The Strengths and Limitations of Epic Secure Chat for Critical Healthcare Communication

As an EHR, Epic is very impressive; it boasts a modern-looking and user-friendly interface, has a deeply integrated clinical decision support system to provide real time alerts and best practice guidelines at the point of care, and is completely customizable to suit each organization's best practices. But, how does it fair as a communication platform? 

Epic has its own HIPAA-Compliant secure messaging solution called “Secure Chat” that’s somewhat similar to Hypercare’s messaging app. Integrated directly into the EHR, Secure Chat is easy to use on the desktop app. However, once you get started, you’ll see the gaps in communication that begin to form. First, you’ll notice that getting a quick response on Secure Chat can often be a hit-or-miss. This is because many doctors don’t receive messages on their phones because they are uncomfortable using Epic’s mobile app “Haiku”.

But, what’s wrong with the “Haiku” app? The answer is actually, well… nothing. You’re not only able to use the Haiku app to send and receive messages, you can also access the entire patient chart. Given the sensitivity of patient data, organizations typically require physicians to have their personal devices managed by Mobile Device Management (MDM) – security software solutions that enable organizations to manage, monitor, and control devices. This is something that physicians aren’t often comfortable with as it provides organizations access to their personal device and all of its contents and functions. This hesitation to install Haiku on their personal devices creates uncertainty as to whether they will get timely notifications, particularly worrisome for critical alerts like code team activations.

Even if it were the perfectly adopted messaging app, communication in healthcare is complex and goes far beyond simply sending and receiving messages – providers frequently need to navigate a maze of channels to ensure they’re reaching out to the right person, at the right time, and with the right mode of communication tailored to the acuity of the situation. Unlike Hypercare, Secure Chat doesn’t quite meet those requirements. Therefore, Secure Chat is rarely if ever used as a full-fledged communication tool and certainly not used in critical communication workflows, such as for code team activations or when escalation of care is required. 

Hypercare is currently used in hundreds of healthcare organizations, some of which are on Epic EHR. However, these organizations choose to use Hypercare specifically to support critical communication pathways. Now you may ask, what does Hypercare do differently that makes it so effective for critical communication? The key difference is that Hypercare looks beyond simple messaging and focuses on the entire communication journey from start to finish.

Here’s a scenario - A patient has arrived in the emergency department at 3AM and is having serious chest pain and having trouble breathing. An EKG is done immediately and it shows findings concerning for a STEMI. How would you communicate this through the relevant teams?

Step 1: Identifying the Right Provider -  Between having to call switchboard locating or search up a call schedule uploaded to the hospital intranet SharePoint, figuring out who’s on-call can be a time-consuming and inaccurate process. Given that this is the first step of the communication journey, it is vitally important that you can accurately and efficiently communicate with the right people in critical situations.

• With Hypercare, the responding clinician can quickly identify and reach out to the interventional cardiologist (IC) on-call by accessing the real-time updated on-call schedule on mobile and desktop-based platforms in just 2 taps

Step 2: Convey the urgency of the situation - You’ve identified the IC on-call, now you need to get in touch with the provider to review an EKG of a patient who’s rapidly deteriorating with a possible STEMI. Given the urgency of the situation, you’ll want to ensure that the notification informing them of the possible STEMI as well as the EKG are going to get their attention even if they’re busy or asleep.

• After selecting the IC on-call, the sending provider can attach an EKG to the message and set the urgency of the message to “STAT” which will bypass do-not-disturb and sound blockers (eg. silent mode) to blare through the receiver’s device
• All this is done in a HIPAA-Compliant secure platform, so full patient information can be securely shared

Step 3: Activate the automated code team notification - The IC has received the EKG and confirmed the STEMI, they’ll need to activate the rest of the STEMI team to come in. Typically this involves a clerk having to figure out each provider on-call then manually page or call those providers - providers would then need to call back to acknowledge the page. This process is needlessly time consuming and takes away resources that would otherwise be spent preparing for the incoming patient. 

• Once STEMI is confirmed, the IC can trigger the “Code STEMI” to notify the relevant techs, nurses, and support staff of an incoming patient with 1 tap
• An activation will create a dynamic group chat and send a STAT message to the specific providers based on who is on-call for each role at that moment. If a team member does not read their message in a timely manner, Hypercare will automatically escalate notifications, including automated phone calls and SMS messages, until the user opens Hypercare to acknowledge the activation. It keeps the entire team informed as to who is on their way and who is still missing, so adjustments can be made rapidly if necessary.

By bridging the various aspects of communication that were once siloed, Hypercare is able to not only streamline Code STEMIs, but many other critical workflows across the hospital (e.g. Code Stroke, Code Blue, Trauma Team Activations). To learn more about the hundreds of healthcare organizations that have adopted Hypercare’s full suite of services to support critical workflows, contact our team of physicians, nurses, and healthcare technology experts to discover how Hypercare can help.