title: Smarter hospital communication: secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow.
abstract: BACKGROUND
  Though current hospital paging systems are neither efficient (callbacks disrupt workflow), nor secure (pagers are not Health Insurance Portability and Accountability Act [HIPAA]-compliant), they are routinely used to communicate patient information. Smartphone-based text messaging is a potentially more convenient and efficient mobile alternative; however, commercial cellular networks are also not secure.
  
  
  OBJECTIVE
  To determine if augmenting one-way pagers with Medigram, a secure, HIPAA-compliant group messaging (HCGM) application for smartphones, could improve hospital team communication.
  
  
  METHODS
  Eight-week prospective, cluster-randomized, controlled trial
  
  
  METHODS
  Stanford Hospital
  
  
  METHODS
  Three inpatient medicine teams used the HCGM application in addition to paging, while two inpatient medicine teams used paging only for intra-team communication.
  
  
  METHODS
  Baseline and post-study surveys were collected from 22 control and 41 HCGM team members.
  
  
  RESULTS
  When compared with paging, HCGM was rated significantly (P < 0.05) more effective in: (1) allowing users to communicate thoughts clearly (P = 0.010) and efficiently (P = 0.009) and (2) integrating into workflow during rounds (P = 0.018) and patient discharge (P = 0.012). Overall satisfaction with HCGM was significantly higher (P = 0.003). 85% of HCGM team respondents said they would recommend using an HCGM system on the wards.
  
  
  CONCLUSIONS
  Smartphone-based, HIPAA-compliant group messaging applications improve provider perception of in-hospital communication, while providing the information security that paging and commercial cellular networks do not.
authors.affiliation: Stanford University School of Medicine, Stanford, California.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Przybylo
authors.forename: Ange
authors.initials: A
authors.lastname: Wang
authors.forename: Pooja
authors.initials: P
authors.lastname: Loftus
authors.forename: Kambria H
authors.initials: KH
authors.lastname: Evans
authors.forename: Isabella
authors.initials: I
authors.lastname: Chu
authors.forename: Lisa
authors.initials: L
authors.lastname: Shieh
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D040421:Cell Phone; D017598:Efficiency, Organizational; D005260:Female; D006747:Hospital Communication Systems / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010465:Perception; D011446:Prospective Studies; D013333:Student Health Services; D060145:Text Messaging; D014481:United States; D057188:Workflow
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