Paul Hess, Research Director, KLAS
The secure communications market was born to fix a gap in health systems’ adherence to HIPAA. One of the generally recognized truths in healthcare is that clinicians often use their personal cell phones to text their colleagues about work. Physicians can easily mention a patient in these conversations and run the serious risk of violating HIPAA.
As we’ve seen in plenty of other healthcare IT segments, once a need or problem is widely identified, vendor offerings explode relative to how high the bar is for entrance into the space. In our first report on secure communications several years ago, KLAS found over 120 vendors that claimed to play in the rapidly emerging market.
Healthcare organizations immediately realized that simply putting a secure-messaging application onto clinicians’ phones at a department level does not ensure adoption, and thus, does not completely address the risks associated with HIPAA.
Since that time, vendors have been known to tout how many millions or hundreds of thousands of messages they have running through their system each month, and how usable their solutions are — as if to say the sheer number of necessary messages clearly demonstrates adoption. The truth is that the number of messages tells us little regarding adoption; healthcare organizations are still at risk.
Some health systems recognized early on that true adoption is likely to occur when a secure messaging solution becomes not only the system’s secure messaging application, but their enterprise communication platform. Those platforms could include communication workflows that enable clinicians and other staff to do their jobs more efficiently; interface with their EMR for role assignments, patient context, nurse call, lab results, secondary alarms and notifications, and ADT feeds; tie together both asynchronous and synchronous communication; and can be used by all personnel. Such a solution can eliminate the potential for breaking HIPAA laws by using SMS texts.
The market has evolved over the years as HIPAA-compliant communication vendors have created additional functionalities. These days, secure communication tools typically aren’t just messaging apps; vendors are targeting the functionality to become communications platforms. These are often referred to as “Clinical Communication and Collaboration” or “Unified (Enterprise) Communication Platforms.”
Clinical Communication & Collaboration Platforms
With these platforms, the emphasis has been patient-centered or role-based communications, where each member of an individual patient’s care team can tie directly into communications relating to the patient. This includes the assigned nurse, hospitalist physician, therapists, dieticians, and any number of on-call specialists. The platforms can also grow to encompass housekeeping and environmental teams.
They require a high degree of interoperability or many interfaces with disparate systems to pull together or utilize data from the EMR or third-party alert systems, including notifications, patients’ test results, updates on patient vitals, secondary alarms from patient monitors, etc. The platforms must provide routing, escalation, on-shift/off-shift intelligence, and other things, all in one communication system.
Unified Communication Platforms
These platforms look to bridge the gap between asynchronous communication — email, text messages, chat, instant-messaging features, synchronous communication, VoIP, PBX phone system interfaces, and clinical communication and collaboration platforms.
Where is the Market Headed?
With the exception of HIPAA-compliant messaging, the secure-communications market is very different from one vendor to the next. Each vendor has looked at this market and tried to solve a specific problem.
For example, Voalte’s strategy has been to get smartphones into the hands of nurses. They also formed a strategic relationship with Connexall, an alarm management middleware vendor, to help pioneer secondary alarms that are delivered directly to smart phones.
Another example is Vocera, which acquired the alarm-management middleware vendor Extension Healthcare back in October of 2016 to enable the delivery of forward alarms to smart devices for nurses and physicians alike.
Other vendors have built physician on-call scheduling functionality as well as interfaces with other vendors’ physician on-call scheduling software in an effort to automate and streamline the communication workflows between on-call physicians and other hospital staff, including nurses.
We also see vendors trying to position their products as more broadly applicable communications platforms. TigerText took the opportunity at HIMSS18 to push their new name, TigerConnect, and Doc Halo has rebranded to Halo Communications to avoid being pigeonholed into anything less than a broadly used communication platform.
For now, the market is segmented by solutions attempting to address different communication workflow challenges — the most basic, of course, being the replacement of personal SMS texts with HIPAA-compliant messaging solutions. Over time, I expect this market to have a set of holistic communication platforms akin to the previously mentioned Unified Communications Platform or Clinical Communication and Collaboration Platforms.
In the meantime, vendors are in the emerging stages of developing splintered functionalities, deploying and testing interfaces, and solving problems with the breadth of communication workflows.
Decision Insights
I’ve been working with our Decision Insights team to uncover providers’ perceptions around secure-communication buying decisions. This market suffers from a flood of marketing speak. I can’t tell you how many times vendors may say, “We can interface to X, Y, and Z!” when in reality, they only have a single customer doing it. And so, while the vendor can in fact create that interface, signing on essentially means you’ll be a beta-test case for them going forward (a detail that often doesn’t make it into the marketing copy).
When we publish our Decision Insights data later this year, we’ll be able to identify why providers chose their current vendors (whether their priority is secondary-alarm functionality or nurse communication), and hopefully begin to shape a pecking order. We’re confident these insights will help providers who are still determining their paths for secure communication.
This piece was written by Paul Hess, a Research Director at KLAS specializing in secure messaging, medical device integration, pharmacy automation, and other clinically focused applications. For more information about KLAS, click here.]
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