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Turning the pagers: mobiles catch on

Communications has moved on and more hospitals are moving to systems where staff can use their own mobile device to stay in touch at work.

Nurses might be using a wider range of mobile devices at work in the future, as a growing number of hospitals throughout Australia look for ways to further integrate communication systems.

Moving away from the routine of paging and waiting for a return call, hospitals are starting to implement technologies that can provide fast, safe alerts to the correct people, at the right time and to a range of different devices.

Traditionally, they have relied on paging systems – efficient for sending a large number of messages to a large number of recipients. This is a trustworthy and reliable system; however, the technology itself has not changed since the 1970s.

“The vast majority of hospitals, certainly in Australia and Europe and to some extent in North America, still rely on paging as a core part of their overall communications strategy,” says Graeme Hull, general manager at Amcom Software.

“The number of pagers in service has certainly dropped but the core reason for them being there has not gone away, and a lot of the newer technologies haven’t quite got to the point yet where hospitals feel comfortable in trusting critical and time-sensitive messaging to them.

“It is starting to change but we are not quite at that tipping point yet.”

Hospitals are now realising that more effective communications systems are important in promoting a more efficient workforce. Staff cannot waste time searching for information, people, supplies or beds and thus there is a need for a more integrated approach.

“Entirely one-way technology does not have that closed loop; you send a message and assume that it has got there but there is no guarantee it has – it is sort of fire and forget,” says Arthur Haycraft, senior healthcare consultant at Amcom Software.

“The pro-loop technologies that are provided by some of the wi-fi phones, DECT [digital enhanced cordless telecommunication] phones and smartphones offer a whole new level of that continuum, closing that loop of the communications process. Hospitals are recognising from a clinical workflow point of view that there are real benefits in that, and are slowly beginning to adopt those more and more.”

As the bring-your-own-device debate gathers momentum in Australia, hospitals are also starting to realise the opportunities that embracing new systems can have. Most younger people starting within hospitals own an Android or iPhone, opening up new potential.

“There is a real opportunity for hospitals here to actually save on communication costs by leveraging off those who use their own devices,” Haycraft says. “This is a win for the organisation because it costs them less in supplying and maintaining equipment and it is also a win for the staff themselves because they are carrying a device that they know and are very comfortable with.”

Just under two years ago, Bendigo Health decided to upgrade their communications system to a better messenger structure – one that enabled communication device interoperability. Their main focus was to enable their varied systems to deliver real-time notifications and messages to devices currently in use across their network and in the future.

They chose Amcom Messenger because it offered flexibility and would fit growing requirements.

Described by Haycraft as “the alarm integration and message management hub”, the system centralises the management of critical alerts and alarms generated by point of care and safety systems such as nurse call and patient monitoring. The alerts are sent to staff mobile devices to accelerate response times.

“It enabled us to roll out a wireless phone system in a lot of our clinical areas using the Cisco wi-fi wireless network we built about four years ago,” said Phillip Coppin, former ICT operations manager at Bendigo Health. “With the Messenger solution, we have been able to interface our nurse call technologies to that Messenger interface and then get the nurse call back to the Cisco wi-fi phones. So now a lot of our wards are silent, there are no alarms or buzzers inside the ward environment.”

“In addition, all of our information is logged, so all the nursing unit managers can go in and look at the button presses and response times and see whether there are any trends or if there is a particular nurse not responding.”

Although not entirely convinced that nursing staff will want to bring their own device to receive nurses’ pages or calls, Coppin says that Bendigo Health is working on a software suite that will give them the level of control needed to allow privately owned devices onto the network to access nurse calls.

“I think that the unionised nature of the workforce and its long history will mean that for the foreseeable future, hospitals will need to be providing phones to staff,” he says.

Developed here in Australia, the system makes staff work patterns more efficient, reduces overhead noise and improves patient care with faster response to requests and critical changes in vitals.

From an organisational point of view, Amcom Messenger offers nurses real benefits in terms of the distribution of message and job allocation of nurses. The system is able to reduce the distance nurses walk unnecessarily around the ward by allocating how specific messages are directed to the right staff member at the right time on the right device.

“Based on a number of criteria – and they might be the type of alarm that’s been triggered, whether it is urgent or non-urgent, whether it requires certain skills – you can really start to map the organisation and make sure that people are being directed and given tasks that are most appropriate for them in a local area for them. It’s a much better use of their time,” says Haycraft.
Coppin agrees, saying that once nurses started hearing about Bendigo Health’s initial system installation at a local high-care residential facility, they started asking for ways to implement the technology in their workplaces.

“We originally started using the system as an RFID [radio frequency identification] duress system because we needed to be able to get messages to all the staff in a duress situation,” he said.

“Once nurses found out what we were able to do, they wanted to know more about how we could modify and adapt to their particular set of circumstances. In fact, this whole thing about the nurses having wireless phones has actually been initiated at their level rather than some sort of management decision.”

IT teams have raised security concerns, reluctant to give wi-fi access to staff due to the risk of compromised electronic patient health information. However, Coppin says that Bendigo Health has had no problems since installation.

“We have no issues at all because we built the network to be totally secure. To get onto the network the device has to be registered and certificates loaded,” said Coppin.

“We have hundreds attempts each day to get on, but no rogue device gets on at all.

“We’re convinced that by pushing the envelope with wirelessly advanced systems, we can enhance efficiency and effectiveness, improve onsite safety, and provide better patient care.”

Graeme Hull believes there are many solutions to how security can be locked down, especially when data is being sent to a non-secured smartphone.

“One of the critical elements in this decision for a hospital is about patient data and patient confidentiality,” he says. “Messenger can actually channel those messages to a secured application within the smartphone that can be locked down remotely or wiped remotely if necessary, for instance if a device is lost. We retain any confidential data within a secured application and do not allow it to be sent as a non-secured SMS, for instance.”

Steve Morland, biomedical technical officer at Greenslopes Private Hospital, which installed Messenger late last year, said the hospital staff have to trust the paging system to be reliable 24/7.

“It is important that the right people get the right messages every time. This system allows alert messages to be copied to specific email address for recording and quality assurance purposes.”

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