Networked Communication: Enabling Mayo Clinic to Scale
The #MayoClinicDNA metaphor of Mayo Clinic's essence includes the "base pair" building blocks of Teamwork, Altruism, Progress, and Stewardship (TAPS) that form two unifying strands. Last week we examined the first of those strands, the revolutionary patient-centered organization.
Today we'll start unwinding the second strand, Networked Communication, and how it has enabled a practice that started with Dr. William Worrall Mayo and his two sons, in collaboration with sisters from a local convent, to grow into a 64,000-person organization while still retaining its essential character.
The Mayo Clinic Model of Care is based on the realization that one physician can't possibly stay up-to-date on everything needed to diagnose and treat patients with complex or unusual conditions, and so a team of specialists is needed.
But how can members of that team effectively gather around the patient and contribute their expertise to the diagnosis and treatment plan?
While they never, to my knowledge, used the term "networked communications," the Mayo brothers and their early colleagues implemented internal communications systems within Mayo Clinic that were essentially analog versions of the digital social networking platforms we know today.
In 1907, Dr. Henry Plummer invented the unified medical record. Before that time, physicians kept notes about their patients in their own journals. Dr. Plummer's insight was that bringing all of the notes and lab results for a given patient together into a single dossier would make the insights of one physician available to all of the team members.
As the practice grew, the Mayo team developed an elaborate network of pneumatic tubes (like you may have used at the drive-through window at the bank) to transport physical medical records to various offices. The goal was to ensure that the file arrived just ahead of the patient before each appointment, so the physicians could see others' observations.
In the 1990s Mayo began the move to the electronic medical record and is now in the midst of transitioning to one Epic medical record for all campuses - Rochester, Arizona, and Florida - as well as Mayo Clinic Health System. In honor of the inventor of the original medical record, we're calling this massive initiative The Plummer Project.
- Semaphore flags (now replaced by brightly colored lights) outside each exam room door to communicate the room's status, so staff could tell at a glance whether a patient was in the room, which physician was responsible, and other information helpful for smooth operations.
- An internal telephone system that enables physicians and other staff to contact each other for consultation by picking up a house phone and entering a five-digit number.
- A related priority paging system that enables the recipient of a page to answer on any house phone (or now via cell phone.) This paging network enables the coordinating physician to get just-in-time expertise from colleagues to best serve the patient.
- Videoconference rooms that enable staff on different campuses to engage in face-to-face meetings while separated by hundreds of miles. This technology has been used within Mayo for about three decades.
- An intranet that makes operations information and organizational news available to all staff.
- Email accounts for all employees.
- Sharepoint and Yammer.
- Skype for Business.
The items in the last few bullets look a lot more like social networking as we understand it today than some of the first ones do. But the point I want to emphasize is the continuity between the earlier forms and current forms, and their fundamentally similar nature.
The electronic medical record provides exponential savings of time and effort as compared to the paper-based record. It also enables shorter patient itineraries, as we don't have to wait for physical records to make their way between physicians. Physicians can even view the same records simultaneously as they consult via phone.
But both the paper and electronic records directly descend from the pioneering invention of Dr. Plummer.
Without internal systems of networked communication, Mayo Clinic could not have grown to be what it is today. In future posts, we'll see that external networked communication has been essential too.
Lee Aase is a Communications Director for Mayo Clinic's Social & Digital Innovation team and is Director of the Mayo Clinic Social Media Network. This post is part of a series called Mayo Clinic's Double Helix: How Revolutionary Organization and Networked Communication Built America's #1 Hospital.