(Article based on Baylor University Medical Center submission to 2008 Computerworld Honors Program on it's pioneering deployment of unified communications in its Radiology Department.)

Baylor University Medical Center - the flagship hospital of the Baylor Health Care System in Dallas/Fort Worth, Texas - is a major patient care, teaching and research center for the southwestern U.S. For the 15th consecutive year, U.S. News & World Report's "America's Best Hospitals" guide has ranked the center among the nation's top hospitals in several medical specialties.

The benefits of the Nortel unified communications solution deployed at Baylor include improved patient care and better utilization of critical radiology resources; both in the form of radiology technicians and mobile radiology equipment (e.g. x-ray machines). In more specific terms, Baylor saves approximately 15 minutes of staff time for every hour of work by decreasing the amount of time it takes to locate and dispatch the right equipment or medical specialist needed. Furthermore, getting the right clinician to the patient quickly enables faster and more accurate care.

Like healthcare systems everywhere, Baylor University Medical Center is challenged with a number of important business realities, which bring profound implications not only for users of the system and health care professionals, but also for network and information management technologists.

For example, medical errors carry high human and financial costs in the form of extended treatment periods and injury/deaths, escalating legal costs and resulting costs of liability insurance. Additionally, IT is under constant pressure to do more with less, to constantly develop information and networking management models to enhance health care delivery. In 2007, Baylor's Radiology Department identified an opportunity to improve communications and thereby streamline the delivery of patient care. Unlike many hospitals that direct patients to a centralized radiology department, members of Baylor's Radiology Department bring radiology to the patient when required, which is less disruptive from the patient's perspective. Regardless of approach, there are challenges to work-flow management, including movement of patients and mobile radiology equipment and how best to allocate the relatively scarce radiology human resources.

It is not uncommon in health care delivery to have a mobile patient population. The patient travels to the physician. Even in major institutions today many radiology patients must travel to the departments for studies. The advent of mobile radiology allowed Baylor to change this model. Mobile radiation technicians now haul huge, bulky and heavy devices into the patient's room in an effort to minimize the impact on patients.

In the old process, the technicians' routes were assigned by a central dispatcher who did not have tools to optimize the technician's route. In most cases, all equipment went out, returned to home base and then the cycle continued.

The existing IT infrastructure utilized conventional pagers and wired telephones. Getting put on hold, being directed to voice mails and the uncertainty about when messages were actually relayed - and seen by radiology employees - were just some of the frustrations experienced by Baylor's staff, resulting in less than optimal workflows.

This communications challenge was seen as part of a broad Hyperconnectivity megatrend, whereby everything and everyone that can benefit from being connected should be connected. Baylor recognized that to achieve best care, it should invest in a state-of-the-art unified communications system.

As a start in evolving toward Hyperconnectivity to improve patient quality and safety, Baylor focused on the mobile radiology technicians working in its Emergency Department who needed to receive orders wherever they were across the medical center's 120-acre campus. A primary goal was to allow the dispatchers to know, with certainty, the availability of mobile radiology technicians and then communicate effectively with them, instantly if possible. Attractive technologies to achieve this goal included presence indicators, instant messaging, e-mails and voice mail.

The biggest challenge was related to the end users and evolving the processes to leverage the new opportunities associated with unified communications. Establishing a strong partnership between IT and the Radiology Department around common business objectives facilitated the introduction of unified communications.

The second challenge was security. For example, a typical instant message in the Emergency Department may read "GSW left arm, STAT" or translated in English, "Gun Shot Wound in left arm, this is a high priority request in the triage protocol." This message had to be securely conveyed (a feature of the Nortel Multimedia Communications System solution) and logged and stored for regulatory and auditing purposes (using technology from Sipera Systems).

After extensive research, Baylor could not find an off-the-shelf solution in the marketplace. It chose to work with Nortel, which had developed Collaborative Clinical Solution , and utilized Nortel's Global Services.

Baylor deployed secure unified communications from Nortel in a mobile environment to achieve Hyperconnectivity. Users can send e-mails, instant message, and make standard telephone calls on a secure mobile network running WiFi?. More specifically the system utilizes unified communications clients and SIP on BlackBerry? devices. The solution delivers significantly new functions now, but also positions Baylor for the future of comprehensive and secure communications in numerous areas. Baylor is making complex technologies easily accessible for workers who deserve simple interfaces.

The combination of people, processes and technologies now make it possible for physician orders to be communicated quickly and securely via instant messaging to radiology technicians who are equipped with unified communication-enabled Wi-Fi BlackBerry? devices. Included in the secure message are the details of the order, including patient location and severity of need. As a result, Baylor gets the right information to the right individual with the right equipment for the right patient at the right time, significantly improving the care delivery processes.

In the new environment, the equipment goes out, the mobile technician alerts the dispatcher that the test is concluded and is redirected to the next best location. Mobile radiology staff who formerly were only able to collaborate when both happened to return to base at the same time can now use e-mail, voice, and instant messaging at any time to seek and provide help, regardless of location.

The transformational benefits of unified communications are further realized when integrated with clinical applications and processes. Communications-enabled applications allow clinicians to collaborate directly within the applications they use daily. They can also leverage unified communications capabilities automatically, triggered by an event or a change to deliver higher, more effective and timely patient care.

The solution was immediately embraced by the radiology technicians and radiology management. When the solution was first piloted and a small group trailed the solution the feed-back was extremely positive. "This tool saves me so much time" and "I can communicate anytime and anywhere" were some of the quotes from the users.

When it was time for the trail units to be picked up, they refused to give them back. The pilot suddenly went from a trial to overnight production. The Information Technologists that developed the solution were ecstatic that their hard work paid off and user acceptance occurred so quickly. To the user, the solution is very simple to use. When you enable ease of communications, 99 percent of your users will embrace and not detract.

To Baylor's knowledge, this is the first application of unified communications, specifically instant messaging and presence awareness on mobile devices. The solution improves efficiency, productivity and increases physician/patient satisfaction in the radiology/emergency room environments. Baylor chose Nortel to support the development of this solution and Nortel's Global Services group was instrumental in its success. Nortel worked with Baylor's technology providers and brought a breadth of experience in accurate, safe and secure unified communication technologies and support. This coordination was the key to the success of this solution.

Going forward, Baylor envisions leveraging unified communications/mobility technology in a number of areas in the system. Whether a member of a rapid response team being dispatched to a STAT or emergency call, or a patient transporter moving patients to other care areas, timely accurate communications is very important. The power of unified communications and leveraging the voice and data network investments will have a continued positive change in the way Baylor communicates. As Baylor continues to develop mobility and unified communications systems that serve health care professionals, the patient is the ultimate beneficiary.