As a pediatric emergency medicine fellow, Benjamin Heilbrunn, MD, often found it difficult to interpret the reasons primary care physicians were sending their patients to the emergency department (ED).
Patients and families often could not relay the medical explanation given to them, or they would simply hand Heilbrunn a scrap of paper with frequently illegible handwriting. In turn, he suspected that primary care physicians also received fragmented information from families after they left the ED or delayed discharge summaries. His concern was that this communication disconnect resulted in medical errors, lack of follow-up care and missed test results.
In September 2016, Heilbrunn, now an assistant professor of pediatrics at the University of Chicago, began working with Clinical Research Coordinator Allison Kniola and Associate Professor of Pediatrics Larry Gray, MD, to survey how often primary care providers received a discharge communication from patient encounters at the Comer Children’s Emergency Department.
They learned that primary care physicians were only aware of approximately 30 percent of their patients’ visits to the Comer Children’s ED. Heilbrunn says this finding is consistent with studies of adult in-hospital discharges but is the first to quantify pediatric emergency activity.
To improve communication between the ED and primary care providers, Heilbrunn collaborated with the Patient Experience Office and Vocera Communications to develop the Good-to-Go PCP Communication application. Through this innovative, internet-based medium, an ED physician or nurse records patient discharge instructions and clinical status on an iPad. The video is immediately transmitted to the primary care physician, who receives an alert, opens the app and plays the short video.
Video-recorded discharge helps us avoid any miscommunication that comes from having patients be the main source of medical information.
~ Benjamin Heilbrunn, MD
After creating the platform, the team contacted 70 primary care pediatricians on Chicago’s South Side. Fifteen agreed to participate in the pilot program and the first video was transmitted in February 2017. Heilbrunn says many of the participants are pleased with the program, especially the ability to receive a real-time clinical status on their patients.
“Effective communication between pediatric EDs, primary care physicians and families is vital for patient safety and continuity of care,” Heilbrunn says. “Video-recorded discharge helps us avoid any miscommunication that comes from having patients be the main source of medical information.”
Heilbrunn’s hope is to operationalize the tool so it becomes the norm across the University of Chicago Medicine. “That would be a tremendous leap forward in how we care for patients, communicate with physicians and respect their role as the primary care providers for these patients,” he says.