The Evolution of Clinical Communication: From Pagers to Smartphones

Imagine a nurse on a busy hospital floor, needing to urgently consult with the on-call senior resident about a patient whose condition is worsening. The patient’s symptoms have taken a troubling turn, and the nurse knows that immediate intervention is essential. However, she doesn’t know who the on-call resident is.

She picks up the phone and places a call to the operator at the hospital's switchboard. The nurse explains the situation and asks to be connected to the on-call senior resident for internal medicine. The switchboard operator looks up who is on call and finds the resident, Dr. Smith, who is currently on duty.

It seems like a pretty organized response, doesn't it?

Wrong.

The switchboard operator pages Dr. Smith's pager, "Urgent call from Nurse [Name] regarding a patient in Room 402." But Dr. Smith is in to see another patient and doesn't immediately see the page. Minutes tick by before he notices the alert and finds a phone to return the call.

The nurse, of course, is waiting anxiously, knowing that every minute counts for the patient’s care. It feels like hours as seconds tick by until finally Dr. Smith calls back and they discuss the situation with the resident giving necessary instructions.

The whole process—from the nurse making a call to the resident's finally returning it—could take some critical minutes. A delay like this in a hospital setting can make all the difference between a timely intervention and worsening of conditions.

Such is the complexity and the challenges of the older methods of communication. The use of pagers and switchboard operators usually caused great delays: messages were not instantly received, and sometimes, a return call just to reply could already take so much time off of critical decision-making. Pagers were unable to give specific details and had to be intervened with manually to convey the message; the switchboard system was always overloaded, therefore always prone to human error, further complicating urgent communication.

Although these at one time were redeeming systems for hospital communications, they have really come a long way. Indeed, some hospitals still use these old workflows, but they are fast becoming the exception. However, to put into better perspective these advancements that make it possible for Dr. Smith to respond instantaneously and, let's say, administer patient-saving treatment—let's first take a step back and understand how communication technology has evolved to get where it is.

Flashback - The Early days of Healthcare Communication

During the late 20th to early 21st centuries, hospitals increasingly relied on a mix of technologies to facilitate communication between healthcare providers. Pagers, or “beepers”, which gained prominence in the 1980s and 1990s, were particularly notable. These devices allowed healthcare professionals to receive critical alerts anywhere within the hospital, thanks to their robust radio frequencies.

During this era, internal telephone systems also became widespread in hospitals, enabling direct communication between departments, wards, and patient rooms. This system introduced efficiencies to healthcare communication workflows by allowing providers to quickly connect and discuss patient care. In parallel, fax machines were used to transfer patient records, prescriptions and other documents between departments and external providers.

As mobile phones and texting became more common in the following years, pager emulation technology began to emerge. Phone apps designed to mimic pagers allowed users to receive and send simple alerts similar to traditional pagers, but with the added advantage of overcoming geographical limitations. This blend of familiar paging interface with the flexibility and reach of mobile networks, offering a more versatile communication tool while still addressing the need for reliable alerting. 

By late 2010s, secure messaging apps began to gain prominence, marking a significant leap in healthcare communication. These tools combined the urgency of a paging app with the encryption and compliance standards of HIPAA, enabling healthcare providers to mobilize teams during emergencies and securely collaborate with staff on the same platform.
The impact of these advancements was recently underscored by astudy conducted at the University of Marland Medical Center in Baltimore, which found that patient survival rates increased by an average of 8%, from 17% to 25%, where care providers were promptly notified of a code blue situation through a smartphone-based clinical communication app.
The rise of secure messaging apps also addressed many of the privacy and security concerns associated with earlier communication methods, providing a more integrated and confidential platform for patient and provider interactions.

Leveraging CC&C Tools for Optimized Workflows

Fast forward to today, and Clinical Communication and Collaboration (CC&C) tools have revolutionized healthcare communication in ways that just about no one would have envisioned a couple of decades ago. The COVID-19 pandemic hasaccelerated the adoption of these solutions and cemented this tool right into the hospital settings for secure, efficient communication.
Now, let’s revisit the scenario from earlier, but this time, with the benefits of modern technology:

The nurse on the busy hospital floor, urgently needing to consult with the on-call senior resident about a patient whose condition is worsening, no longer faces the cumbersome process of paging through a switchboard. Instead, she uses a smartphone-based clinical communication app. This app is seamlessly integrated with the hospital's medical systems and other collaboration tools like Slack and Teams, providing a centralized, secure interface for all critical communications.

With just a few taps, the nurse sends an urgent consult request to the "on-call resident" group. The app, leveraging configurable on-call schedules, automatically identifies Dr. Smith as the primary on-call resident and instantly delivers the necessary patient information to him in real-time, ensuring he is fully informed and ready to act. The nurse can also quickly access the app to view the on-call schedule, confirming who received the message, and check read receipts to ensure the alert was acknowledged.

The beauty of this system is that it’s quick, flexible and highly dependable. An instant alert will be received by Dr. Smith. If he is unable to respond, the app automatically escalates the alert to the next available resident based on pre-established escalation policies, ensuring that no time is lost. In this streamlined workflow, the delays that once plagued hospital communication are virtually eliminated, allowing Dr. Smith to deliver timely, life-saving care.

The benefits are clear: CC&C tools have transformed the way healthcare teams communicate, collaborate, and coordinate. Additionally, the system maintains on-call schedules, enables priority-based messaging, enables automated call routing from patients, and provides phone alerts for any critical updates related to the patient from EHR.  By consolidating various communication functions into a single, unified platform, these tools empower healthcare professionals to work more efficiently and effectively.

The evolution from outdated pager systems to sophisticated CC&C solutions marks a significant leap forward in healthcare technology, ultimately leading to better patient outcomes and a more responsive care environment.

In this new era of healthcare communication, every moment counts—and now, every moment is optimized to save lives.