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Original research
Evaluation of Secure Mobile and Clinical Communication Solution (SMaCCS) across acute and community practice settings
  1. Sean P Spina1,2,3,
  2. Kristin M Atwood4,
  3. Peter Loewen2
  1. 1 Pharmacy Admin, Royal Jubilee Hospital, Victoria, British Columbia, Canada
  2. 2 Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3 Health Information Sciences, University of Victoria, Victoria, British Columbia, Canada
  4. 4 Transitions in Care, Divisions of Family Practice, Victoria, British Columbia, Canada
  1. Correspondence to Dr Sean P Spina, Pharmacy Admin, Royal Jubilee Hospital, Victoria, V8R 1J8, Canada; sean.spina{at}


Aims Clinicians struggle to provide information to each other that supports safe patient transitions, especially across acute and community care jurisdictions. They need flexible communication tools to improve care coordination. Island Health introduced a Secure Mobile and Clinical Communication Solution (SMaCCS) to address these challenges in 2018. In this study we evaluated the SMaCCS system to understand the (1) volume and flow of healthcare communication, (2) degree of adoption and accessibility of the system and (3) user experience.

Methods This was a prospective, cross-sectional, observational study. Island Health Information Management/Information Technology (IMIT) selected Vocera Collaboration Suite as the secure messaging platform. We invited healthcare providers in various roles in the hospital and community to use SMaCCS for their daily communications and system and survey data were collected between February and August 2018. System data and survey data were used to determine outcomes.

Results A Sankey diagram represents the volume and flow of communication. A total of 2542 messages were sent and 79% of conversations included more than a single message. Eighty-one per cent of participants agreed that using a secure communication tool made them feel more comfortable sharing patient information. Most users (65%) perceived that the application was a useful method for transmitting simple information.

Conclusion However, our study showed that different occupational roles require different frequencies and volumes of communication and there are numerous barriers to adoption that must be addressed before secure messaging can be an effective, ubiquitous method of clinical communication.

  • health care quality
  • access
  • and evaluation
  • health services administration
  • hospital administration
  • health

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  • Contributors SPS initiated the study idea, while SPS, KMA and PL jointly planned the study. All authors contributed to writing the manuscript and SPS submitted for publication.

  • Funding Funding for this study was provided by the Shared Care Committee, a joint initiative of the British Columbia Ministry of Health and the Doctors of British Columbia, and from an unrestricted research grant provided by Vocera.

  • Competing interests The corresponding author (SPS) has received an unrestricted research grant from Vocera.

  • Patient consent for publication Not required.

  • Ethics approval The Island Health Research Ethics Board approved and provided ethical oversight of this study. Use of SMaCCS did not preclude providers from using other means of communication. Patient risk due to delays in transmission of communication was expected to be no greater with SMaCCS than any other communication methods currently in use. However, to minimise this potential risk, participants were given explicit instructions to not use the app for urgent communication. Participants were not compensated for using SMaCCS. Sessional payments were provided for physicians and gift cards to other participants for responding to surveys.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Individual deidentified participant data that underlie the results reported in this article can be shared beginning 3 months and ending 5 years following article publication. Study protocol and analytic plan can also be available. Data will be shared with researchers who provide a methodologically sound proposal for the purposes of achieving the aims in the approved proposal. Proposals should be directed to . To gain access, requesters will need to sign a data access agreement.