Phoning it in: New devices improve patient safety, care at Michigan Medicine

Most clinicians have been there before: They page a colleague and then wait, wait and wait some more for the person on the other end to get back to them.

Now, a new system — with the help of brand-new iPhones — makes the paging process easier and more efficient at Michigan Medicine. And that will lead to better patient care and outcomes.

But paging reduction isn’t the only benefit of the new Unified Clinical Communication (UCC) iPhones. Here’s a closer look at the devices and why they’re so important. 

Turning the page

As previously mentioned, paging a coworker can be a cumbersome process.

“First, you are dependent upon technology that is nearly 30 years old when you send a page,” said Ranjit Aiyagari, M.D., chief medical information officer at Michigan Medicine. “When that happens, you have to hope that when you send a page, it goes through correctly, and then you have to hope that the person on the other end reads it, understands it and responds to it promptly.

“At every step, there is a chance for failure. This new process helps avoid that.”

Indeed, instead of paging, employees can send secure, HIPAA-compliant text messages to colleagues using their UCC iPhone or any clinical workstation. When a colleague reads the message, a “read” receipt will automatically appear, so it is immediately evident when the message has been received. And the texting service works within seconds, while pages can take up to two minutes at peak hours.

Secure texting is only part of the improved communication picture.

The new phones can also be used for clinical documentation, voice calling, and to receive alarms and alerts.

“It was essential that we gave our bedside clinicians the ability to do their work as effectively as possible,” Aiyagari said.

Therefore, they can scan medications, input vital patient information into MiChart, take and upload photographs of wounds and carry out other tasks right on their secure phones.

“Typically, you’d see a patient, log in to the computer in the room and input information. Then you’d go to another room, see the patient, log in to another computer — and go on right down the line,” Aiyagari said. “When you have 3-4 patients you’re taking care of, that takes time and attention away from keeping patients safe.”

How it works

The UCC iPhones — which for now are used by nurses, respiratory therapists and a few other inpatient clinicians — are given out at the beginning of each shift.

They are equipped with an app developed by the organization alongside Epic, which also created MiChart, the electronic health record.

“Each unit has a set of phones that are kept at mass charging stations,” said Carleen Penoza, MHSA, B.S.N., R.N., the organization’s chief nursing informatics officer. “At the beginning of each shift, a staff member checks out a phone and logs in, automatically connecting them to all of their necessary information.”

This means there are no more phone numbers to memorize in order to reach colleagues, as all you have to do in order to text someone is look up their names.

“The message will be sent to them no matter what phone they have that day,” Penoza said.

And for those who have downloaded Haiku to their personal devices, they are able to utilize the app on their own phones to carry out their work. 

If certain processes are easier to carry out on a computer, those remain available in every patient room.

“This is a supplement to current technology, not a replacement for it,” Penoza said.

Praise for the pilots

The UCC iPhones system is slowly making its way through all inpatient units at University Hospital and the Frankel Cardiovascular Center. The process has been slowed by the COVID-19 pandemic — but the hope is for it to be in place throughout the adult hospitals by June.

“We wouldn’t be at this stage without the work of a few pilot units that have perfected the system over the years,” Penoza said. “For instance, the nurses and staff members on 6C worked relentlessly to help us make the system as intuitive and helpful as possible.” 

Indeed, that unit completed a successful pilot in 2018 which led to the health system providing funding to begin a rollout of the system to all units beginning early in 2020.

On top of the clinicians, the program wouldn’t be possible without the tireless efforts of Health Information Technology & Services.

“There were at least six different HITS groups that have worked together to make this all work,” Aiyagari said. “It’s a remarkable example of teamwork.”

And their work isn’t done yet.

“As more people join the program, the more feedback we’ll receive and more improvements we’ll make,” Aiyagari said. “We know we don’t have a finished product yet.”

But it’s a product that has proven to be popular and helpful. In September 2020, for instance, 20,000 secure text messages were sent by clinicians. By February of this year, 110,000 were sent.

“That means information is being shared more frequently and decisions are made quicker — giving our patients a better experience,” Aiyagari said. “We’re proud of this program and we think our employees will be thrilled to utilize it in the months and years ahead.”