Where Whiteboards Fail


Feb 13, 2017 Phil Leung, Director of Product

If you spot a whiteboard in a classroom or in an office, you probably wouldn’t think much of it. It’s a fitting tool in those environments. It’s cost effective and basic, and with no learning curve, a perfectly good tool for jotting down ideas, list reminders, and diagrams – something you can use to quickly and simply keep track of information.

A whiteboard hanging in the hall of a hospital, however, jumps out at me every time.

It stands out because I’m perplexed as to how things as important as clinical staff schedules and contact information are 1) handwritten, 2) stored on a physical tool, 3) and positioned in a hallway. There’s so much vital information on those boards that I’ve become drawn to them. It’s almost like being given special access to go behind the scenes. Like catching a brief glimpse of the back kitchen of a bustling restaurant, witnessing all that organized chaos come together. Or maybe like being backstage at a play, seeing various pieces of a set transform the stage from scene to scene.

On a whiteboard at a hospital, you can see the entire team of doctors, nurses, and support staff that are scheduled there at this moment and most importantly how to reach them. Today, in many hospitals across the country, this is a common sight. If you’re frantically looking for the resident on duty? Go check the board. Or you’re trying to get a hold of the neurologist on-call? Yup, check the board. This is the equivalent of a rolodex for a sales executive, the playbook for a coach, the navigation system for a pilot. It helps you do your job, it’s important! It’s actually one of the more critical sources of information on the hospital floor, and it baffles me that there isn’t a better process in place for organizing and presenting it in a more meaningful way.

The first concern I have is the high risk of human error, transcribing this information by hand from a schedule. One wrong digit of a pager number can cause a huge communication headache, and significantly impact patient care. A recent Johns Hopkins study reveals that the third highest cause of death in the U.S. is due to medical error, right behind cancer. They explained that the errors aren’t inherently due to bad clinical practice: “Rather, they say, most errors represent systemic problems, including poorly coordinated care.”

The practicality of the whiteboard also comes to mind. It may be useful if you are standing in front of it all day, operating in the same proximity, but the reality is that you are on your feet, transitioning from room to room, on opposite ends of a floor, or different floors altogether. Does it make sense to rush back to that board every time you need to reach someone? OK fine, maybe you write down this information on a sticky note each day, but that brings us back to the question of human error. And finally there is efficiency. When you do find out who you are looking for, the instruction on that board is to dial their pager numbers…so you do, then wait for them to call you back.

I can’t think of anything that more clearly highlights the incongruous realities of healthcare than this whiteboard. There is a better way, and the healthcare community and its patients deserves it.

That is what we set out to do a year ago at TigerText, to come up with ways to make this a more efficient and effective experience. We want to help care teams locate people on-duty quickly and be able to communicate with them instantly — our answer to managing shift-based communications. After rounds of interviews, marketplace research, and user testing, we’ve marched down this path and executed on our vision of Roles. Part one of Roles was launched, providing an intuitive system that allows you to assign staff members to various roles (or functions) they perform, and in-turn lets everyone in the organization view this information anywhere on the floor (mobile or web). It also allows you to set your own shift by opting in and out of a role, as your schedule dictates. If you need to reach someone, you simply look for the role and message it directly, which will be routed to the person occupying that role, all in one seamless flow. Conversations that took place while you were in a role will be inherited by the next shift owner so that they have full context of what took place prior. This is all done in a simple, intuitive, and visually appealing manner. There’s more detail of the feature here.

That brings us to today, where we are thrilled to launch part two of this vision. We’re calling it Roles Scheduling Automation, which opens up our Roles interface and functionality to consume scheduling information from any source (cloud-based like AMiON or offline like MS Excel). It allows users to automate role assignment for all shift-based staff, and in-turn be able to display these scheduled shifts in various calendar views, in addition to tracking down who is on duty for a particular role, today or in the future.

We’re excited to have developed this technology in partnership with AMiON, one of the most widely used cloud-based scheduling solutions in the healthcare industry. We’ve gained a ton of insight and industry best practices around scheduling from the AMiON team, allowing us to streamline our development efforts and bring this technology to market relatively quickly.

With this vision, we are not aiming to boil the ocean, and I don’t think any one entity can, but I believe if we can contribute incremental improvements like these, and do so with a high degree of thoughtfulness and empathy, we can bring real benefits to the industry over time.

Along with my colleagues at TigerText, I’ll be at the HIMSS conference February 19-23 (booth #1187). I hope to meet you there and chat more about my vision for our product and the future of healthcare communications.