7 Mistakes to Avoid When Implementing Secure Messaging
October 31, 2018
Secure messaging designed for healthcare has been around for about a decade, so you may think that most hospitals are using it today.
But we’ve discovered that isn’t the case at all. During the rise of secure messaging solutions, EHR implementation and optimization have dominated health IT leaders’ attention—and budgets. So the secure messaging market is just really starting to heat up right now. Consider these stats:
- 32 percent of hospital leaders see implementing secure messaging as the biggest opportunity for mobile communication improvements over the next 3-5 years (2018 Spok Mobile Strategies Survey)
- 72 percent of CIOs say secure messaging is a priority; 76 percent say it will be a priority in the next three years (2017 Spok survey of CHIME CIOs)
- More than 100 4- and 5-star hospitals are likely to buy secure messaging for the first time in the near future, demonstrating the current state of low adoption and tremendous potential for the “essential tool for coordinating patient care moving forward” (2018 HIMSS Analytics Deep Dive into Secure Messaging Technology)
So, there’s a good chance that you are evaluating secure messaging solutions for your hospital at this very moment. The delay in addressing the challenge of clinical collaboration may even work in your favor, since the market has had time to mature, and the solutions are more robust. It is undoubtedly a busy yet exciting project—the potential positive impact on patient care and satisfaction as well as clinician efficiency and contentment is tremendous.
But I must ask you to proceed carefully: 70 percent of hospital strategic initiatives fail, going 45 percent over budget and 7 percent over time to deliver 56 percent less value than predicted, according to McKinsey & Company. As a former IT leader at Emory Healthcare, mobility consultant for dozens of hospitals in my prior role within Spok Professional Services, and current product manager of secure messaging for Spok, I’ve witnessed several common missteps when implementing secure messaging in the hospital.
For maximum secure messaging success, avoid these seven mistakes:
1. Incorrect stakeholders
At Connect 18, our most recent annual user conference, Darrell Messersmith, CIO at Vail Health, was asked to share his top piece of advice for clinical communications. He said, “Find the smartest, fastest, coolest people from each department and bring them together to solve a compelling problem.” He even admitted that it sounds simple, but it’s much more difficult in practice and was a key lesson for him.
Secure messaging is an enterprise project—it will affect your clinical departments, contact center, and administration. However, many hospitals try to implement secure messaging with a project team composed solely of clinicians or 100 percent IT folks. From the project kickoff to ongoing optimization, it’s critical to have a diverse group of stakeholders deeply involved in and committed to the project. It’s not easy, as everyone is busy with their day-to-day responsibilities and may be reluctant to get on board. Determine the right mix of people to successfully steer the secure messaging initiative, then find an executive-level champion like Darrell who may be able to use his or her influence to rally the team. Your team might include people from clinical informatics, clinical departments, IT, telecommunications/contact center, or executive administration.
2. Poor wireless infrastructure
It seems obvious that you need a reliable wireless network to successfully roll out secure messaging, but so many hospitals have had projects stall or fizzle, not because of the merit of the solution itself, but the shortcomings of the network. Since 2016, Wi-Fi coverage has been the most common challenge to secure messaging implementation and adoption, and 87 percent say it is business critical. A poor wireless infrastructure can cause message delays or failures, which can prevent users from trusting the application.
As an initial step to any secure messaging project, I recommend conducting a wireless infrastructure audit. Your IT team may be able to do this on their own, or you can tap a vendor (Spok partners with Black Box to offer this service) to complete the assessment on your behalf. The audit should reveal complete heat maps of your facilities (determine dead zones and additional access points needed) and best practice configurations. For a double layer, work with the primary cellular data carrier in your area to ensure cellular coverage across your campus in addition to Wi-Fi coverage (see how Roswell Park did it).
Improving your coverage may include:
- Extending distributed antenna systems (DAS)
- Increasing Wi-Fi coverage/boosting connections
- Mapping and upgrading routers
- Adding cell towers in the hospital for all major carriers
- Installing additional access points for Wi-Fi and various repeaters, and amplification of RF signal for paging
- Working with providers to map weak spots and determine the best options for increased coverage with additional antennas, repeaters, etc.
3. No success measures defined
“You can’t manage what you can’t measure,” is a cliché, but it’s also a true cliché. Too many health IT projects start without documenting clear, objective success measures. The goal must go beyond “improve care team communication” or “safeguard PHI in messages.” What will success look like, and how will you know when you’ve achieved it? A couple of examples from successful Spok customers include:
- Demonstrably creating a quieter hospital: UPMC Pinnacle eliminated overhead paging and reduced disruptive hallway conversations or “curbside consults” by converting those announcements and conversations to messages. UPMC Pinnacle sends 1,400+ messages each day.
- Ensuring all messages are sent securely, reliably, and quickly: With a reliable wireless infrastructure and Spok secure messaging, Robert Wood Johnson University Hospital was able to improve average message delivery time by more than 80 percent, so now all messages are received in less than 1 minute.
Measuring and validating secure messaging success may include:
- Education or other training programs
- Using technology or data gathered from devices
- Data from related measures, such as workflow efficiency tracking or HCAHPS scores
- Direct feedback from end users
4. No directory integration
In order for a secure messaging solution to make it easier for care teams to consult with each other to coordinate care, it needs to be integrated with a single source of truth for contact details, schedules, and preferences. If clinicians and other staff members need to know the number or even the name of the person they need at that moment in time, it’s going to result in wasted time and frustration.
With a secure messaging solution that integrates with a web-based enterprise directory, personnel and schedule information is readily accessible and always up-to-date. Staff can log on to the application to search the directory, see who’s on call, and send important messages. Unlike the EHR, which typically only gives access to staff who have clinical credentials, this enterprise directory spans all members of the care team, from the physicians and nurses to the contact center operators and housekeeping staff.
5. No ability to send alerts from systems
Secure messaging used to be called secure texting, but the name has changed because the solution has evolved far beyond text conversations between two people. A perfect example of this evolution is middleware integration to send alarms and alerts from systems like the EHR, nurse call, and patient care monitoring. Without the ability to connect systems to people, you limit your ability to drive high-value workflows. Clinical alerting technology sends critical information and updates from your alert systems to your staff’s mobile devices. This creates an enterprise-wide approach to management, prioritization, and response to key events, and supports true workflow-driven communication. Let’s look at a couple of examples:
Improve Patient Discharge Times:
Speed Response to Nurse Call Requests:
6. Lack of education
Technology is just one piece of the puzzle. Process and people are just as important. Whether presenting secure messaging to a pilot department or rolling it out across the enterprise, it’s vital to provide education so they understand what’s in it for them. What challenges are you trying to solve? Why are you introducing this solution and how will it fit in with existing workflows?
Be sure to clearly outline the value for each type of end user. For example, a physician might be excited about the ability to message an on-call colleague, even if she doesn’t know who it is that day. Whereas a nurse might be thrilled about the ability to receive alerts from nurse call and patient care devices on his smartphone, because it limits unnecessary trips to patient rooms and reduces alarm fatigue. Finally, treat your secure messaging rollout like an ongoing exciting event: Support it with some memorable marketing in addition to informative communications.
7. No plan to sustain and optimize the solution
As EHRs have proven, there’s no such thing as an “install it and leave it” approach to healthcare technology that’s embedded in clinical workflows. The initial implementation is just phase one. How will your hospital sustain and optimize secure messaging to achieve the full benefit of the solution and realize greater success?
Look beyond the go-live and rollout from the outset to ensure you have a plan in place to reinforce the value of the solution with ongoing messaging and training. Many rollouts go out with a bang and then quickly burn out. Maintain interest by holding contests for app activity (your vendor may even be able to provide swag for prizes!), posting reminders of what the solution can do to make their lives easier in cafeterias and break rooms, and hosting periodic help desk sessions to answer questions.
Advance Patient Care With Mobile Technology
I hope that by calling out these seven common mistakes that hospitals make when rolling out secure messaging, you and your team will be able to avoid them with confidence and successfully navigate your way to clinical collaboration success.
By Jason Stanaland, Product Manager, Mobile Solutions
Jason is a mobility solutions expert at Spok. He has 10 years’ experience in systems architecture design, enterprise mobility management, IT service management, project management, consulting services, and product marketing. This includes designing and supporting the critical messaging system at a large hospital system. In that role he developed business cases to justify the use of critical messaging systems and architected an enterprise emergency notification system. While there he also implemented a secure messaging solution and successfully deployed it to over 3,000 users. Jason is helping Spok customers plan and successfully launch critical, secure messaging solutions in their hospitals. Connect with Jason on LinkedIn.