title: A web-based and mobile patient-centered ''microblog'' messaging platform to improve care team communication in acute care.
abstract: Communication in acute care settings is fragmented and occurs asynchronously via a variety of electronic modalities. Providers are often not on the same page with regard to the plan of care. We designed and developed a secure, patient-centered "microblog" messaging platform that identifies care team members by synchronizing with the electronic health record, and directs providers to a single forum where they can communicate about the plan of care. The system was used for 35% of patients admitted to a medical intensive care unit over a 6-month period. Major themes in messages included care coordination (49%), clinical summarization (29%), and care team collaboration (27%). Message transparency and persistence were seen as useful features by 83% and 62% of respondents, respectively. Availability of alternative messaging tools and variable use by non-unit providers were seen as main barriers to adoption by 83% and 62% of respondents, respectively. This approach has much potential to improve communication across settings once barriers are addressed.
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.|Harvard Medical School, Boston.
authors.forename: Anuj K
authors.initials: AK
authors.lastname: Dalal
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.|Harvard Medical School, Boston.|Partners HealthCare, Boston.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Schnipper
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.|Harvard Medical School, Boston.
authors.forename: Anthony
authors.initials: A
authors.lastname: Massaro
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: John
authors.initials: J
authors.lastname: Hanna
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Eli
authors.initials: E
authors.lastname: Mlaver
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Kelly
authors.initials: K
authors.lastname: McNally
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Diana
authors.initials: D
authors.lastname: Stade
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Constance
authors.initials: C
authors.lastname: Morrison
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.|Harvard Medical School, Boston.|Partners HealthCare, Boston.
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D020407:Internet; D007400:Interprofessional Relations; D063731:Mobile Applications; D010348:Patient Care Team / Q000458:organization & administration*; D058996:Quality Improvement; D060145:Text Messaging
keywords: care coordination; care team communication; innovation; quality improvement; secure messaging