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A “microblog” of conversations about patient care can be an effective way to get team members all on the same page, but suffers the same limitation of many such platforms-- getting everyone involved, according to a small study published in the Journal of the American Medical Informatics Association.
The research took place in a medical intensive care unit and two noncritical care units at a large academic medical center in Boston as part of its quality improvement efforts.
The upside of microblog technologies is providing a single place where all the conversations about a specific patient’s care live indefinitely on a virtual “wall." There’s no need to forward messages to new providers when a patient is transferred elsewhere. However, the challenge is doing so in a way that protects the patient’s privacy.
The researchers began by creating HIPAA-compliant web-based and mobile messaging applications for these conversations. These apps are unique, according to the authors, by being linked to the electronic health record system and by being synchronized in real time.
They used team-mapping functionality to help ensure messages were being sent to the right person; it routed messages to different people when there was a shift change, for instance.
The system was typically used for patients admitted twice or more and with longer lengths of stay, and it was most often used for care coordination, clinical summarization and care team collaboration. Seventy-six percent of participants viewed all the messages.
Users liked the transparency and persistence of the conversations, according to the study.
The biggest barriers they cited, however, were the array of different other technologies, pagers, email, texting, that members of the care team used, and that it was not available to external providers.
To learn more:
- check out the research