Docs Love Mobile Devices, But Need Smarter Features

Vendors need to provide native applications and more intelligence to get EHRs to “play nicely” with mobile devices.

“Whatever the objections to mobility have been in the past, they are falling away as everything wireless becomes more powerful, more affordable and more user-friendly.”

That’s the conclusion of a new white paper from research firm Frost & Sullivan that summarizes the burgeoning new uses for mobile devices in healthcare.

Kenneth Kleinberg, a consultant with the Advisory Board, agreed with this perspective. “There’s a huge flood of interest in using tablets and smartphones by physicians,” he said. “They’re going to use whatever works to make their jobs easier and faster. They love these devices. They want to use them in the hospital and the provider environment.”

Frost & Sullivan projects smartphone penetration in North America will jump from 24% to 67% by 2015. Physicians are far ahead of the general population in this respect. Sixty-four percent of doctors were using smartphones in March 2010, according to a Manhattan Research study.

Frost & Sullivan noted that smartphone applications for healthcare range from drug and clinical references to diagnostic tools to real-time patient recordkeeping. In addition, its report said, “Electronic health records (EHRs) can be accessed via smartphone, allowing caregivers to diagnose and communicate virtually anywhere, anytime, including at the point of care.” It noted, however, that smartphones have limited displays and processing power, so they may yield incomplete information and require time-consuming paging through multiple screens.

The white paper pointed out that tablet computers have been around since the 1980s–and, noted Kleinberg, have had some impact on healthcare for the past decade. “However,” Frost & Sullivan observed, “a slimmer, less expensive, more feature-packed version is now taking the mobile device industry by storm. These new iterations, launched by a growing list of top-tier vendors, have significant potential in the healthcare sector.”

Among the uses for these tablets–which include iPads and the like–are applications for “diagnostic imaging and video, quick access to educational and reference resources, and on-the-spot access to electronic patient records,” said the report. Native applications being developed for the tablet, it notes, include those for MRI viewers, mobile film readers, and mobile medical calculators.

Kleinberg pointed out that clinicians can’t make good use of EHRs on either tablets or smartphones unless the software vendors have written device-specific native versions of their EHRs. “Depending on how the screen was designed and what the resolution is, the application might not fit well,” he said, if it were accessed through a browser or Citrix. “Also, the handwriting recognition might not be effective.”

So where do the vendors stand on mobile devices? “Almost every major vendor has a ‘skunkworks‘ that is working toward native support of at least a couple of these devices, like an iPad or an Android smartphone,” Kleinberg responded. “Some of them can demonstrate this now; some of them have even released it. But it’s a difficult, time-intensive venture to design these versions.”

The mobile health explosion is coming at a time when other issues–including Meaningful Use and ICD-10–are placing big demands on their resources, Kleinberg noted. The bigger companies are capable of forging ahead on all fronts, but the smaller firms may have to put off designing native mobile applications.

The new generation of devices “is almost there,” he said, for effective use of EHRs. A physician can document a visit on an iPad, for example, by using the touchscreen, typing, digital handwriting, and voice recognition. But the workflow factor has not been sufficiently addressed. To reduce the number of screens a physician has to go through and the amount of data he has to enter, he said, applications must be designed with more intelligent features.

“EHR vendors have not done a very good job of designing knowledge-based algorithms that take the information you’ve provided and attempt to reduce the number of questions you have to answer to get to the solution,” said Kleinberg.

iPads are perfectly capable of handling other tasks, such as viewing digital images or taking photos of a patient to show his condition, Kleinberg said. And doctors can use various mobile devices to place orders in computerized physician order entry systems, as long as they don’t expect much in the way of decision support, he added.

The main advantage of mobile devices, he said, is that they have the potential to increase physician adoption of health IT, because doctors love their smartphones and iPads. “If these mobile devices get physicians to use these systems, the adoption issue–which is crucial for Meaningful Use—will be alleviated.”