From Pagers to Smartphones: Selecting a Clinical Communication Platform Against Weighted Criteria, With the Case Against Two Alternatives
Student Name
Doctor of Nursing Practice Program, Aspen University
DNP865: Healthcare Technologies and Informatics
Instructor Name
Month Day, Year
From Pagers to Smartphones: Selecting a Clinical Communication Platform Against Weighted Criteria, With the Case Against Two Alternatives
Selecting a clinical information system is a decision with years of consequences, and it should be made against criteria defined before vendors are compared. This paper selects a clinical communication platform for a composite 260-bed hospital that still relies on pagers, overhead paging, and unsecured personal text messages. It defines weighted criteria, scores three options, argues for the selected option, and explains why the others were rejected.
The Problem
Nurses at the hospital reach physicians by numeric pagers and wait for callbacks, a median of 14 minutes on nights according to a two-week log. Alarms from cardiac monitors and nurse call lights reach nurses only through hallway displays and overhead announcements. Some staff use personal phones to text colleagues, sending patient information through channels that are neither secure nor recorded. A secure, integrated communication system is needed.
Criteria and Weights
Six criteria were defined with the selection committee of nurses, physicians, informatics staff, and the security officer, and weighted by importance. Usability, 25 percent: whether nurses and physicians can send, receive, and act on messages quickly in real conditions. Following the TURF framework's three dimensions of usability, usefulness for the work, ease of use, and user satisfaction, all three were tested in simulated scenarios (Zhang & Walji, 2011). Integration, 25 percent: whether the platform connects to the electronic health record, nurse call system, and physiologic monitors, so that alarms and patient context reach the right phone. Security and compliance, 20 percent: encryption, device management, message retention, and audit trails. Reliability, 10 percent: coverage throughout the building and downtime procedures. Cost, 10 percent: five-year total cost of ownership. Vendor support, 10 percent: implementation services and references from similar hospitals.
A case study of a health system's evaluation of secure messaging applications stratified 19 vendors into tiers, from basic secure messaging, to messaging within an existing clinical application, to dedicated communication and collaboration systems, and found that security and communication functions were essential while advanced features were secondary (Liu et al., 2019). The hospital's criteria follow the same logic.
The Options
Option A is the secure messaging module offered by the hospital's electronic health record vendor, running on hospital-issued smartphones. Option B is a dedicated clinical communication and collaboration platform from a specialist vendor, also on hospital-issued smartphones, with integration to the electronic health record, nurse call, and monitors. Option C is an upgrade of the existing paging system to two-way alphanumeric pagers with a secure texting gateway, keeping overhead paging for emergencies.
Scoring
Using a five-point scale, committee members scored each option on each criterion after demonstrations, simulated scenarios with 20 nurses and 8 physicians, and reference calls. Option A scored 3 on integration overall, strong with the electronic health record but weak with nurse call and monitors, along with 3 on usability, 4 on security, 4 on reliability, 4 on cost, and 4 on support, for a weighted total of 3.50. Option B scored 5 on integration, 4 on usability, 4 on security, 4 on reliability, 2 on cost, and 4 on support, for a weighted total of 4.05. Option C scored 1 on integration, 2 on usability, 3 on security, 5 on reliability, 5 on cost, and 3 on support, for a weighted total of 2.65. The cheapest option scored lowest, and the option that cost most scored highest, because the criteria weighted what nurses need to do their work, not what the budget prefers.
The Case for Option B
Option B is recommended because it best meets the two most heavily weighted criteria. Its integration routes monitor alarms and nurse call lights directly to the assigned nurse's phone with patient context, which addresses the hospital's dependence on hallway displays and overhead announcements. In simulated scenarios, nurses completed a physician consultation, from message to reply, faster than with the other options, and physicians rated its interface the easiest. Adoption also depends on how users perceive a system: a review of the technology acceptance model in health care concluded that how useful and how easy clinicians judge a technology to be accounts for a substantial share of whether they accept and use it (Holden & Karsh, 2010). Option B scored highest on both in the post-scenario survey.
The Case Against Option A
Option A's close connection to the electronic health record is a real advantage, and its cost is lower. It was rejected because it does not integrate with the hospital's nurse call and monitor systems, so alarms would continue to rely on hallway displays, the problem nurses rated most important. Its interface for group messaging and escalation was also less usable in simulation. If the vendor adds alarm integration in the future, the decision should be revisited.
The Case Against Option C
Option C is the least expensive and most reliable, since pagers work where cellular and wireless signals do not. It was rejected because it preserves one-way, context-free communication, does not integrate with alarms or the record, and would not end the use of personal phones, since staff would still lack a convenient secure alternative. Its reliability advantage will be preserved in the recommended design by keeping a small number of pagers for downtime and for areas with poor coverage.
Sensitivity of the Decision
Because weights involve judgment, the committee tested whether the recommendation depended on them. If cost were weighted at 25 percent instead of 10, with usability and integration reduced to 17.5 percent each, Option B would still lead, at 3.68 against 3.65 for Option A and 3.18 for Option C, although its margin would nearly vanish. That result shows the decision rests on how much weight integration and usability deserve, which the committee judged the right priority for a system nurses will use every hour. The committee also agreed on conditions that would reopen the decision: a failed pilot on two units, a security review that found unacceptable risks, or a price increase of more than 15 percent before contract signing.
Conclusion
Selecting a clinical communication platform against weighted criteria defined in advance led to a clear recommendation: a dedicated platform that integrates alarms, nurse call, and the electronic health record on hospital-issued smartphones. Its higher cost is justified by its performance on the criteria that matter most for nurses and patients, and the reasons the alternatives were rejected are documented so the decision can be reviewed if circumstances change.
References
Holden, R. J., & Karsh, B.-T. (2010). The technology acceptance model: Its past and its future in health care. Journal of Biomedical Informatics, 43(1), 159-172. https://doi.org/10.1016/j.jbi.2009.07.002
Liu, X., Sutton, P., McKenna, R., Sinanan, M., Fellner, B., Leu, M., & Ewell, C. (2019). Evaluation of secure messaging applications for a health care system: A case study. Applied Clinical Informatics, 10(1), 140-150. https://doi.org/10.1055/s-0039-1678607
Zhang, J., & Walji, M. F. (2011). TURF: Toward a unified framework of EHR usability. Journal of Biomedical Informatics, 44(6), 1056-1067. https://doi.org/10.1016/j.jbi.2011.08.005
How this DNP 865 Module 5 example is structured
DNP865 Module 5 samples usually argue a system selection against defined criteria and rejected options. Aspen does not publish module deliverables, so check your classroom for the exact prompt. This example defines weighted criteria with sources, describes the options, reports scores, argues for the winner and makes a fair case against each alternative.
DNP865 Module 5 questions, answered
What does DNP865 Module 5 usually ask for?
The module usually asks you to select a health information system or technology against defined criteria, explaining the choice and why alternatives were rejected. Aspen does not publish module deliverables, so your classroom's instructions govern.
How should criteria for selecting a clinical system be weighted?
Weights should reflect what matters most to the users and patients the system serves, agreed by a multidisciplinary committee before vendors are compared, so that the scoring cannot be shaped to favor a preferred option.
What is the technology acceptance model?
A theory that users' acceptance and use of technology depend largely on its perceived usefulness and perceived ease of use. A review found it predicts a substantial portion of clinicians' use of health IT.
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