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Beyond Phones

July 21, 2009
by Kate Huvane Gamble
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Judy hanover

Judy Hanover

Hospital leaders are constantly inundated with requests for the latest technologies, and often forced to balance the wants of clinicians with the organization's financial strategy. One technology that is quickly gaining popularity among clinicians is the smartphone. According to data compiled by New York-based Manhattan Research, 64 percent of U.S. physicians use the devices, compared with just 30 percent in 2001. Diffusion Group, a research firm based in Rockville, Md., predicts that 70 percent of physicians will own a smartphone by 2011.

Scott levy, m.d.

Scott Levy, M.D.

And while devices such as the iPhone, BlackBerry and Treo offer a convenient means of communication for mobile professionals, today's smartphones have evolved far beyond the phone component. Clinicians are using them to look up drug references or lab value charts, and access medical calculators, decision-support tools and electronic records. Some are even leveraging them for e-prescribing and charge capture.

Rich pollack

Rich Pollack

“Smartphone use, in general among providers, is quite high for things like accessing medical information and prescribing databases,” says Judy Hanover, research manager at Framingham, Mass.-based Health Industry Insights, an IDC Company. “Particularly on the ambulatory side, we're hearing a lot about accessing EHR data from the smartphone, whether it's through the browser on the smartphone or through a specific application.”

The devices are gaining traction in the acute setting as well, a factor that Scott Levy, M.D., vice president and CMO at Doylestown Hospital (Pa.), attributes to ease of use. “Probably the greatest thing is the simplicity. You can literally pick it up without spending two weeks learning how to use it,” he says. “There's a whole robust set of applications, so wherever the physician is, inside or outside of the hospital, they can download or read any dictated report, vital signs, mediations, labs - it's all available on the iPhone.”

When it became known that a large percentage of Doylestown physicians were Apple iPhone 3G users - Levy estimates the number at 80 percent - executive leaders at the 207-bed community hospital decided to connect the iPhone to the hospital information system. Westwood, Mass.-based Meditech's Client Server 6.0 has an application that allows physicians to access the patient record from the device, according to Levy.

Physicians provide the phone, and Doylestown supplies the data plan and the wireless connectivity. According to Levy, the devices are WiFi-enabled, so as long as users can access a Safari browser on the iPhone, they can retrieve patient data from any location. When they are inside the walls of the hospital, “There's always a five-bar signal,” Levy says. “The physicians are comfortable that wherever they are in the building, they have a signal to get communications. So that was a very important piece of it.”

In fact, many consider the infrastructure piece to be the most critical component in rolling out mobile devices.

At Virginia Commonwealth University Health System (Richmond, Va.), the IT team embarked on a three-year project to provide 1 million square feet of wireless throughout the 779-bed organization, in order to support the various devices that would be used to access EMRs, including smartphones. The “aggressive deployment,” as Rich Pollack refers to it, started in 2006 when he stepped in as vice president and CIO. “It was pretty obvious that in order to effect completion of the EMR with capability and functionality in the patient space, we would need to provide at least the facility for wireless use. It went hand-in-hand,” says Pollack.

The roll-out included retrofitting wireless systems in its older facilities, as well as installing a distributed antenna system from Richardson, Texas-based InnerWireless in VCU's new 250-bed, 15-story critical care tower. With the infrastructure in place, VCUHS selected a solution from PatientKeeper (Newton, Mass.) that provides both charge capture capability and clinical results review from the Kansas City, Mo.-based Cerner EMR. It is scheduled to go live later this month on the BlackBerry devices used by clinicians at VCU.

The PatientKeeper application, says Pollack, extracts data out of the Cerner system and presents it in a format suitable for the small screen of the BlackBerry. “It takes the labs and puts them in a fishbone diagram,” he says. “Clinicians will tell you, ‘I don't need the whole interactive flow sheet, or pages and pages of narrative discharge summary. I just need a patient list and current lab results and summary results of the radiology report. They're not expecting the full experience of Cerner Millennium that they would get on a 19-inch display.”

What clinicians are looking for, he says, is a much smaller subset of critical data, which alerts them to take a separate action like making a phone call, entering an order, or performing a full inquiry at a terminal. “They don't need a complete EMR in their hip pocket.”