Its no secret that healthcare providers are adopting tablets at a rapid pace – one survey found that over 25% of physicians own a tablet and that was nearly nine months ago.
This trend, both with tablets and smartphones, has generally been bottom-up; physicians, PA’s, NP’s, nurses, and other healthcare providers are buying consumer devices and bringing them into the clinical world.
However, as Eric Yablonka, CIO of University of Chicago Hospitals put it, “This is not ‘nice to have stuff’ anymore, this is life saving stuff now.”
And so we’ve seen institutions across the country move to implement mobile devices on an enterprise level – from the Johns Hopkins and University of Chicago Internal Medicine residency programs to the entire VA healthcare system. However, Kaiser Health News reports that less than 1% of hospitals have fully functional tablet systems and points out how one of our biggest investments in health IT, the HITECH act, may be part of the reason why.
When the iPhone was first released, it transformed the way people interact with mobile devices – they became something better than just mini-computers. However, as pointed out by Jenny Gold, staff writer at Kaiser Health News,
“The most popular systems don’t yet make apps that allow doctors to use electronic medical records on a tablet the way they would on a desktop or laptop. To use a mobile device effectively requires a complete redesign of the way information is presented, Jonathon Mack, director of clinical research and development at the West Wireless Health Institute, says.”
We would first point out that the assertion isn’t entirely accurate – Epic, Allscripts, and Centricity as well as many cloud based EMR vendors like MacPractice and Dr. Chrono do have iPad and in some cases Android apps. That being said, these apps are, in many cases, limited – some allow read-only viewing for example.
What is often true, though, is that for hospitals, accessing these apps requires substantial additional cost. For example, Epic and Allscripts both require a separate licensing agreement for their mobile platforms. As Mr. Mack points out, many hospitals and healthcare systems have just made major investments in their IT infrastructure, a trend which was accelerated by the HITECH act. As he puts it, “When you look at a health system that has bought into an EMR, they’re not ready to turn the boat around and start over.”
As a result, healthcare providers are very reliant on workarounds to shoehorn tablets into existing infrastructure. For example, apps like Citrix or VMWare enable access to virtual Windows environments on the iPad or Android tablets, allowing access to fully functional EMR’s, radiology viewers, and so on.
In my own experience, while this method works, it just turns these devices into laptops without the keyboard. Windows is designed for computers and laptops; Microsofts release of Windows Phone and abandonment of Windows Mobile is a testament to that.
Despite these obstacles, healthcare providers like Kate Franko, a physician assistant highlighted in the article, are still finding utility for tablets to improve efficiency, patient communication, and more. While there are many issues to be addressed – cost, security, infection control, and so on – tablets are likely to be an increasingly common feature on medical wards and it’s only a matter of time before the IT infrastructure is forced to catch up.