Appl Clin Inform 2016; 07(03): 777-789
DOI: 10.4338/ACI-2015-11-RA-0151
Research Article
Schattauer GmbH

Perfect Storm of Inpatient Communication Needs and an Innovative Solution Utilizing Smartphones and Secured Messaging

Neha Patel
1  Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania
James E. Siegler
2  Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Nathaniel Stromberg
3  Center for Clinical Effectiveness & Quality Improvement, University of Pennsylvania Health System, Philadelphia, Pennsylvania
Neil Ravitz
4  Presbyterian Medical Center, Philadelphia, Pennsylvania
C. William Hanson
5  Department of Anesthesia, and Chief Medical Informatics Officer, University of Pennsylvania Health System, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

received: 14 November 2015

accepted: 27 March 2016

Publication Date:
19 December 2017 (online)



In hospitals, effective and efficient communication among care providers is critical to the provision of high-quality patient care. Yet, major problems impede communications including the frequent use of interruptive and one-way communication paradigms. This is especially frustrating for frontline providers given the dynamic nature of hospital care teams in an environment that is in constant flux.


We conducted a pre-post evaluation of a commercially available secured messaging mobile application on 4 hospital units at a single institution for over one year. We included care providers on these units: residents, hospitalists, fellows, nurses, social workers, and pharmacists. Utilization metrics and survey responses on clinician perceptions were collected and analyzed using descriptive statistics, the Kruskal-Wallis test, and Mann-Whitney U test where appropriate.


Between May 2013 and June 2014, 1,021 providers sent a total of 708,456 messages. About 85.5% of total threads were between two providers and the remaining were group messages. Residents and social workers/clinical resource coordinators were the largest per person users of this communication system, sending 9 (IQR 2–20) and 9 (IQR 2–22) messages per person per day, and receiving 18 (IQR 5–36) and 14 (IQR 5–29) messages per person per day, respectively (p=0.0001). More than half of the messages received by hospitalists, residents, and nurses were read within a minute. Communicating using secured messaging was found to be statistically significantly less disruptive to workflow by both nursing and physician survey respondents (p<0.001 for each comparison).


Routine adoption of secured messaging improved perceived efficiency among providers on 4 hospital units. Our study suggests that a mobile application can improve communication and workflow efficiency among providers in a hospital. New technology has the potential to improve communication among care providers in hospitals.

Citation: Patel N, Siegler JE, Stromberg N, Ravitz N, Hanson CW. Perfect storm of inpatient communication needs and an innovative solution utilizing smartphones and secured messaging.