Patient Apps Help Families Communicate With Caregivers

By John Palmer

One of the most harrowing experiences for the family or loved ones of a patient going into the hospital, whether for routine or emergency care, is the lack of communication that they have with a caregiver.

It’s often not the caregiver’s fault—they could be busy with clinical work, engaged in seeing other patients, or simply not have any new information.

Since radio silence can be troubling for the patient’s family, even a small gesture from a physician—like a positive update or a pat on the back with some good news—can promote a sigh of relief and a sense of closure. But the ability to reach out isn’t always as easy as it should be.

“The problems of communication are quite real, and they’ve been around for 200 years,” says Kevin de la Roza, MD, a pediatric cardiac anesthesiologist at The Heart Center at Orlando Health Arnold Palmer Hospital for Children and an assistant professor of anesthesiology at the University of Central Florida College of Medicine. “Operating rooms are closed-off places, with not a lot of information and people sealed in. We are trying to break down those barriers.”

That lack of information and the inability to communicate with family members became more disheartening over the last several months because of the COVID-19 pandemic, which found some patients going into the hospital and never coming out—in some cases dying alone while hooked up to ventilators.

The pandemic has made communication between care teams and families particularly challenging, leading hospitals to seek new ways to reach out to loved ones who often can’t be by a patient’s side—or even in the waiting room—during a surgery. Having a means to communicate securely beyond the hospital walls, whether the receiving family member is waiting in their car outside the facility or at home across the country, is essential for reducing anxiety, increasing understanding, and creating a better healthcare experience.

“[COVID-19] has highlighted the problem to a greater degree because when a person comes into a hospital they may not come out, which really is always the case,” de la Roza says. “Communication can’t prevent COVID, but it can make it more bearable. If they are going into surgery, you still can’t be there, but we wanted to find a way where the family can take the journey with them.”

The answer to his problem came almost accidentally in November 2012 when his colleague Hamish Munro, MD, director of pediatric cardiac anesthesiology with The Heart Center, began providing patients’ families with updates through pictures and videos on Instagram and Twitter.

At first Munro was only doing this a few patients, but a woman whose daughter was having heart surgery was insistent to the point of tears that the doctor keep her updated—as it was the only way she could imagine getting through the operation with her daughter.

It was then that the two doctors realized they might be on to something. They convinced their superiors at the hospital to allow them to collect research on 50 patients and developed a revolutionary patient app known as EASE.

Munro and de la Roza continued their research, figuring out how to get through the HIPAA loopholes, working with developers, and dealing with security challenges to launch the secure app to the public in 2013. Industry leaders took note of the app’s positive impact on patient and family experience, and in 2020, Vocera Communications, Inc., acquired EASE.

It’s a pretty basic system. First, the patient adds friends and family members to their distribution list. Then, with a simple tap, the doctor or nurse can send texts, photos, and videos about the patient’s progress to that list. More than 1.6 million messages have been sent since the app was first rolled out in 2013.

“Patients are also a lot less scared if they know their loved ones have information,” de la Roza says. “We realized this could go elsewhere. We wanted to create complete experiences where the minute you come into the hospital to the minute you leave, you are getting messages.”

EASE is certainly not the only app of this type to be invented. Hundreds of hospitals across the country have adopted secure communication tools to help families stay connected with patients and enable care team members to send them texts, photos, and videos. Such solutions provide families with peace of mind while also preserving the safety of care providers, patients, and themselves.

Examples include an app called myICUvoice, which was designed by an ICU doctor in the United Kingdom and uses touchscreen technology on an iPad^® to facilitate communication with patients.

Another system developed by Israeli company EyeControl is wearable, screenless, and lightweight. It uses a heat-mounted infrared camera to track the patient’s eye movements, then translates those movements into audio communication.

While they all work differently, the apps are designed with one goal in mind: bringing communication into areas of the hospital where visitors aren’t typically allowed, to keep family members connected and make the hospital experience a little less scary. De la Roza says he foresees a time when EASE will be used in places like the ICU, emergency department, and radiology lab.

“Our team understood how difficult it can be for families and friends waiting for updates about loved ones who are undergoing surgery,” says Hope Johnson, DNP, MSN, MBA, RN, CNOR, NEA-BC, administrator of perioperative services at Lehigh Valley Health Network in Nazareth, Pennsylvania, which has used the EASE app since 2018.

Johnson says that EASE has provided the organization with a secure way to update families in real time before, during, and after a surgical procedure. Families have the freedom to leave the waiting room without worrying that they will miss an update from a care team member. Loved ones who cannot come to the hospital can also stay updated. Care team members can send updates to patients’ loved ones via text, photos, and videos.

“We wanted to help ease some of that stress and worry,” says Johnson. “Vocera EASE helps us improve the healthcare experience by improving communication with patients and families.”

The healthcare organization started using the app in 2018, and since then has sent more than 172,000 secure messages and photo updates to patients’ loved ones across 50 states. In turn, these families and friends have been able to respond to care teams with more than 136,000 emojis, including thumbs-up, hearts, and prayer hands.

Part of EASE’s helpful functionality, says Johnson, is its customizability, so messages can be personalized. In addition, it’s secure—all messages, photos, and videos disappear 60 seconds after being viewed. It’s free for family members and easy to load on their personal devices, and the app can send messages in nine languages.

During the COVID-19 pandemic, Lehigh Valley has found EASE to be vital in helping families when visitors aren’t allowed to accompany patients to the hospital.

“The app does not replace the face-to-face meetings our surgeons have with families post-surgery, but this digital communication bridges the gaps between the time patients go in for surgery and this postoperative conversation,” Johnson says. “Clinicians can also use the app to notify family members that they need to come back to the waiting area if they stepped away and a face-to-face is needed.”

The app has also been used to connect families that have U.S. military members operating overseas.

“One of our patients shared that a family member receiving our EASE updates was her son, who was deployed in Afghanistan,” Johnson says. “Being able to keep him connected and updated on her progress in real time was a relief for them both, and it really meant so much to the care team.”

John Palmer is a freelance writer who has covered healthcare safety for numerous publications. Palmer can be reached at johnpalmer@palmereditorial.com.