The impact of mobile technology on teamwork and communication in hospitals: a systematic review

OBJECTIVES Effective communication is critical to the safe delivery of care but is characterized by outdated technologies. Mobile technology has the potential to transform communication and teamwork but the evidence is currently uncertain. The objective of this systematic review was to summarize the quality and breadth of evidence for the impact of mobile technologies on communication and teamwork in hospitals. MATERIALS AND METHODS Electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL Plus, HMIC, Cochrane Library, and National Institute of Health Research Health Technology Assessment) were searched for English language publications reporting communication- or teamwork-related outcomes from mobile technologies in the hospital setting between 2007 and 2017. RESULTS We identified 38 publications originating from 30 studies. Only 11% were of high quality and none met best practice guidelines for mobile-technology-based trials. The studies reported a heterogenous range of quantitative, qualitative, and mixed-methods outcomes. There is a lack of high-quality evidence, but nonetheless mobile technology can lead to improvements in workflow, strengthen the quality and efficiency of communication, and enhance accessibility and interteam relationships. DISCUSSION This review describes the potential benefits that mobile technology can deliver and that mobile technology is ubiquitous among healthcare professionals. Crucially, it highlights the paucity of high-quality evidence for its effectiveness and identifies common barriers to widespread uptake. Limitations include the limited number of participants and a wide variability in methods and reported outcomes. CONCLUSION Evidence suggests that mobile technology has the potential to significantly improve communication and teamwork in hospital provided key organizational, technological, and security challenges are tackled and better evidence delivered.

[1]  Robert C. Wu,et al.  Research and applications: The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals , 2013, J. Am. Medical Informatics Assoc..

[2]  R. Wyber,et al.  The Gr8est Good: Use of text messages between doctors in a tertiary hospital , 2013 .

[3]  Emily Newman,et al.  PROSPERO International prospective register of systematic reviews , 2017 .

[4]  Ritu Agarwal,et al.  Quantifying the Economic Impact of Communication Inefficiencies in U.S. Hospitals , 2010, Journal of healthcare management / American College of Healthcare Executives.

[5]  Dante Morra,et al.  A smartphone-enabled communication system to improve hospital communication: usage and perceptions of medical trainees and nurses on general internal medicine wards. , 2015, Journal of hospital medicine.

[6]  W. Dunsmuir,et al.  Association of interruptions with an increased risk and severity of medication administration errors. , 2010, Archives of internal medicine.

[7]  R. Wu,et al.  Educational impact of using smartphones for clinical communication on general medicine: more global, less local. , 2013, Journal of hospital medicine.

[8]  Enrico Coiera,et al.  Interdisciplinary communication: an uncharted source of medical error? , 2006, Journal of critical care.

[9]  Kambria H. Evans,et al.  Smarter hospital communication: Secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow , 2014, Journal of hospital medicine.

[10]  Ivan Ng,et al.  Multimedia Messaging Service teleradiology in the provision of emergency neurosurgery services. , 2007, Surgical neurology.

[11]  Maria Lindén,et al.  Clinical decision support systems in hospital care using ubiquitous devices: Current issues and challenges , 2019, Health Informatics J..

[12]  A. Lefevre,et al.  Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist , 2016, British medical journal.

[13]  Brian P. Bailey,et al.  On the need for attention-aware systems: Measuring effects of interruption on task performance, error rate, and affective state , 2006, Comput. Hum. Behav..

[14]  Sasa Espino,et al.  Alphanumeric paging: a potential source of problems in patient care and communication. , 2011, Journal of surgical education.

[15]  C Zinn,et al.  14000 preventable deaths in Australian hospitals , 1995, BMJ.

[16]  Daniela P Ladner,et al.  The role of technology in clinician-to-clinician communication , 2013, BMJ quality & safety.

[17]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement , 2009, BMJ : British Medical Journal.

[18]  C. William Hanson,et al.  Perfect Storm of Inpatient Communication Needs and an Innovative Solution Utilizing Smartphones and Secured Messaging , 2016, Applied Clinical Informatics.

[19]  Tom C Nguyen,et al.  Alphanumeric paging in an academic hospital setting. , 2006, American journal of surgery.

[20]  N Sevdalis,et al.  The association of workflow interruptions and hospital doctors' workload: a prospective observational study , 2011, BMJ quality & safety.

[21]  Robert C Wu,et al.  Analysis of Smartphone Interruptions on Academic General Internal Medicine Wards , 2017, Applied Clinical Informatics.

[22]  Sean P. Spina,et al.  Integrating smartphone communication strategy and technology into clinical practice: A mixed methods research study , 2016 .

[23]  R. Wu,et al.  The use of smartphones on General Internal Medicine wards , 2014, Applied Clinical Informatics.

[24]  E. Coiera.  When conversation is better than computation. , 2000, Journal of the American Medical Informatics Association : JAMIA.

[25]  Stacey L Gulick,et al.  To text or not to text? , 2012, Journal of the American College of Radiology : JACR.

[26]  Samina A. Khan,et al.  Mobile Phone Use Among Medical Residents: A Cross-Sectional Multicenter Survey in Saudi Arabia , 2016, JMIR mHealth and uHealth.

[27]  M. Kerin,et al.  Interns and their smartphones: use for clinical practice , 2013, Postgraduate Medical Journal.

[28]  V. Mounasamy,et al.  “WhatsApp”ening in orthopedic care: a concise report from a 300-bedded tertiary care teaching center , 2015, European Journal of Orthopaedic Surgery & Traumatology.

[29]  D. Moher,et al.  CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials , 2010, BMC medicine.

[30]  C. Weissman,et al.  Cell Phone Calls in the Operating Theater and Staff Distractions: An Observational Study. , 2017, Journal of patient safety.

[31]  Ara Darzi,et al.  The ownership and clinical use of smartphones by doctors and nurses in the UK: a multicentre survey study , 2015, BMJ Innovations.

[32]  Rai-Fu Chen,et al.  An Investigation on Task-Technology Fit of Mobile Nursing Information Systems for Nursing Performance , 2012, Computers, informatics, nursing : CIN.

[33]  S. Brandt,et al.  Mobile Electronic Medical Records Promote Workflow: Physicians’ Perspective From a Survey , 2016, JMIR mHealth and uHealth.

[34]  Karl A. Stroetmann,et al.  United in Diversity: Legal Challenges on the Road Towards Interoperable eHealth Solutions in Europe , 2012 .

[35]  Vineet M Arora,et al.  Resident Use of Text Messaging for Patient Care: Ease of Use or Breach of Privacy? , 2015, JMIR medical informatics.

[36]  Aude Motulsky,et al.  Using mobile devices for inpatient rounding and handoffs: an innovative application developed and rapidly adopted by clinicians in a pediatric hospital , 2017, J. Am. Medical Informatics Assoc..

[37]  Robert C. Wu,et al.  Effects of clinical communication interventions in hospitals: A systematic review of information and communication technology adoptions for improved communication between clinicians , 2012, Int. J. Medical Informatics.

[38]  Kevin J O'Leary,et al.  Where did the day go?--a time-motion study of hospitalists. , 2010, Journal of hospital medicine.

[39]  Robert C. Wu,et al.  The use of smartphones in general and internal medicine units: A boon or a bane to the promotion of interprofessional collaboration? , 2012, Journal of interprofessional care.

[40]  D. Moher,et al.  CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials , 2010, Journal of clinical epidemiology.

[41]  Umut Gulacti,et al.  An Analysis of WhatsApp Usage for Communication Between Consulting and Emergency Physicians , 2016, Journal of Medical Systems.

[42]  E. Coiera,et al.  Improving clinical communication: a view from psychology. , 2000, Journal of the American Medical Informatics Association : JAMIA.

[43]  Wendy L. Currie,et al.  A cross-national analysis of eHealth in the European Union: Some policy and research directions , 2014, Inf. Manag..

[44]  M. Farrell.  Use of iPhones by Nurses in an Acute Care Setting to Improve Communication and Decision-Making Processes: Qualitative Analysis of Nurses’ Perspectives on iPhone Use , 2016, JMIR mHealth and uHealth.

[45]  W. Dunsmuir,et al.  The impact of interruptions on clinical task completion , 2010, Quality and Safety in Health Care.

[46]  Scott Reeves,et al.  An Evaluation of the Use of Smartphones to Communicate Between Clinicians: A Mixed-Methods Study , 2011, Journal of medical Internet research.

[47]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement , 2009, BMJ.

[48]  David N. Ranney,et al.  Resident Workload, Pager Communications, and Quality of Care , 2010, World Journal of Surgery.

[49]  The Joint Commission's Sentinel Event Policy: ten years of improving the quality and safety of health care. , 2005, Joint Commission perspectives. Joint Commission on Accreditation of Healthcare Organizations.

[50]  K. Sutcliffe,et al.  Communication Failures: An Insidious Contributor to Medical Mishaps , 2004, Academic medicine : journal of the Association of American Medical Colleges.

[51]  J. Murphy.  The General Data Protection Regulation (GDPR) , 2018, Irish medical journal.

[52]  Marc Berg,et al.  Viewpoint Paper: Some Unintended Consequences of Information Technology in Health Care: The Nature of Patient Care Information System-related Errors , 2003, J. Am. Medical Informatics Assoc..

[53]  Enrico W. Coiera,et al.  Communication behaviours in a hospital setting: an observational study , 1998, BMJ.

[54]  Chris O'Connor,et al.  Research Paper: The Use of Wireless E-Mail to Improve Healthcare Team Communication , 2009, J. Am. Medical Informatics Assoc..

[55]  Hyejung Chang,et al.  Technology Acceptance and Adoption of Innovative Smartphone Uses among Hospital Employees , 2014, Healthcare informatics research.

[56]  S. Wani,et al.  Efficacy of communication amongst staff members at plastic and reconstructive surgery section using smartphone and mobile WhatsApp , 2013, Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India.

[57]  Abdul Rashid,et al.  The m-Health revolution: Exploring perceived benefits of WhatsApp use in clinical practice , 2017, Int. J. Medical Informatics.

[58]  R. Wu,et al.  Analysis of Smartphone Inter- ruptions on Academic General Internal Medicine Wards , 2017 .

[59]  Kristina Groth,et al.  Of organization, device and context: Interruptions from mobile communication in highly specialized care , 2012, Interact. Comput..

[60]  F. Lau,et al.  It's not about pager replacement: an in-depth look at the interprofessional nature of communication in healthcare. , 2013, Journal of hospital medicine.

[61]  Guy Martin,et al.  Mobile revolution: a requiem for bleeps? , 2016, Postgraduate Medical Journal.

[62]  Dharshana Jayewardene,et al.  The use of smartphones in clinical practice. , 2014, Nursing management.

[63]  H. Wong,et al.  Understanding interprofessional communication: a content analysis of email communications between doctors and nurses , 2012, Applied Clinical Informatics.

[64]  A. Darzi,et al.  Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams. , 2015, American Journal of Surgery.

[65]  Z. Daruwalla,et al.  The Application of Telemedicine in Orthopedic Surgery in Singapore: A Pilot Study on a Secure, Mobile Telehealth Application and Messaging Platform , 2014, JMIR mHealth and uHealth.

[66]  Robert C. Wu,et al.  Short message service or disService: Issues with text messaging in a complex medical environment , 2014, Int. J. Medical Informatics.

[67]  Warren S. Sandberg,et al.  Development and implementation of an integrated mobile situational awareness iPhone application VigiVUTM at an academic medical center , 2012, International Journal of Computer Assisted Radiology and Surgery.

[68]  The use of smartphones in hospitals. , 2012, Clinical nurse specialist CNS.