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10 steps to a successful clinical smartphone strategy
Healthcare IT executives can improve mobile device usage to meet organizational objectives.
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More clinicians are using smartphones to communicate in hospitals
Physicians and nurses increasingly are using personal or hospital-supplied phones to improve communication while increasing efficiency and productivity. Now, some hospitals are adopting “clinical” smartphones using enhanced Wi-Fi and management features to support team-based care while achieving consistent secure communications across the hospital. Spectralink, which sells Wi-Fi phones and smartphones, offers the following ways to succeed with a smartphone strategy.
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1. Define an overall vision for mobile technology initiatives
Develop a vision statement clearly defining how a clinical smartphone strategy will improve outcomes and satisfaction. Include specific timelines and results such as reduction in overhead paging, higher HCAHPS scores and improved response time to patients. The vision can be crafted by a variety of leaders, including the chief nursing officer, chief medical information officer or even the CEO.
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2. Understand information flows and application requirements
Conduct interviews with key stakeholders to help identify specific communication issues and the workarounds that have been created to address them. In particular, ask these six questions:

* How are care teams communicating with each unit and across departments?

* Are caregivers using personal smartphones to send unsecured text messages within or outside the hospital?

* Are nurses experiencing delays in getting the information they need from physicians and other care team members?

* How do nurses currently conduct patient handoffs?

* How is effective communication among care teams measured? How does this translate into better patient care?

* Are there communication gaps or inefficiencies contributing to patient dissatisfaction or potential sentinel events?
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3. Review technology considerations
The solution architecture must be vendor neutral and scalable to meet current and future device and application needs. Middleware should be flexible to easily integrate with the PBX, biomedical devices, clinical information systems and nurse call systems. Clinical smartphones must support HIPAA-compliant messaging applications, alert/alarm management and patient records systems, while also providing access to vital signs, input/output and pain scores, which should be collected, validated and stored in the electronic health record.
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4. Evaluate enterprise-class smartphones
Because cellular coverage in a hospital can be spotty, connectivity to an in-building Wi-Fi network can ensure that phones support seamless roaming across the network, particularly for real-time voice communication. Phones need extensive battery life to ensure coverage for eight-hour shifts, and clinicians need to be able to easily swap out batteries that can be charged outside the device.

Nurses use strong solutions to disinfect phones, and while consumer phones can’t withstand frequent cleaning, an enterprise clinical smartphone can, as well as also better surviving frequent bumps and drops.
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5. Assess the IT infrastructure
Is the existing Wi-Fi network designed to handle voice and data traffic? Many such networks aren’t designed with voice in mind. Consequently, wireless infrastructure should be design-engineered to provide adequate bandwidth and coverage to support call volume, seamless roaming and mixed wireless client usage. Also assess if the network can accommodate wireless communication throughout the facility. Clinical smartphones must work in all areas of the hospital, including restrooms, cafeterias, elevators and stairwells.
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6. Conduct a site assessment
Conduct a site assessment across the hospital’s current infrastructure, technology assets and workflows to collect data that can be used to develop a comprehensive smartphone strategy. The assessment often starts with a comprehensive review of the hospital floor plan and layout to identify the location of communication hubs that may need additional bandwidth, or physician locations such as operating rooms or radiology labs where wireless signal strength may be weak. Also, include an interference detection assessment that enables the IT team to evaluate and identify rogue devices that can create issues on the network.
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7. Create a mobile device management plan
This plan includes reporting tools to track and report mobile device usage and potential threats to patient information, over-the-air application distribution tools to separate personal and hospital data, and remote wiping to delete data from lost or stolen devices.

Seek answers to these questions:

* Who is responsible for purchasing, servicing and maintaining the clinical smartphones and applications?

* How will clinical smartphones be assigned to caregivers and/or teams? How will these devices be stored when not in use?

* Who can authorize the purchase of replacement devices?

* Who is responsible for uploading applications to the smartphones?
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8. Implement a proof of concept and pilot program
A proof of concept outlines factors that determine the viability of the proposed solution. The pilot includes an assessment of IT infrastructure to support mobile devices, identification of users and use cases for clinical smartphones, establishing processes for gathering feedback and suggestions, and understanding the logistical implications of mobile devices, such as battery management, loss and theft prevention, and usage etiquette.
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9. Address experience and confidence levels
While smartphones are increasingly popular, not all caregivers have adopted them in their personal lives. Therefore, it is important to tailor the orientation to a variety of experience levels for the team to gain the comfort and confidence to use the phones.
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10. Address operational issues
Such issues include training and support requirements as deploying a clinical smartphone strategy will impact clinical workflows or create new workflows, which will require staff education. Determine the level of support the in-house IT team will provide for mobile issues related to the device, applications, provisioning, configuration and connectivity. Augmenting the IT team with outside technical resources may be necessary to offer 24-by-7 support.