Digital mobile technology facilitates HIPAA-sensitive perioperative messaging, improves physician-patient communication, and streamlines patient care

The number of digital mobile applications (“apps”) focused on medicine and healthcare
has increased drastically throughout the past decade, with greater than 40,000 apps
currently available 4], 5]. Despite this impressive volume of software, a reliable mobile communications platform
designed specifically for use by physicians, their patients, and their patients’ support
networks is not currently available. Our study demonstrates that there is a potential
market for such a product: we have shown that smart phone-based communication between
healthcare providers, their patients, and their patients’ designees, greatly improves
satisfaction with the perioperative experience. Our results indicate that the use
of this technology significantly enhances connectivity between surgical patients and
those they identify as their closest advocates. The vast majority of those surveyed
stated that they would recommend this type of product to their loved ones. The results
of this study indicate that an accessible digital communications platform capable
of facilitating physician-patient communication would be well received in today’s
medical marketplace.

In the perioperative surgical setting, which this study has focused on, the current
methods that are used to communicate with patients’ relatives are highly variable
and often antiquated. At many institutions, circulating nurses or other operating
room staff are called upon by the operating surgeon to deliver status updates via
telephone to family members sitting in a remote waiting room. Such a phone call is
typically brief and usually provides only limited information (e.g., “all is going
well”). While this method of communication can be meaningful, it has significant disadvantages.
First, the surgical waiting areas of many hospitals often lack privacy and the opportunity
for discretion. Family members might be uncomfortable receiving sensitive information
regarding a potentially stressful situation in a public setting. Private mobile messaging
liberates families from the waiting room, allowing them to find a peaceful environment
of their choice where they can await news. Next, when telephone updates are delivered
to a singular family member, that person might then have the unwelcome burden of transmitting
sensitive information to a host of additional members of the support group. This might
add additional stressors to the family member who takes the call. By allowing messages
to be delivered to an unlimited number of individual recipients, mobile messaging
spares any one member of the larger support group from serving as a secondary messenger.
This would be particularly useful in facilitating updates for friends or family members
that are not physically present at the hospital at the time of surgery, including
relatives who might live out of state but whom the patient would like to keep informed.
In addition, by allowing surgeons to generate an unlimited number of custom templates,
messages of any level of detail can be drafted and delivered. Recipients would therefore
be able to receive messages with greater meaning and relevance regarding their loved
one’s status. This flexibility also alleviates the ancillary staff who are making
the update phone calls of the burden of trying to provide a higher level of information
than the standard curt summary that is usually provided, which is often followed by
more probing questions from the family member on the receiving side. It further frees
all operating room staff, including the surgical team, to focus on the task at hand:
completing the operation safely without any lapses in focus or concentration.

While this study focused on the discipline of surgery, we can easily imagine the benefits
of this type of communications application outside of the surgical model that we have
studied. The results of any laboratory, pathology, or radiography studies can be instantaneously
shared with concerned family members all over the globe. In the critical care setting,
doctors can communicate with a patient’s extended support group more efficiently and
in a less stress-inducing environment than the typical crowded consultation room outside
of the intensive care unit. News of the arrival of a newborn baby boy or girl can
be sent to eager aunts, uncles, and grandparents back home. The opportunities for
enhancing communication pertaining to medical issues are seemingly limitless.

Effective communication between physicians and patients lays the foundation for an
optimal patient experience with high satisfaction. Patients who feel they have more
effective lines of communication with their physicians tend to be more compliant,
more successful in modifying unhealthy habits, and engage more actively in the management
of their own health 6], 7]. Improving communication during perioperative period may have downstream effects,
including a decline in adverse outcomes. This may be particularly relevant when members
of a patient’s support network will actively be providing care to the patient throughout
the duration of their surgical or medical illness, and therefore would benefit from
the most current information related to their loved one. Furthermore, studies have
shown that failures in communication alter the surgeon-patient relationship and can
lead to poor outcomes, ultimately increasing the chances of malpractice suit 8], 9]. Occasional lapses in communication have also been found to decrease word-of-mouth
recommendations by patients to their friends and family 10].

A recent study of 78 medical practices utilizing electronic methods to communicate
with their patients concluded that the use of digital media in the physician-patient
relationship improves access to care, saves patients time, and increases overall patient
satisfaction 11]. Physicians reported that electronic communications systems improved overall productivity,
as sending patients secure digital messages was less time consuming than attempting
to reach them by phone. Yet another study has examined the impact of implementing
a communications training program for physicians and other healthcare providers caring
for cardiothoracic surgery patients. The authors found that those patients cared for
by healthcare workers with communications training experienced fewer post-operative
complications 12]. While the sample sizes of these types of studies are limited, the relationship between
improved provider-patient communication and better patient care is intuitive and worthy
of future study.

In summary, our results illustrate the benefit of formally implementing mobile digital
communications technology into the doctor-patient relationship. It can be done simply,
with minimal cost, and can have far-reaching effects in streamlining patient care,
improving patient satisfaction with that care, and improving medical and surgical
outcomes. While we acknowledge study weaknesses including a low survey response rate,
we believe meaningful conclusions can be drawn from our findings. We believe further
study of the feasibility of incorporating communications platforms such as the one
used in this study at the enterprise level are warranted.