Secure Messaging in Practice: Optimizing Clinic Value

The Canadian healthcare system is overburdened. One of the main contributors to excess demand is a structure built around referrals. Patient hand off in the form of referrals is an open chasm through which thousands of patients fall each year. Even when hand offs are successful, patients can wait as long as 2 years for a specialist appointment only to discover there is a specialist-condition mismatch and they need to get in another line. These inefficiencies are not the fault of any member of the system, but of the system itself, and they are completely avoidable with the use of secure messaging.

The problem with current clinical communication

If Canadian Physicians want to get serious about fixing the system, they need to axe the fax. Healthcare professionals rely heavily on access to health information from outside their organizations to make treatment decisions, yet communicating or accessing that information remains a difficult task. While clinics can communicate somewhat effectively within their four walls, it becomes problematic when institutional silos try to share patient information. Even though patient information is largely electronic, the phone/fax are still the main modes of exchange used. While fax machines may be able to transmit information with a measure of security, that information isn’t completely secure. Important data can be lost amongst stacks of pizza flyers and travel offers; resulting in hours of time-consuming follow-up and confirmation. Perhaps most importantly there’s no traceable chain of custody to know if the right person has received the fax (misdials?), or how many other prying eyes viewed confidential information while it sat in the open, waiting for it’s intended recipient. Phone is not efficient because it is meant to be a real-time form of communication but modern use relies on voicemail. People don’t answer their phone and when they check messages, they often don’t have a pen and paper to copy down a return number. Using secure messaging in your clinic allows for greater detail in messages and includes the reply button phone messages sorely lack.  

Physician To Physician Secure E-Consultation

Changes made to the Alberta Health Care Insurance Plan Schedule of Medical Benefits on April 1, 2016, have introduced several policies that uniquely support and encourage the clinical use of secure messaging in healthcare. By adopting secure messaging to communicate with patients and other healthcare professionals, clinics can accelerate treatment, reduce administrative costs, and employ additional service codes in day to day practice. Dr. Mark Lewis, clinic director of the Caleo clinic in Calgary, Alberta explains "In the past, we had 'file rooms' full of documents so if a patient called to see if we'd received their referral, we'd have to go into that room and search through hundreds, sometimes thousands of pieces of paper”. Through the implementation of secure messaging the clinic is now seeing better collaboration with referring clinics, decreased wait times, and improved patient outcomes as overhead shrinks significantly. “The time to make first contact with a referred patient has dropped up to 90 per cent, from six to twelve weeks to just five days. The time to see our spine assessment team has also dropped by 60 per cent, from six to eight months down to two to three months”. This is significantly below the Fraser Institute’s 2015 report that estimated patient wait times of 8.5 weeks for an appointment with a specialist. Lengthy patient wait times for specialist consultations and treatment present some of the largest barriers to accessing care in Canada. E-Consult services have the potential to play a key role in breaking down these barriers and can result in improved patient outcomes at a lower cost. E-Consults provide timely collaboration between physicians as well as other allied healthcare professionals. These discussions assist General Practitioners in providing better patient outcomes in their home clinics, reducing the number of unnecessary specialist referrals. Specialists that provide opinions via e-Consultations will also benefit by streamlining their referrals to ensure accurate information is being sent the first time. In fact, by focusing clinical and administrative efforts on patients that require an office visit, and redirecting those in the wrong line, specialist clinics become more productive with fewer missed or canceled appointments.  

Patient to Physician Secure Communication

Patient-physician secure messaging is another way that secure messaging technology is creating clinical and administrative efficiencies. As of April 1, 2016, physicians in Alberta are able to bill for medical advice included in secure messages delivered to patients. Addressing patient concerns via secure mail reduces unnecessary patient visits, making room for patients in need of in-person examinations; increasing overall capacity to care for new and existing patients. Shauna Wilkinson, Executive Director, Crowfoot Family Village Practice explains that “Patients who receive email are thrilled to have their questions answered without ever having to come into our clinic.” A study by Kiaser Permanente examining the use of secure mail between physicians and patients heard doctors say, “[Patients] follow my instructions to the letter with e-mail. It’s easy, helpful, and better than playing phone tag.” The next step, according to Dr. Norman Yee, “is to loop in the patient to this secure system of communicating”. While physicians may be the ‘custodians’ of patients health information, the results are owned by the patient. Dr. Norm Yee says he emails with his patients using Brightsquid. “It’s my goal to bring patients into the communication loop where they advocate for themselves, maintaining their own personal health record.  

Optimized Clinic Value

Clinics that choose to axe the fax in favour of secure medical grade messaging technologies enhance clinic productivity, ensure better treatment compliance, and accelerate referrals to reduce wait times from months to days. Collaboration through the use of Brightsquid’s Secure Health Exchange provides secure access to medical records from any internet enabled device. Rohit Joshi, CEO, Brightsquid Secure Health Exchange believes that “in the next 5 years clinical care coordination will do more to advance patient health than any single drug or medical device”. It’s with that mindset that Brightsquid’s medical-grade messaging platform was born. The service provides an entry point from which physicians, practitioners and allied healthcare professionals can access and exchange health information in collaboration with their patients and their patients’ healthcare teams.