Nurses left out of mobile initiatives

Big gap likely to change, driven in part by push for care coordination
By Eric Wicklund
03:00 PM

Nurses may face "explosive growth" ahead in the use of mobile communications solutions – primarily because they've been ignored for so long.

Indeed, 42 percent of hospitals still rely on pagers, overhead paging systems or landline phones for their nurses, even though 67 percent have nurses who are already using their own smartphones to support clinical communications and workflow, according to a new report from Spyglass Consulting.

Not surprisingly, that finding has given rise to quite a few eyebrows, says Gregg Malkary, Spyglass' founder and managing director.

It highlights a surprising dichotomy in hospitals between mHealth solutions for doctors and nurses – namely, while doctors are gaining access to and adopting mHealth solutions, nurses are left to deal with legacy systems and are filling the gaps with their own smartphones.

'They're underappreciated," Malkary said. "Nurses are looked upon as the single largest line item on the balance sheet," while doctors are considered the revenue-generators and the face of the healthcare institution.

Malkary said the mHealth market has evolved with the doctor in mind, to the point that hospital IT departments are focused on those and other concerns and leaving nurses to their own devices. They don't have the time or resources to deal with nurses, he said.

"This is a huge line-item expense," he added.

Add to that the pressures nurses face in the hospital setting, and a looming shortage that won't be resolved if nurses aren't treated better. Malkary points out that nurses work in high-stress, data-intensive environments that are still paper-based, yet they're under pressure to "communicate, collaborate and coordinate care" for a patient population that requires more care.

Security concerns? They're just as important as ever. With data breaches reported in the media on an almost-weekly basis and a proliferation of personal devices in the hospital setting, 88 percent of hospitals surveyed expressed concerns about HIPAA guidelines and the risk of unprotected mobile devices.

With vendors like Voalté, Extension, Spectralink, Mobile Spaces, Polycom and TriageLogic claiming roughly 5 percent of the market with mHealth solutions for nurses, Malkary sees a lot of growth in the coming 12 to 18 months.

More than 50 percent of the hospitals surveyed, he said, are evaluating enterprise-class nursing smartphone solutions, many of which would integrate with the hospital's PBX, clinical information systems, devices and nurse call systems.

"Consumer-grade apps don't fit the bill," Malkary said, pointing out that tailor-made solutions for nurses work well but aren't being recognized by hospital executives as a necessary service.

"This is not a technology issue. The technology exists, but we need to adapt it to fit into healthcare," he explained.

Will that happen soon?

Malkary thinks so. The Affordable Care Act, he said, is forcing hospital executives to change their opinion of nurses. Tough new reimbursement standards, re-admission penalties and a move toward patient-centered and collaborative care are combining to bring nurses and other support personal into the healthcare conversation.

"Pressure is building on (hospital executives) to look at care coordination," he said. "Are they using the right tools to support the nurse?"

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