The Center for Tech Innovation at the University of Maryland Medical System/UMD School of Medicine has created a custom secure messaging platform fully integrated into the organization's electronic health record, which leverages their secure messaging vendor API to allow for flexibility and scalability.

This development has opened enormous opportunities for more intelligent targeted decision support, and it also allows them to customize messages to provide meaningful content to the right clinicians at the right time.

The triggering framework was designed to leverage existing EHR hooks and rules, making incremental deployment fast, easy and reliable, explained Dr. Dan Lemkin, senior director of the Center for Tech Innovation at the University of Maryland Medical System/UMD School of Medicine.

Lemkin, who will speak on the topic next week at HIMSS22, explained the EHRs are built upon frameworks that leverage extensive rules engines.

"They are also constantly logging timestamps and events to document actions and facilitate accountability," he said. "Fortunately, these actions are often directly correlated with relevant clinical and operational actions which would benefit from automated secure messaging."

For example, if you wish to be notified when patients meeting specific clinical criteria arrive in the ED, you can simply leverage a standard ADT arrival event to trigger an outbound secure message.

To ensure the message is only routed on appropriate patients, you can leverage the native rules engine to compare criteria for each patient, for example, patients over 65 years old or with a history of hypertension.

These native functions provide two key elements: the trigger or hook, which initiates the message, and the logic validation to meet the required clinical or operational goal of the message.

Lemkin pointed out the use cases for such a messaging system are as vast as medicine itself.

"Basic drivers would include patient safety, critical result notifications, patient throughput, provider efficiency, provider satisfaction, financial considerations and regulatory compliance," he said.

He added that because clinicians are inundated with information constantly, if you blast people with alerts that are not providing them actionable information, you are just creating more noise.

"For example, our code blue alert is not just announcing a room to respond to – it is providing critical information about the patient so responding providers can mentally prepare for the resuscitation," he said.

"If you provide relevant information that makes it easier for people to perform their duties, they will accept and come to depend on it. If you blast people with noise, they will ignore it."

Lemkin's HIMSS22 session, "Intelligent, Deeply EMR Integrated Secure Messaging Service," is scheduled for Tuesday, March 15, from 10:30-11:30 a.m., in room W330A. 

Nathan Eddy is a healthcare and technology freelancer based in Berlin.
Email the writer: nathaneddy@gmail.com
Twitter: @dropdeaded209