WakeMed Improves Patient Throughput With Faster Consults


Inefficient processes for sending specialist consults caused delays in patient care and extended average length of stay in hospital

It’s very common for patients in the hospital to require a consultation with a specialist – in fact, over 300 inpatient consults are ordered everyday at WakeMed, a 900+ bed system located in Raleigh, NC.

While ordering a consult for a hospitalized patient is a fairly straight-forward process in most EHRs, getting that consult delivered to the right person can be complicated, require multiple resources and take many hours – delaying patient care and extending average length of stay.

In the most straight forward process, where the consult is to a specific provider (ie. Dr. Jones), after the consult is entered into the EHR it will be ‘in-boxed’ directly to the requested provider. However, there is no way to know if that provider is working, on call or on vacation. It could be hours before the EHR inbox is even checked.

If a group or specialty is indicated (i.e “Triangle Cardiology”, or just the “Cardiology Service”), it is typically tasked to a unit secretary to track down information to find out:

  • Who is on call right now?
  • How do I reach that person or group?
  • Is “first call” a resident, APP, attending or office staff?
  • Can I transmit patient information securely (HIPAA compliant)?

Regardless of how the consult is ordered, physicians frequently rely on unit secretaries to monitor consult orders and notify or remind consulting providers via phone call, page, emails or in-basket if the consult does not happen.

The bottom line is that while WakeMed physicians could request a specialist consult through the hospital’s EHR, the EHR simply doesn’t provide an automated process to ensure the delivery of that request directly to the consulting physician, or to actively alert that physician about a consult.

This inefficient process often led to confusion and frustration for everyone involved in the consult process, in addition to delays and unnecessary costs for both the patient and hospital.

PH Connect used to reach the right specialist right away

WakeMed worked with Proficient Health to leverage PH Connect’s integration with the EHR, in addition to PH Connect’s Intelligent Consult Notification (ICN) functionality to automate message routing, enable real-time notification and optimize care delivery.

PH Connect uniquely and intelligently routes messages based on many different factors, including clinical service resource availability (residents, PAs, etc.), time of day, consulting physician workflow and preferences, to ensure that the consult is automatically delivered to the right person – the first time. Providers are ‘actively’ alerted through their phone or pager to a new consult. PH Connect even allows providers to queue messages as appropriate, with the understanding that some less urgent consults can wait or should be batched together for early morning delivery.

PH Connect supports preferred workflows for not only the consulting provider, but also for the ordering physician. The ordering physician doesn’t have to open PH Connect at all. They simply log into the EHR and request the consult as they normally would. They receive a notification that the message has been read, with the date, time and reader saved to the EHR.

Reduced time to consults and decreased ALOS across the facility

It is believed that this immediate notification of a consult request has dramatically improved time to consult and decreased average length of stay (ALOS) across the facility.

“As a hospital that frequently runs at full capacity, we know that being able to get consults completed quickly will has a direct and positive impact on average length of stay and our bottom line,” said Denise Warren, WakeMed Executive Vice President & Chief Operating Officer.

PH Connect can be rolled out on a service by service basis or system-wide. The new process allows providers to order consults int the EHR  with the desired specialist or practice – and the appropriate on-call provider automatically receives a secure, HIPAA-compliant text message, via PH Connect, within seconds.

Additional advantages have included:

  • PH Connect always has the up to date call schedules, so the appropriate provider is automatically contacted.
  • PH Connect’s secure, HIPAA-compliant messaging allows more detail than simple texting.
  • Providers do not need to be logged into the EHR to learn of a new consult request“.

PH Connect’s immediate delivery of consult orders to the right resources (physician, resident, NP, etc.) ensures that our patients are getting the clinical care they need as quickly as possible,” explained Ted Tsomides, MD, WakeMed Health and Hospitals.

Today, more 2400 providers, including 72 physician specialties and 43 ancillary specialties, are participating in this more efficient process. Thousands of messages are sent through PH Connect each month and the median read time for inpatient consult requests is less than a minute.