The use of smartphones for clinical communication on internal medicine wards

Authors

  • Robert C. Wu MD MSc,

    Corresponding author
    1. Division of General Internal Medicine, University Health Network, Toronto, Canada
    2. Department of Medicine, University of Toronto, Toronto, Canada
    3. Centre for Innovation in Complex Care, University Health Network, Toronto, Canada
    • Toronto General Hospital, 14EN-222, 200Elizabeth St, Toronto, Ontario, Canada, M5G 2C4
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    • Telephone: 416-340-4567; Fax: 416-595-5826

  • Dante Morra MD MBA,

    1. Division of General Internal Medicine, University Health Network, Toronto, Canada
    2. Department of Medicine, University of Toronto, Toronto, Canada
    3. Centre for Innovation in Complex Care, University Health Network, Toronto, Canada
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  • Sherman Quan BSc,

    1. Centre for Innovation in Complex Care, University Health Network, Toronto, Canada
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  • Sannie Lai RN BScN,

    1. Division of General Internal Medicine, University Health Network, Toronto, Canada
    2. Centre for Innovation in Complex Care, University Health Network, Toronto, Canada
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  • Samira Zanjani RN BScN,

    1. Division of General Internal Medicine, University Health Network, Toronto, Canada
    2. Centre for Innovation in Complex Care, University Health Network, Toronto, Canada
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  • Howard Abrams MD BSc,

    1. Division of General Internal Medicine, University Health Network, Toronto, Canada
    2. Department of Medicine, University of Toronto, Toronto, Canada
    3. Centre for Innovation in Complex Care, University Health Network, Toronto, Canada
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  • Peter G. Rossos MD MBA

    1. Department of Medicine, University of Toronto, Toronto, Canada
    2. Centre for Innovation in Complex Care, University Health Network, Toronto, Canada
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  • Funding for part of this implementation was made possible through the work of a clinical alerting project funded by the Canadian Patient Safety Institute. The remainder of the funding was from the University Health Network.

  • Disclosure: None of the investigators have a direct personal financial interest in Research in Motion. Research in Motion did not fund this study and has not provided any funds to University Health Network to the best of our knowledge.

Abstract

BACKGROUND:

Communication between clinicians is hampered by the frequent difficulty in reaching the most responsible physician for a patient as well as the use of outdated methods such as numeric paging. The aim of this study was to evaluate the use of smartphones to improve communication on internal medicine wards.

METHOD:

At the Toronto General Hospital, residents were provided with smartphones. To simplify reaching the most responsible resident for a patient, a smartphone designated as “Team BlackBerry” was also carried by each senior resident and then passed to the resident covering the team at night and on weekends. Nurses were able to send email messages or call smartphones directly.

RESULTS:

There were on average of 9.1 incoming calls, 6.6 outgoing calls, 14.3 received emails, and 2.8 sent emails per day to each Team BlackBerry. Team BlackBerrys received up to 35 calls and 57 emails per day. Residents strongly preferred the smartphones over conventional paging with perceived improvements in all items measured and felt that it improved efficiency and communication. Although nurses perceived a reduction in the time required to contact a physician (27.6 vs. 11 minutes P < 0.001), their overall satisfaction with physician's response time for urgent issues did not improve significantly.

DISCUSSION:

When smartphones were used for clinical communication, residents perceived an improvement in communication with them. Residents strongly preferred emails as opposed to telephone calls as the prime method of communication. Further objective evaluation is necessary to determine if this intervention improves efficiency and more importantly, quality of care. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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