Wireless VoIP benefits being frustrated in healthcare: study

Big picture view needed for infrastructure and nurses' workflow

By John Cox, Network World
February 05, 2010 01:37 PM ET

Wireless VoIP and unified communications promise better patient care at homes and hospitals, yet the deployment of these technologies is being hamstrung by a piecemeal approach that often ignores or even interferes with that care, according to a new study by Spyglass Consulting Group, a consulting group focused on healthcare IT.

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To realize the benefits, healthcare organizations need to take an enterprise-wide approach to wireless infrastructure and mobile devices, and to involve nurses early in the planning stages, the study concludes.

The report, "Point of Care Communications for Nursing," is based on 100 in-depth interviews with nurses in home health and acute care facilities. The interviews covered existing workflow bottlenecks and inefficiencies in communications with patients and other staff, how mobile devices and systems are actually being used, and barriers to wider adoption of these technologies, according to Gregg Malkary, managing director for Spyglass.

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The results are not encouraging. Sixty-six percent of the hospital-based nurses say their organizations have deployed VoIP communications. But 71% say the wireless networks are poorly designed: there are coverage gaps, interference and overloaded access points. Data and voice connections often get dropped.

Concerns over the cost of such deployments often results in limiting them to one or a few specific hospital departments, and VoIP handsets are in short supply.

UC is an attempt bridge the many communication gaps that exist in healthcare, Malkary says. Many nurses carry anywhere from two to five different communication devices including cell phones, VoIP phones and pagers. And, while they want improved communication and smoother, saner workflows, the term "unified communications" is one they can't or don't define. "They say 'it's a meaningless marketing term that has no bearing on what I'm doing,'" Malkary says.

For example, one constant refrain from nurses who were interviewed was that VoIP communications often can be disruptive of patient care. With a VoIP mobile device, nurses have to field calls in the midst of medical procedures and treatments.

"Today, you typically have a department secretary that triages incoming calls," Malkary says. "But with wireless VoIP, this is shifted to the nurse at the patient's bedside. If you push more onto the nurse, it disrupts her thinking process and her treatment, especially if she's doing things like administering medications."

Often, the call can't simply be ignored. For example, if a patient has a heart attack or other medical emergency, the nurse may be forced to respond. But it requires nurses to be multi-tasking, while still providing quality patient care, a potentially dangerous combination, according to Malkary.

The wireless VoIP systems also often create an unexpected gotcha: nurses and hospitals suddenly discover that a nurse is forbidden by the Health Insurance Portability and Accountability Act (HIPAA) to talk over a wireless voice connection about one patient's condition while in the presence of another. "This is actually a big issue in healthcare," Malkary says.