Many primary care physicians no longer go to the hospital.
Let’s pause for a moment to consider that. It felt like a relatively minor workflow shift as it was happening, but it has major implications for patient care.
The shift emerged gradually. As in-patient primary care evolved into a specialty of its own, primary care physicians were able to rely on well-trained hospitalists—a new type of primary care physician with acute-care expertise—to care for their patients upon admission to the hospital. This allowed traditional PCPs to concentrate on their outpatient practices, focusing their attention on the patients who come into the office. Completing the physician triangle are the specialists—cardiologists, oncologists, nephrologists—who now work with both PCPs and hospitalists to deliver the appropriate care.
The transition has created more efficient and specialized care for patients, as well as a better quality of life for physicians. It has also created one significant challenge.
The Challenge: Communication
Primary care physicians remain the captains of the ship, and as such they’re in charge of coordinating care among hospitalists, specialists and outpatient follow-up back in their offices. Primary care physicians want to be contacted when their patients are admitted so they can provide medical history that may prove to be crucial for in-patient treatment. They also want to be able to reach specialists quickly, either to get advice or request an official outpatient consult.
However, hospitalists and specialists often find it difficult to reach primary care physicians. At the front lines of acute care, they don’t have time to wait on hold while the office receptionist pulls the PCP out of a patient exam room. Primary care physicians, on the other hand, never know which hospitalist is taking new admissions or which specialist is on call for consults.
A recent study led by physicians at the University of Colorado School of Medicine shined a spotlight on the communication breakdown that often occurs between hospital discharge and outpatient follow-up. In the worst cases, primary care physicians were actually unaware that their patients had been admitted to the hospital.
Why is this such a significant challenge? Because nearly 80 percent of serious medical errors involve miscommunications during patient transfers.
The Solution: Communication Technology
A communication platform designed specifically for healthcare provides the link that connects healthcare’s triple team. The following three essential components work together to bridge the communication gap.
- Asynchronous Secure Communication (Secure Text Messaging)—Secure messaging technology allows physicians to text each other directly and immediately see the content and urgency of the message. The sender can see that the message has been read, and the receiver can make a decision to respond based on his or her availability and the urgency of the message. This technology is changing the face of healthcare communication workflow and minimizing the interruption of synchronous communication, such as unneeded phone calls between physicians. In fact, the fear of interrupting a colleague is one among several reasons that physicians do not reach out to other physicians.
- Organizational Contact List—A sophisticated, searchable directory (by physician, department or specialty) enables hospitalists find the right PCP at the right time. Once hospitalists find the correct primary care physicians, they have the option to send urgent or regular secure messages. PCPs have the option to respond or tap the call-back button inside the mobile app if they want a more in-depth conversation.
- Physician On-Call Management—An integrated enterprise-wide mobile physician on-call management system is currently the only reliable way to locate the on-call specialist or hospitalist. The system auto-forwards messages to covering physicians, tells hospitalists whether the PCP is in the office, identifies the hospitalist who is on shift, indicates whether specialists are taking new consults, and much more.
The evolution of healthcare’s triple team represents a remarkable shift in the management of in-patient and outpatient care. Now it’s time to provide the technology to back it up.
Amit Gupta, MD, President of Doc Halo, is a Hematologist/Oncologist and a partner at Springfield Clinic.