Using communication to drive workflows: Spok

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Free: How do you help organizations create mobile communications systems that avoid workflow problems and regulatory penalties?

Edds: Number one, we ensure that all the PHI stored at rest is in a secure data center. We developed an application that encrypts data at rest, and it can reside within the organization’s data center. When working with staff’s smartphones, we encrypt the data on those devices using a similar encryption technique on the device to encrypt the data at rest there. Our partners have total control of their data at all times.

Number two, we encrypt any data in motion. We employ a number of industry-standard best practices relative to encrypting data in motion. We use AES256 which is the same technology that banks use to encrypt their transactions. 

The next step we take is toward user authentication. We ensure that our clients know who’s using a given device. Many of our customers choose to do this at the operating system (OS) level. They implement mobile-device management strategies that require the user to re-authenticate themselves at the OS level. Solutions like ours can do that at the user level, or at the application level. The application is encrypted and the user has to either type in a code or use their thumbprint to authenticate themselves at the application level.

That leaves the final element, which is audit management. We make it easier to keep track of the devices that people have within the working environment. We have a series of administrative controls around who has the applications, who was in the directory, who moved the messages, or any of the data or applications and cases lost. Our client partners are able to control how long messages are stored on the device, whether it’s one hour, one week or 30 days. Those messages can easily be removed so they are vulnerable for no longer than they need. We really built out a whole series of functionality to meet those particular requirements.

Free: Through your extensive work with your customers, what best practices have you discovered relative to texting in healthcare?

Edds: Organizations need to be proactive. They need to map out all the different roles and each application that is going to need mobility. This is important because our customers have several different solutions on their smart devices, whether it be their electronic medical record (EMR) application, a drug reference application, some computerized physician order entry (CPOE) or even imaging software. Their strategy needs to be based upon who are the people they employ, what are their roles and what data do they need access to.

44Early on, organizations must also figure out on what network they are going to place their systems. This sounds more tactical, but it’s really important. People say, “Well, I will run on a Wi-Fi network or I will run on the cellular network.” Obviously, a hospital can be a big campus. They often have basements where important things happen and communication coverage in all of those areas is critical. Choosing which cellular or wide area providers you partner with to improve coverage in your workplace is a decision that requires great thought. Whether it is Verizon, AT&T, T-Mobile, Sprint or whoever is the local provider, you need to determine if they have strong Wi-Fi coverage and how are they going to get your staff authenticated within those networks.

Free: What areas do organizations sometimes overlook when creating their mobile communications plans?

Edds: The first area that comes to mind that many people often neglect to review is their Human Resources policies. Often times, there are policies on the books that do not allow physicians to use their personal devices at work. That policy is a carryover from the 90’s when you couldn’t carry cell phones in hospitals because everyone thought they were going to hurt people. Organizations need to look at those rules and make sure that they aren’t in place to serve as obstacles to implementation. We have had a couple of customers who started to roll out our product and then later realize they had rules against having products such as ours in their work spaces.

Healthcare organizations also need to look at their facility’s specific working environments, for example,

surgical environments. In the old days, the doctors came in and they put their pager on a tray and there was a nurse who was kind of a communication hub. She would answer the pages and answer phone calls and kind of deal with all that. Now you have a smart phone sitting on that tray and it is locked. Is that nurse allowed to open up that doctor’s cell phone? Is he allowed to tell her his password to get into it to answer the message or answer the phone call? HR policies are a big thing that if you think about it moving from 50 people to about 100 people, out to 1,000, 10,000 or even 50,000 people. Those are the kinds of things that our customers have stumbled into.

The final thing to consider is this is a mission-critical application, which means having everything tested and having proper backup procedures created is important. They must think through what happens when the communication system is unavailable, because at some point it will be unavailable. For example, wireless networks will be down. That’s where backup systems need to be in place.

Finally, mobility strategies have to include secure texting applications, pagers and other communication devices. A mobility strategy is much more than just a cell phone. 



Free: Spok operates outside healthcare in the fields of government, hospitality and higher education. How does this outside experience benefit your medical partners?

Edds: In short, Spok specializes in campus-based communications. All of our customers are, whether it be hospitality, retail, federal government or public safety, often based on campus. The biggest lesson that can be learned from these fields is having a view of communication on an enterprise scale – not looking at it department by department. That siloed view is rarely taken in those other industries, but it’s something that has been done in healthcare time and time again. We have a nursing solution. We have a doctor solution. We have a solution for this department. We have a solution for that department. Thankfully, we have been hearing from our healthcare customers that this fragmented mindset is changing. 

Free: How do you see the future of communications evolving in healthcare?

Edds: Our vision for the future, and how we like to differentiate ourselves, is that healthcare communication systems should help to create the most efficient workflows possible.

Throughout an organization there is a series of workflows, and it is more than just Dr. A trying to get in touch with Dr. B. In the past, it was more about person-to-person communication, but increasingly, we are starting to see machine to human communication, which is really enabling more effective workflows. So at the end of the day when there are lab results that need to get to a physician, we can help automate that process. Critical results are sent out to the prescribing physician, but if that physician doesn’t answer, we can design workflows that push that information on to an on-call physician or a nurse that is covering the room.

Apple-iWatch_newAs we look to the future, we also envision an increase in the number of automated workflows throughout the day. There will still be people to people communication. That’s always the best way to communicate, but there will be an increasing number of systems that will have data that needs to be communicated out. Rather than just take that data and put it in a database, we try to determine ways to get the data out to the people that need to use it.

The second trend that is really interesting is wearables. The world has been experimenting with these devices over the last couple of years. There was the Google Glass fad that did not last very long, but we now have something new that seems to be holding on stronger. This most recent introduction of watches, particularly with Apple developing theirs, I think, is also going to change from a provider standpoint, the culture of communication in ways we can hardly imagine.

I personally received my Apple watch a couple of weeks ago so I am a couple weeks in and we have reviewed this with our innovation partner alliance which is a series of some of our best customers. We have asked them how do they see the future wearables and they think that it is not going to be a fad. They think this one is going to stick and I tend to agree with them that it is going to change the communication. No longer do you have to dig your phone out of your pocket to communicate. You can type short answers or speak to your wrist to do that. Watches are just the start of it. As I look over the next five years, I think wearables are now here to stay. I think there will be a ton of innovation around what we can do with a screen, a speaker, a microphone that is always present in your daily life.

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Apple Watch, HIPAA, HIPAA audit, mobility strategy, Spok, Texting, The Joint Commission


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