Figure 1. Messages are displayed on the family member’s device.

The Familyfirst Messenger application is a provider to the family communication platform. Familyfirst Messenger is a one-way messaging mobile platform for iPhone and Android devices that is compliant with HIPAA (Health Insurance Portability and Accountability Act of 1996). Family members can now free themselves from the confines of the waiting room, as information about their loved ones can be accessible wherever there is Wi-Fi or a cell signal. Families that are located in other states or abroad are made to feel as if they are close to their loved ones.

This application has become mainstream in hospitals and skilled nursing facilities, including one of the larger academic health care systems—The Westchester Medical Center Health Network—located throughout New York State.

A Pioneer in Hospital Communication

Figure 2. Medical staff have access to the web app on the hospital’s computers to review and send messages.

I co-founded the Familyfirst application (iOS; Android) with my college roommate’s son, Randy. Until this point of my career, I had no prior experience with technology, beyond the typical daily use of an iPhone. Despite my inexperience in the technology world, I began the mission to build a robust software solution for an issue we all have experienced as a medical provider or family member.

Randy and I have different skillsets that were channeled toward designing this application. My clinical and administrative roles have provided me with a unique exposure to the many different facets of health care. I am able to recognize workflows that need improvement, with a vision of how physicians and nurses can operationalize for success. Randy has the expertise of software engineering to complement and implement the thought process. We have since expanded our software team to enable the application’s evolution.

The application allows family members to receive real-time updates before, during, and after surgery. The medical staff can send messages at any time to the family members of their patients. Family communication has been shown to reduce a family’s anxiety and stress level.^1,2 Familyfirst was not designed to replace face-to-face communication but to help enhance direct contact when desired. Physicians now have an efficient means of communication to schedule a convenient meeting time and place to review the surgical and medical events with the family.

Families are enrolled into Familyfirst remotely (anywhere in the world) or onsite in the hospital. The medical providers or family members do not expose their personal information. Cell phone numbers or email addresses are not used to make the connection, thus preserving privacy for both sides.

The app is a free download for all family members. Familyfirst has been designed to require a minimum number of clicks to avoid user “burnout.” Each provider is instructed on how to use the app through a 5-minute tutorial or with a user-friendly dropdown knowledge reference located within the app.

The messages are translated automatically into any language on the family member’s device. The messages that the provider chooses to send can either be selected from a prefabricated library or an original custom message can be composed spontaneously.

Family members interface with Familyfirst on the mobile app (iOS and Android) to read messages anytime and anywhere (Figure 1). However, the medical staff has convenient access to the website (web) app, located on all of the hospitals’ computer stations (Figure 2). The web app enables providers to send the family messages from the operating room, intensive care units (ICUs), or from any mobile computer station while on morning and afternoon rounds.

There has been a disconnect in communication between medical providers and a patient’s family, which became most apparent to me during my years of caring for active and retired U.S. servicewomen and -men at the Minneapolis Veterans Administration Hospital.

Throughout the United States, families are left adrift to wonder and worry about the status of their loved ones during the preoperative, intraoperative, and postoperative phases of care. Currently, families rely on an occasional telephone call or are left to stare at an “airport” screen in the hospital waiting room for status updates. Families are forced to forego meals and restroom needs while sitting in the surgical or ICU waiting rooms for hours, with the fear of missing the medical provider’s information.

ICU nurses spend a disproportionate segment of their shift answering calls from concerned family members who are desperate for information. Globally, hospitals have faced a nursing shortage, which has already challenged bedside care.^3,4 Now, hospital staff can provide morning and evening updates to family members through the application and allow nurses to have additional precious bedside care time.

Providers are focused on the medical and surgical care they provide, but hospital systems have their own agenda. In addition to providing excellent care for their community, hospital systems strive to have top Press Ganey (outpatient survey) and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS, inpatient survey) scores.

Hospital costs have spiraled, whereas reimbursements have declined. Hospitals strive to obtain top HCAHPS scores as a vital means to an additional income stream. Those hospitals that achieve the best HCAHPS scores are eligible for a bonus payment. The funds are dispersed from a Medicare pool annually. Top-box scores also help to boost a hospital’s image within the community upon the publication of hospital ratings. Therefore, hospital systems have a dual purpose to optimize communication within the hospital environment.

Digital Medicine Expands

Physicians are in a unique position to understand the aspects of health care that require improvement. Digital medical companies need physician leadership to lead health care innovation.

Communication is a clear indicator of how we move information in society. We need to continue to innovate and adopt technology that exemplifies our dedication to our patients and their families. However, we must always protect the privacy of our patients and ensure HIPAA compliance within software platforms.

Urologists have contributed to medical device innovations through collaborating with Industry. Familyfirst Messenger is a digital innovation co-developed and led by a urologist. The development of our communication solution is a byproduct of clinical requirements guiding software engineering.

We, as physicians, are in the perfect position to recognize health care impediments and lead change through digital solutions.