• Article
  • July 30, 2021

Bypassing EHR Bottlenecks to Enable Faster Specialist Consults

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This hospital leveraged an automated process to ensure the timely delivery of messages and alerts in the electronic health record.

To request a specialist consult, WakeMed physicians would write orders through the electronic health record (EHR). However, the EHR system did not always provide an automated process to ensure the delivery of the request directly to the consulting physician or alert the physician about the consult. 

With no automated process in place, a variety of methods were used to bridge the communication gap. Some ordering physicians relied on unit coordinators to monitor consult orders. They would notify or remind consulting providers via phone call, page or emails with limited information for security reasons.  Many of these communication methods resulted in the delivery of abbreviated or confusing messages with missing pieces of critical information

In some cases, the consulting physician would not see the consult orders until they checked their EHR system patient list, which could be hours later or the next day. In other cases, the orders may go to the wrong provider altogether due to the EHR’s inability to automatically route messages based on the day and time of message, provider availability, call schedules and workflows.
 
Ordering physicians were forced to choose from hundreds of names within the EHR, without knowing if the consulting physician was on vacation or if another member of the care team should be receiving the consult. This process often led to confusion and frustration for everyone involved in the consult process, and delays for both the patient and hospital.

Enabling automated message delivery in the EHR

To address this issue, WakeMed worked with Proficient Health to leverage PH Connect integration with the EHR and Intelligent Consult Notification (ICN) functionality. This allowed the organization to automate message routing, enable real-time notification and optimize care continuity.

PH Connect is a tool that routes messages based on six different factors, including clinical service resource availability (residents, physician assistants) and consulting physician workflow and preferences, ensuring the consult is automatically delivered to the right person—the first time. 

The consult delivery allows for preferences of the services that would not typically be notified at night but would expect notification of new consults at the start of morning shifts.

PH Connect supports preferred workflows for not only the consulting provider, but also for the ordering physician. PH Connect’s integration with the EHR allows the provider to simply log into the EHR and request the consult. They receive a notification the message was sent and can expect a faster response from the consulting physician.

Improving patient care

This approach to consult orders has improved time to consult and reduced length of stay across WakeMed. Thousands of consults are being sent through PH Connect with read and response times as quick as two to three minutes. Services benefitting from the PH Connect integration and ICN include Pediatric Endocrinology, Pediatric Surgery, Pediatric Hospital Medicine, Pediatric Intensive Care, Pediatric Cardiology, Pediatric Urology and Pediatric Gastroenterology. The hospital plans to roll the feature out to all services.

“PH Connect allows providers real-time access to consulting specialists without prior knowledge of call schedules; enables them to share patient-specific information securely, unlike conventional texting; and provides read receipts to communicate those messages have been received,” says Ted Tsomides, M.D., WakeMed Health & Hospitals.

Interested in learning more? John Proficient Health for a webinar, Hospital Leaders Discuss Trends Driving Change in 2021.  

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