title: Perfect Storm of Inpatient Communication Needs and an Innovative Solution Utilizing Smartphones and Secured Messaging.
abstract: In hospitals, effective and efficient communication among care providers is critical to the provision of high-quality patient care. Yet, major problems impede communications including the frequent use of interruptive and one-way communication paradigms. This is especially frustrating for frontline providers given the dynamic nature of hospital care teams in an environment that is in constant flux.
  
  
  
  We conducted a pre-post evaluation of a commercially available secured messaging mobile application on 4 hospital units at a single institution for over one year. We included care providers on these units: residents, hospitalists, fellows, nurses, social workers, and pharmacists. Utilization metrics and survey responses on clinician perceptions were collected and analyzed using descriptive statistics, the Kruskal-Wallis test, and Mann-Whitney U test where appropriate.
  
  
  
  Between May 2013 and June 2014, 1,021 providers sent a total of 708,456 messages. About 85.5% of total threads were between two providers and the remaining were group messages. Residents and social workers/clinical resource coordinators were the largest per person users of this communication system, sending 9 (IQR 2-20) and 9 (IQR 2-22) messages per person per day, and receiving 18 (IQR 5-36) and 14 (IQR 5-29) messages per person per day, respectively (p=0.0001). More than half of the messages received by hospitalists, residents, and nurses were read within a minute. Communicating using secured messaging was found to be statistically significantly less disruptive to workflow by both nursing and physician survey respondents (p<0.001 for each comparison).
  
  
  
  Routine adoption of secured messaging improved perceived efficiency among providers on 4 hospital units. Our study suggests that a mobile application can improve communication and workflow efficiency among providers in a hospital. New technology has the potential to improve communication among care providers in hospitals.
authors.affiliation: Neha Patel, MD, MS, 3400 Spruce Street, 5020 Maloney, Philadelphia, PA 19104, Neha.Patel@uphs.upenn.edu, Fax: 215-662-6250, Phone: 215-847-9916.
authors.forename: Neha
authors.initials: N
authors.lastname: Patel
authors.forename: James E
authors.initials: JE
authors.lastname: Siegler
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Stromberg
authors.forename: Neil
authors.initials: N
authors.lastname: Ravitz
authors.forename: C William
authors.initials: CW
authors.lastname: Hanson
mesh_terms: D016494:Computer Security; D007297:Inpatients; D062069:Inventions / Q000706:statistics & numerical data*; D000068997:Smartphone / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Communication; mobile; provider-provider interaction; secure texting; secure-messaging