HIM 350 Module 4 Project One Example

Project One: Every Way We Talk, a Communication Technology Audit of Sandstone Behavioral Health

[Student Name]

Southern New Hampshire University

HIM 350: Communication and Technologies

Project One

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Project One: Every Way We Talk, a Communication Technology Audit of Sandstone Behavioral Health

Sandstone Behavioral Health has added communication tools one at a time, each for a good reason, without ever stepping back to see the whole picture. This audit does that. It inventories every channel used to communicate with clients and among staff, gathers evidence on how each performs and scores them against consistent criteria, so the improvement plan in Project Two can focus on what matters most.

Scope and Methods

The audit covered all six clinics and the mobile crisis team over one quarter. Methods included an inventory of channels and their owners; an anonymous staff survey completed by 184 of 310 employees, a 59% response rate; a client survey completed by 260 clients in waiting rooms and by phone; message and call logs from the reminder, portal and record systems; a review of written policies; and documentation checks on a sample of records. The privacy officer approved the client survey, which collected no identifying information.

Evaluation Criteria

The team graded each channel on a five-point scale, where 1 signals serious weakness and 5 signals strength, across six yardsticks: effectiveness, meaning evidence that the channel achieves its purpose; access, meaning whether all client groups can use it; documentation, meaning whether content that matters reaches the record; privacy and security; cost; and staff experience. Scores reflect survey results, logs and research, and were reviewed with the clinical director.

Video and Audio Visits

Video visits are the agency's most important new channel. Research supports them: Hilty et al. (2013) found telemental health effective and comparable to in-person care across many populations. Clients rated video visits highly for convenience, and 71% of therapists prefer offering them. Weaknesses are access and documentation. Video no-shows are higher among clients on Medicaid, and the Module Two audit found client location missing in 23% of notes. Audio-only visits scored well on access but lower on effectiveness for assessment.

Reminders and the Portal

Appointment reminders go out as automated voice calls two days ahead. Logs show that 18% of calls reach a disconnected number or full voicemail, and 43% of surveyed clients said they would prefer a text. The portal, launched in 2021, has 22% of active clients enrolled, with enrollment lowest among clients over 60 and those without email. Kontos et al. (2014) found that people with lower income and education use online health tools less, and Berkman et al. (2011) linked low health literacy to poorer health outcomes, both of which help explain why portal use is lowest among the clients who most need support.

Staff-to-Staff Channels

Record in-baskets are documented and linked to charts but overloaded, with psychiatrists averaging more than 150 items a day. Pagers are reliable in rural areas but carry no detail. There is no secure messaging tool. Przybylo et al. (2014) found clinicians rated secure group messaging more effective than paging, which suggests the crisis team's reliance on pagers and personal phone callbacks is a gap. Staff gave internal communication the lowest satisfaction rating of any area in the survey.

The Unofficial Channel

The audit's most serious finding concerns a channel that does not appear on any list. In the staff survey, 62% of case managers reported texting clients from their personal phones, usually to confirm appointments or check on clients between visits. Clients value this: several called their case manager's texts the most helpful thing Sandstone does. But the messages sit on personal devices outside the record, without encryption or retention controls, and some include clinical content. For clients in the substance use disorder program, such messages may fall under stricter federal confidentiality rules.

The Public Social Media Page

Sandstone's public social media page shares events and mental health resources. A review of the past year's comments found eleven in which clients or family members disclosed diagnoses or treatment details, and two in which staff replied in ways that confirmed someone was a client. There is no written social media policy for staff or for monitoring the page.

Scoring Summary

Table 1 shows scores for each channel. Video visits and in-baskets score highest overall, while personal-phone texting scores lowest on documentation and privacy despite high client value. The pattern shows that the agency's most valued informal tools are also its riskiest.

Table 1. Communication Channel Scores (1 poor to 5 strong)

Note. Scores by the author from survey, log, policy and documentation evidence, reviewed with the clinical director.

Key Risks

Three risks stand out. First, clinical content in personal text messages is outside the record and unprotected, creating privacy and legal exposure. Second, clients with limited internet access, literacy or technology skills are underserved by the portal and video, widening gaps in engagement. Third, staff communication tools are slow and overloaded, contributing to missed handoffs such as the 16-day post-discharge delay described in Module Three.

Strengths to Build On

The audit also found real strengths. Clients trust their case managers and respond to personal outreach. Video visits work well for most therapy. The record system can support secure messaging and texting modules that Sandstone has not yet turned on. And staff are eager for better tools; 78% of survey respondents said they would use an approved secure texting app.

Limitations

The client survey reached clients who attend visits or answer calls, missing those most disconnected. Staff may have underreported personal texting despite anonymity. Scores involve judgment, although the criteria and evidence are documented so others can check them.

Conclusion

Sandstone's communication tools work reasonably well one by one but leave clinical content outside the record, leave some clients behind and slow staff coordination. The highest priorities for Project Two are bringing client texting into a secure, documented channel, widening access for clients with limited technology and replacing paging with secure messaging for the crisis team.

References

Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine, 155(2), 97-107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005

Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013). The effectiveness of telemental health: A 2013 review. Telemedicine and e-Health, 19(6), 444-454. https://doi.org/10.1089/tmj.2013.0075

Kontos, E., Blake, K. D., Chou, W.-Y. S., & Prestin, A. (2014). Predictors of eHealth usage: Insights on the digital divide from the Health Information National Trends Survey 2012. Journal of Medical Internet Research, 16(7), Article e172. https://doi.org/10.2196/jmir.3117

Przybylo, J. A., Wang, A., Loftus, P., Evans, K. H., Chu, I., & Shieh, L. (2014). Smarter hospital communication: Secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow. Journal of Hospital Medicine, 9(9), 573-578. https://doi.org/10.1002/jhm.2228