FROM THE CALL CENTERTO SECURE TEXTING

15 YEARS OF CLINICIAN COMMUNICATION AT KETTERING HEALTH NETWORK

ABOUT KETTERING HEALTH NETWORK (KHN)

• Ohio’s leading heart hospital

• Eight hospitals• Nine emergency departments • 120 outpatient facilities • 2,100 physicians• 11,000 employees

Kettering Health Network is a not-for- profit network serving southwest Ohio

• Revolutionary brain and spine surgery

KHN COMMUNICATION EVOLUTION TIMELINE

1998 Grandview

Operator Console

2001Kettering Operator Console

2007Web & On-Call

Scheduling

2009GV/KH

Consolidation

2011Greene

Operator Console

2012GM/KH

Consolidation

2014Secure Texting

201xFH/KH

Consolidation

OPERATOR CONSOLE

OPERATOR CONSOLE

OPERATOR CONSOLE

• 1998: CTI proposed as part of Grandview PBX replacement

– Simplified user interface

– Reduced paper-based process

– Centralized source for contact information

• Alternate telephone numbers

• Pager and cell phone numbers

– Programmable keyboard to support click to dial, transfer, page

– Document and automate emergency procedures

– Later added ADT and EDIX feeds to automatically update database

KHN COMMUNICATION EVOLUTION TIMELINE

1998Grandview Operator Console

2001Kettering Operator Console

2007Web & On-Call

Scheduling

2009GV/KH

Consolidation

2011Greene

Operator Console

2012GM/KH

Consolidation

2014Secure Texting

201xFH/KH

Consolidation

GV/KH Databases Merged

(AD Enabled)

Installed As Separate Site w/

Separate Database

Installed As Separate Site w/ Shared Database

OPERATOR CONSOLE

Simplified call processing with centralized directory

• Reduced average wait time

• Reduced average length of call

• Improved communication, especially in emergency situations

• Improved satisfaction among staff/physiciansBY THE NUMBERS:• Live operators answering 24x7x365

• Centralized switchboard answering for 7 of 8 hospitals

• Operators handle an average 3,500 calls per day

WEB DIRECTORY AND ON-CALL

WEB DIRECTORY/ON-CALL SCHEDULING

Enable authorized users to log on securely, anywhere at any time to:

• Update contact information

• Look up others’ contact details and send messages

– Reduced dependency on the switchboard

– Reduced response times

• Manage schedules and on-call information

* Credentials tied to Active Directory *

BUILDING AN ENTERPRISE DATABASE

• 2007: Kettering implemented IntelliWeb as enterprise directory, officially replacing home-grown web application

• Users authenticated by their network credentials, as defined in active directory, giving users access to individual profiles

• EDIX data did not include active directory credentials

– Adding ‘Web Username’ manually became part of our Support Desk process for creating new user accounts

– Usernames were added to existing records with a support ticket

• EDIX data also did not include important profile data on non-employed contacts, namely affiliated physicians (managed manually)

KHN COMMUNICATION EVOLUTION TIMELINE

1998Grandview Operator Console

2001Kettering Operator Console

2007Web & On-Call

Scheduling

2009GV/KH

Consolidation

2011Greene

Operator Console

2011Data Sync w/

Metaverse

2012GM/KH

Consolidation

2014Secure Texting

201xFH/KH

Consolidation

GV/KH Databases Merged

(AD Enabled)

BUILDING AN ENTERPRISE DATABASE

• Microsoft describes the ‘metaverse’ as:

“A set of tables…that contain the combined identity information for a person or resource. Management agents update and modify the metaverse from multiple connected data sources, and in turn, management agents use the data in the metaverse to update and modify the connected data sources.”

https://technet.microsoft.com/en-us/library/jj590171(v=ws.10).aspx

BUILDING AN ENTERPRISE DATABASE

IntelliDesk (SQL)

Active Directory

UltiPro (HR

System)

MSOW (Med Staff)

• Flow of data is bi-directional

• Coordinated scripts run to ‘stare and compare’ data from each source

• Each source contributes specific data; identified as “source of truth”

• Eliminated a lot of manual data management

Metaverse

• Phone Numbers

• Messaging Devices

• Network U/N• Email

Address

• Employee Name

• Department• Title

• Physician Name

• Specialty

WEB DIRECTORY/ON-CALL SCHEDULING

• Everyone with a network ID (including affiliates) has a profile and access rights

• Profiles automatically created/removed with sync to metaverse

• Profile data is more robust and accurate

• Combined with on call, improves likelihood of getting “right message, right person, right time”BY THE NUMBERS:• More than 200 on-call schedules across all campuses,

including administrative, medical, and support teams

• Also includes 20 physician practices, entering and maintaining their own schedules with more in the pipeline. Remote access to EMR paved the way for affiliates not on network.

SECURE TEXTING WITH SPOK MOBILE®

SPOK MOBILE

• Separate inbox

• Status settings

• Option for premise or hosted in cloud

• Programmable templates

WHAT DIFFERENTIATES SPOK MOBILE?

• Device diversity

• Escalations for unanswered messages

• Full integration with the hospital directory & on-call schedules

• Receive alarms and alerts from nurse call, patient monitors, Lab, Radiology, and EMR systems

SECURITY AND ENCRYPTIONPROTECTING SENSITIVE INFORMATION WITH SPOK MOBILE

• Provide security for ePHI

• Meet HIPAA and HITECH Act guidelines with a business associate agreement (BAA)

• Encryption via SSL connection – application, as well as data during transit and storage

• Remote device wipe and automated message removal

• Application screen lock and access code

SIMPLICITY – APPEALING TO BUSY CLINICIANS

• Easy to register by email

• Mobile app and directory authentication

• Intuitive

KHN COMMUNICATION EVOLUTION TIMELINE

1998 Grandview Operator Console

2001Kettering Operator Console

2007Web & On-Call

Scheduling

2009GV/KH

Consolidation

2011Greene

Operator Console

2012Secure Texting

Research

2012GM/KH

Consolidation

2014Secure Texting

201xFH/KH

Consolidation

SECURE TEXTING DRIVERS

Potential solution for pager replacement

Mobile access to the directory and to the on-call schedules

HIPAA compliance: Provide clinicians secure solution for communicating PHI

Update/replace existing, dated workflow (physician orders)

1

2

3

4

SECURE TEXTING AND PHYSICIAN ORDERS

Objectives:

• Replicate and improve existing process

• Address compliance concerns with existing process

• Reduce cost

• Standardize on Spok for all texting

In 2012, Kettering began looking at how Spok Mobile might replace an outdated solution that was implemented in 2008 to support timely administering of TPA to stroke patients.

SECURE TEXTING AND PHYSICIAN ORDERS

• Because the process involved medication orders, it had to be approved by the state pharmacy board

• Spok worked with us to develop the tools required to support the new process and meet the board’s requirements

• Those tools are now available to all Spok customers as Spok Care Connect® and Spok® Device Preference Engine (DPE)

• March 2014: Kettering received approval from state pharmacy board for physician order process. This establishes Spok Mobile as Kettering’s secure texting solution.

• April 2014: Soft launch of Spok Mobile to physicians

– Supplement other devices, not replace

– Allow physicians time to learn and develop level of confidence

SECURE TEXTING TIMELINE

• July 2014: Incoming residency classes set up to use Spok Mobile

– Adoption grows among residents in years 2-4 and others associated with medical education program

• February 2015: Hospitalist program established, using Spok Mobile

• March 2015: Nursing competency for Spok established

SECURE TEXTING TIMELINE

TODAY: 500 active users

LOOKING AHEAD

KHN COMMUNICATION EVOLUTION TIMELINE

1998 Grandview Operator Console

2001Kettering Operator Console

2007Web &On-Call

Scheduling

2009GV/KH

Consolidation

2011Greene

Operator Console

2012GM/KH

Consolidation

2014Secure Texting

201xFH/KH

Consolidation

LOOKING AHEAD

• Disaster recovery solution to back up data center

• Piloting mobile devices for nursing with support for Spok Mobile

– Zebra® MC-40HC

– Cisco® 7925

• Planning to implement Spok® Messenger for nurse call integration to Spok Mobile in Fall 2015

• Expanded API’s for Epic integration

• Exploring decentralized call accounting for physician practices using Spok® Eclipse

• Infrastructure

– Servers and workstations (production and backup)

–Wireless Infrastructure (cellular and/or Wi-Fi)

• Planning

– It’s not all about IT!

– Engage physicians, nurses and ancillary staff early and often (this will drive adoption and ensure it’s done right)

LESSONS LEARNED

• Training and support

– In addition to IT trainers and Help Desk, engage Informatics, Staff Development, and Marketing

– Use organization’s Intranet or knowledge base to provide tip sheets, FAQs, and videos

– Give IT support the training and resources they need to provide tier-1 support

• Data is GOLD

– Look for other sources in addition to EDIX and ADT

–Will drive adoption, improve reliability of data and reduce management

LESSONS LEARNED

• Spok Mobile implementation will be challenging

– Introducing an app:

• Installed on 100s of different device configurations

• Running in a variety of wireless environments

• Users will expect it to be as reliable and simple as their pagers

– Users will become polarized, but be patient

– Spend one-on-one time with users not adapting easily

– Highlight the successes

– Once users grasp the functionality, they begin to innovate, and that’s when adoption sinks in

LESSONS LEARNED

• Get engaged– Spok webinars not only provide

education, but also discussion/feedback from users

– Spok online (customer portal, blog)

– Spok Directions User Group

– Spok Conference: Connect

• Invite others from within your organization to participate

• One last thought…

LESSONS LEARNED

LET’S GET IN TOUCH!

Learn more:

CASE STUDIES VIDEOS

We’d love to hear from you!

spok.comgetinfo@spok.com