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?:abstract
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BACKGROUND The novel coronavirus (COVID-19) pandemic has significantly altered the delivery of healthcare, requiring clinicians and hospitals to adapt to rapidly changing hospital policies, as well as social distancing guidelines. In our large academic medical center, this prompted clinician feedback that existing information distribution channels, including email and hospital intranet, were inadequate to keep all abreast of these changes. To help address these challenges, we adapted an internally developed mobile app to communicate critical changes in hospital policies and enable direct phone communication between clinical team members and hospitalized patients, to support social distancing guidelines and remote rounding. OBJECTIVE To describe the unique benefits and challenges of adapting an internal application rapidly to facilitate communication and remote rounding during the pandemic. METHODS We implemented moblMD, a mobile app for iOS and Android. In conjunction with our Hospital Incident Command System, Resident Advisory Council, and health system innovation center, we identified critical and time sensitive policies to distribute using the app. A shared collaborative document was used to align communication on the app with more traditional communication channels. To minimize synchronization efforts, focus was directed towards high-yield policies, and the time of last review and reviewer were noted in each protocol. To facilitate social distancing and remote patient rounding, the app was also populated with a searchable directory of numbers to patient bedside phones and hospital locations. We monitored anonymized user activity from February 1 - July 31, 2020. RESULTS Following the first announcement of its availability, the app was downloaded by a total of 1104 clinicians during the observation period, with 46% (508) downloads in the first 72 hours. Review of COVID policies using the app was most common during the first week (801 views). Users made sustained use of hospital phone dialing features, including weekly peaks of 2242 phone number dials, 1874 directory searches, and 277 room number searches in the last two full weeks of the observation period. Fifty-six content and phone number suggestions were submitted via the app. CONCLUSIONS We were able to rapidly develop and deploy a communication-focused mobile app in the early period of the COVID-19 pandemic that has demonstrated initial and sustained value for clinicians in communicating with inpatients and each other in the context of social distancing. Our internal innovation benefitted from our team\'s familiarity with institutional structures, short feedback loops, limited security and privacy implications, and a path toward sustainability provided by our innovation center. Challenges in content management were overcome by synchronization efforts and timestamping review. As COVID-19 continues to alter healthcare delivery, user activity metrics suggest that our solution will remain important in our efforts to continue providing safe and up-to-date clinical care. CLINICALTRIAL
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