators can see the native speaker's facial expressions and hear vocal nuances, they can make more accurate translations.
Administrators, however, are more interested in UC's benefits in reducing costs, Beals said. That means the major roadblock to getting a UC strategy off the ground is convincing administrators that a new UC system is a cost saver, not a cost center. During the HIMSS webinar, two hospital IT leaders shared their advice on how to do just that.
In its UC system, Clarian hooks up labs, call centers
Clarian Health uses UC to connect many services, including lab facilities and call centers, to the 20 Indiana hospitals in its network, said Colby Arnold, the first participant in the HIMSS webinar, and manager of unified communications for the organization. Voicemail and call routing are the bread and butter of the UC system; one key feature that was missing from the old system was the ability for call center workers to locate specialists quickly for patients calling in, and route the calls through.
Arnold offered several tips for keeping costs down when UC systems are implemented.
- Get the telecommunications and network teams working together in the early planning stages of any UC proposal. "That sounds like an easy challenge [but it isn't]," Arnold said. "To make it successful, those teams need to be collaborating."
- Interview UC vendors. Bring them in, sit them down and treat them as you would a prospective employee. That way, you're more likely to choose the partner that will help you stay within your budget.
- Lease UC gear -- down to the cabling required, if you can. It can seem like a full-time job in itself to keep up with new technology and roll it into your system as old devices break or become obsolete. Leasing gear not only is less expensive than buying -- even when you take into account the cost of ownership over time. It also puts the burden of "technology refresh" on the equipment distributor, not you.
- Find ways to improve care and clinical workflow with the features that unified communications adds, instead of replacing your old phone system but using the new UC system just for the same calls and voicemail. Clarian Health will be tapping into video capabilities in its call center routing, and putting patients in touch with physicians via videoconferencing when that's appropriate, Arnold said. It will mine new Cisco Systems Inc. presence features, too. Presence technology determines where physicians are, what they are doing, whether they are available to interact with a patient calling in and the best way to message them at that moment. Roll those benefits into the ROI presentation.
Lastly, pick a vendor and present a well-developed implementation plan to administrators: "We approached all our executives not only with the ROI, but with the solution also," Arnold said. "When you really start showing them the power of the solution for the teams that work for them -- [for instance] for the chief nursing officer to deliver real-time messages and alerts -- I think that was key for us."
Instead of just ripping and replacing ... find ways to improve care and clinical workflow with the new features that unified communications adds.
Ambulatory provider offers unified communications advice
The justification for implementing a UC system at Cornerstone Health Care PA was to hook up its 290 ambulatory practitioners at disparate locations -- physicians, physicians' assistants and nurse practitioners -- with four-digit dialing, said Jackie Barnes, the second participant in the HIMSS webinar, and communications analyst at the physician-owned group in north-central North Carolina's Triad region. A UC system reduces the time it takes to get answers from practitioners. Instead of building up a queue of messages and having someone get to them over time, UC makes it happen closer to real time.
"We're able to provide better patient care by being able to get someone on the phone quicker," Barnes said, "instead of having [messages] sit and wait in a queue, waiting for an operator to answer the phone. We don't have time for that, sometimes, in patient care."
During the HIMSS webinar, Barnes provided this advice for getting the most out of a UC implementation:
- Integrate it with your EHR system. Cornerstone plans to tackle this in the near future by integrating its ShoreTel Inc. UC system with its EHR system to get a patient's record automatically on-screen when the patient calls in. In cases where there is more than one EHR associated with a telephone number -- for instance, it belongs to a family with several children -- a screen pops up offering the choice of which record to open.
- Consider a UC vendor with experience in health care, not just general unified communications. Those vendors will bring along best practices from their previous implementations so you don't have to reinvent the wheel.
- Plan to handle training in-house. You know your workflow and are able to explain how the UC system will make it work better.
"We have found that our own style of training was what made it the best, because we knew what people needed from us in order to make this successful," Barnes said.
Let us know what you think about the story; email Don Fluckinger, Features Writer.
This was first published in March 2011