Improving Communication in a Large Urban Academic Safety Net Hospital System: Implementation of Secure Messaging.

Given the complexities of communication within health systems, we investigated how the implementation of secure messaging in addition to traditional paging would impact hospital communication. This study was implemented at Grady Health System (GHS), a large safety net academic hospital system in metro Atlanta that includes inpatient and ambulatory settings. GHS uses Epic Electronic Health Record (EHR), and secure messaging was performed using Epic Haiku Platform. To assess states of communication, we implemented pre- and post-surveys. The secure messaging data tracked from 2018 to 2022 demonstrated a rise in usage from 9,378 chats per month when it went live in August 2018 to greater than 200,000 monthly messages during the pandemic when social distancing measures were enacted. Monthly usage peaked in March 2022 with 378,932 messages. Pre-and-post survey questions using a Likert scale (1-4) showed increased agreement in the ability to reach all team members through secure chat amongst healthcare workers. Within our unit staff, communication improved by being more rapid and reliable, as the Likert scale means increased from 2.18 pre-survey to 2.63 post survey. Pre-and-post survey analysis indicates improved satisfaction across GHS stakeholders with the implementation of secure chat in addition to the existing direct-paging system. Next steps could include exchanging digital media through secure messaging to facilitate faster diagnosis and treatment of certain medical conditions. Secure messaging integrated within the EHR (including mobile devices) enhances communication between healthcare team members in a HIPAA-compliant way reducing the number of pages and phone calls.