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Using communication to drive workflows: Spok

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Clear and trusted communication is the foundation for all medical care, however, communication for the sake of communication is no longer enough. In order to attain the highest levels of efficiency, meet stringent regulatory requirements and keep costs low, healthcare providers must explore new ways to leverage long established and newly emerging communication tools.

This task can be quite tricky, and many in our field are still wrestling with how to locate potent positions within their working environments for even the most common forms of communication. For example, while popular culture has fully embraced text messaging, even with the distracted teenagers and sometimes confusing emoticons that often go along with it, many organizations succumb to “paralysis by analysis” when considering the tightly intertwined opportunities and dangers of texting within healthcare workflows. 

To learn more about the issues our industry must consider when devising implementation plans and establishing best practices relative to its communications systems, I spoke with Brian Edds, Vice President of Product Strategy, Spok. Not only did I develop a deeper appreciation for Spok’s expertise in creating such strategies, but I also can now see how wearable technologies may soon hold the key to maximizing the power of future communication systems in healthcare. 

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

Free: Please describe your background and how your work at Spok has evolved overtime.

Brian Edds, Vice President
Brian Edds, Vice President of Product Strategy, Spok

Edds: I have been with the company for almost 5 years. I came on board to help start our mobility strategy and our secure texting implementations.

Prior to coming to Spok, I worked in mobile workforce management applications across a variety of industries. My career has been around mobile strategy probably since before it was a good idea.

In the mid 2000’s that all changed with the introduction of smartphones. Doctors and nurses were increasingly bringing their smartphones and using them at work. Spok brought me on to help address the question: How can we best leverage smartphones as a workflow tool in healthcare?

That’s really the journey we and our customers have been on over the last five years. It really started a couple years ago, when “Hey, I have this smartphone. How can I connect it to my Spok system?” We came out with our product at that time. We called it Spok Mobile, formerly referred to it as Amcom Mobile Connect. That product put an app on the phone and it allowed us to send messages to the phone. Those messages were secure as opposed to regular [short message service] SMS. Those messages were traceable so you could understand when they were delivered which was an advantage over prior communication methods. They were also differentiated. That was an important aspect too because we all know we receive a ton of different notifications and alarms and messages on our phone. What our customers told us was that the types of messages that they wanted to send from the Spok system out to these devices was special and different, and they needed to be treated as such.

That’s the genesis of our work today and my existence here at Spok.



Free: Can you trace how smartphones created the new security and workflow challenges that some experience today within healthcare?

Edds: That’s a good question because we see many instances of younger professionals who seem to be a bit out of touch with the not-so-distant past. Many don’t understand how we got to where we are in terms of communications.  

If you deconstruct how communication used to happen: There were physicians. They would often call an operator. The operator would page the other party. That person would call back to the operator, and then that operator would tell that other person, “Hey, Dr. So-and-So wants to talk to you.” Then those two people would then be connected. The reason that the operator was in the middle of that, and that the doctors weren’t necessarily paging each other, is that they wanted validation that it was being done. So if the person didn’t call back, the operator would remind them and page them again. That was kind of the world before we had mobile phones.

Around the late 1990s and early 2000s, doctors started to have smartphones that were capable of texting. Most of these early smart devices were BlackBerries. That phase seemed to last until 2008 when the iPhone came to be. In healthcare, the concern became, “Hey, this messaging back and forth with our staff is not secure because SMS is not secure.” The Joint Commission also had some concerns that the communication was not passing through a tracking system. This concern grew with the introduction of the iPhone, along with the subsequent introduction of Android, and texting became easier and easier.

Doctors and nurses were purchasing these tools in their personal lives and using them for business purposes. Their IT teams really had no management or control over this huge change in both the forms and the frequency of communication on their campuses. They couldn’t ensure that the data was secure. They couldn’t ensure that it was traceable and they definitely couldn’t ensure that it was differentiated because doctors were using the same text message apps to text their buddies and their wife as they were their colleagues at work.

Free: In the early days, some organizations were not as careful as they should have been in terms of enabling text messaging, but few have ever been held accountable for the errors that may have been committed in the process. How would you account for such a chaotic environment to exist? 

Edds: It was a chaotic environment. In many ways, however, we needed to make a few of those mistakes to find our way forward. 

It started as legislation and regulation with the HIPAA and HITECH Act of 1996. That laid the foundation for this and subsequent updates to that over the next 10 years, added more and more regulatory compliance since to start there wasn’t a lot of teeth in it. There was laws out there, but there weren’t any fines.

Over the last two years, there have been well-publicized cases of physician practices being fined $100,000 because they were texting protected health information (PHI) in an unsecured manner. This type of enforcement has not been widespread, but I do think that the various agencies have given a head nod that this type of penalty is going to increase in the future. There is both the carrot and stick at play here. The fines are obviously the stick and then there’s the carrot for having your Medicare payments being accepted.