Evaluating Effect of New Secure Smartphone Texting Tool in Obstetrics [7K

Abstract

INTRODUCTION: As hospitals consider adopting HIPAA-compliant smartphone-based messaging, it is necessary to determine impact. Small studies found texting reliable and efficient, but insecure for patient information. Literature is sparse on new HIPAA-compliant texting, with no relevant studies in obstetrics. We evaluated a new HIPAA-compliant texting system (MH-Cure by Mobile Heartbeat) implemented in obstetrics at Yale-New Haven Hospital in 2016 for perceived effect on care and workflow. METHODS: Before implementation, surveyed residents and nurses on effects of current communication system (pagers with text receiving, service mobile phones, personal cellphones) on clinical workflow and patient care. Following roll-out (1-month), teams were again surveyed with same questions. Surveys used both 5-point Likert scale and open-ended questions. Results compared using Student t-tests. RESULTS: In both resident (n=18) and nursing (n=47) domains, new communication tool was perceived to improve efficiency (improving from no effect to moderately effective (Residents: p < .001, Nurses: p < .001)) and enhance patient care (improving from minor negative impact to minor positive impact (Residents: p < .001, Nurses: p < .001)). Qualitative results strongly favor two-way messaging (60% of respondents mentioned) and indicate quick adoption (89% of respondents using) with concerns regarding new system's impact and connectivity during emergencies (35% of respondents mentioned). CONCLUSION: New text-based communication tool does not demonstrate subjective workflow interruptions, and may improve efficiency and care. Despite significant shortcomings, even in first month of implementation a system can demonstrate impactful benefits. We recommend teams implementing new technologies for communication plan, test, and communicate strategies to avoid implementation flaws during emergencies.